Journal of Haematology and Stem Cell Research

Diagnostic Threshold of Immature Granulocytes in Pediatric Infections

Fatima Farhan, Bushra Moiz, Shariq Shaikh, Arshalooz Rahman — Tue, 19 May 2026 00:00:00 +0000

Objectives: This study aimed to assess the optimal cutoff and the diagnostic utility of IG in common pediatric infections.

Methodology: This case-control study included children aged 1–17 years presenting with suspected infection or sepsis between December 2024 and July 2025. Clinical and laboratory parameters (WBC, ANC, IG%, and absolute IG count) were recorded within 24 hours of presentation and compared with age-matched non-infected controls. Receiver Operating Characteristic (ROC) curve analysis was performed to evaluate diagnostic performance and calculate the area under the curve (AUC).

Results: A total of 150 patients (85 males, 65 females) with a mean age of 5.74 ± 4.59 years were included. Over 80% had gastrointestinal or respiratory infections. Compared with controls, patients showed significantly higher WBC and ANC (p < 0.001), IG% (0.91 ± 1.31 vs 0.22 ± 0.09; p = 0.001), and absolute IG count (0.13 ± 0.26 vs 0.02 ± 0.01 ×10?/L; p < 0.001). An IG% cutoff >0.25 yielded 82.0% sensitivity (95% CI 75.1–87.3) and 68.0% specificity (95% CI 60.2–74.9). Multivariable analysis confirmed IG% as an independent predictor of infection (p < 0.001).

Conclusion: IG% is a useful early biomarker that can be used in conjunction with traditional leukocyte indices (WBC and ANC) to detect pediatric infections, demonstrating improved overall diagnostic accuracy and facilitating timely clinical decision-making.

Thrombocytosis: A Disease or a Response?

Maheen Rana, Aiman Mahmood Minhas, Mahnoor Mumtaz; Iqra Rasool; Ayisha Imran — Tue, 19 May 2026 00:00:00 +0000

Objective: The aim of our study is to investigate the etiologic causes of thrombocytosis and check the presence of JAK2 mutation in these cases of thrombocytosis, retrospectively.

Methodology: This is a cross-sectional study conducted at Chughtai Institute of Pathology, Lahore from January to July 2025. A total of 100 patients with persistent thrombocytosis were included in the study. Both male and female patients above 18 years of age were included in the study. Already diagnosed cases were excluded along with patients on any sort of chemotherapy. A detailed history of the patient was taken, and all aspects of their present illness and previous medical history were analyzed. CBC counts and JAK2 mutation were analyzed and data were analyzed using SPSS.

Results: In our study a total of 100 patients were recruited which consisted of 46 females and 54 males. The average age was 53.4 years (range 24 to 76 years). The presence of JAK2 V617F mutation was detected in the total of 44 patients indicating primary thrombocytosis whereas 56 patients had secondary thrombocytosis.

Conclusion: It is essential to investigate thrombocytosis especially in old age, as it might be the only sign indicating a hidden MPN. Thereby, it is imperative that thrombocytosis should not be overlooked and must be thoroughly investigated

Clinical Correlation of Positive Lupus Anti-Coagulant Cases: A Cross-Sectional Study

Eshmal Arshad, Ayisha Imran, Iqra Rasool, Asma Nasir, Sariya Abbas, N A Malik — Tue, 19 May 2026 00:00:00 +0000

Objective: To evaluate the clinical profile of lupus anticoagulant–positive patients and to determine the association between LA ratio levels and clinical manifestations.

Methodology: This cross-sectional descriptive study was conducted between September 2025 and January 2026 at Chughtai Institute of Pathology, Lahore. A total of 138 patients aged 8–90 years undergoing LA testing were included. Lupus anticoagulant was detected using a two-step dilute Russell viper venom time (DRVVT)–based screening and confirmatory assay. Results were interpreted using LA1/LA2 ratios and categorized as strongly positive (>2.0), moderately positive (1.5–2.0), weakly positive (1.2–1.5), or borderline (1.0–1.2). Clinical data were extracted from patient records.

Results: Of the 138 LA-positive cases, 59% were female. Strongly positive LA ratios were observed in 26 cases, moderately positive in 28, and weakly positive in 82 cases. Venous thrombosis was the most frequent clinical manifestation, particularly among strongly positive cases (50%). Recurrent miscarriages and arterial events, including stroke and ischemic heart disease, were also noted. Among weakly positive cases, 31% were asymptomatic.

Conclusion: LA positivity is associated with a broad spectrum of clinical manifestations, with venous thrombosis being the most common. Weakly positive LA results may be clinically silent, emphasizing the importance of correlating laboratory findings with clinical context and follow-up to exclude transient or false positivity.

Frequency, Risk stratification, Complications and Outcome of Polycythemia Vera: A Single Institute Experience.

Tue, 19 May 2026 00:00:00 +0000

Objectives: To evaluate the frequency of PV among patients with high hemoglobin and hematocrit, risk stratification, complications, and long-term outcomes of PV patients in a single institute tertiary care setting.

Methodology: This retrospective cohort study is conducted at Aga Khan University Hospital, Karachi, duration from January 2020 to December 2024. Sixty nine patients were diagnosed with PV based on WHO 2022 criteria and molecular testing out of 450 who presented with erythrocytosis. Data was extracted from electronic medical records and analyzed using SPSS.

Results: The prevalence of JAK2-positive PV was 15.3% (n=69) among patients presented with erythrocytosis. Cohort showed a male predominance (66.7%) with a mean age of 58.5 years. Hypertension (56.5%) and headache (55.1%) were the most common comorbidity and symptom assessed, respectively. High-risk patients constituted 63.8% of cases. Pre-treatment thrombotic events observed exclusively in the high-risk group (52.3%). Post-treatment complications (including arterial/venous events, leukemic transformation, and secondary malignancies) were observed in 20.5% of high-risk patients, however low-risk patients experienced no complications. The overall 5-year mortality rate was 8.7%, entirely in the high-risk group. 65.2% of the total cohort remained alive at the final follow-up.

Conclusion: Significant thrombotic morbidity and mortality were observed in high risk patients of PV in this South Asian cohort. These findings emphasize the inevitability of early molecular diagnosis, risk-adapted cytoreductive therapy, and structured long-term monitoring to improve clinical outcomes.

Key Words: Lupus Anticoagulants, Systemic Lupus Erythemotosis, Miscarriages, Venous Thrombosis

Comparison of total body irradiation-based conditioning regimens vs chemotherapy-based protocols in haploidentical stem cell transplants in a Pakistani cohort – A single-center experience

Tue, 19 May 2026 00:00:00 +0000

Objective: To compare the outcomes of total body irradiation (TBI)-based and chemotherapy (CT)-based conditioning regimens in patients undergoing haploidentical hematopoietic stem cell transplantation (Haplo-HSCT).

Methodology: This retrospective single-center comparative study included 50 consecutive patients who underwent Haplo-HSCT at Shifa International Hospital, Islamabad, between January 2016 and September 2023. Patients received either TBI-based conditioning (n=21) or CT-based conditioning (n=29). Primary endpoints were overall survival (OS), progression-free survival (PFS), and graft-versus-host disease/relapse-free survival (GRFS). Secondary outcomes included neutrophil and platelet engraftment, transplant-related mortality (TRM), non-relapse mortality (NRM), relapse, engraftment failure, and graft-versus-host disease (GvHD). Survival outcomes were analyzed using Kaplan-Meier methods.

Results: The mean age was 23.4±12.2 years in the TBI group and 28.7±11.9 years in the CT group; 76% of patients were male. Median follow-up was 11.5 months. Two-year OS was 37.0% in the TBI group and 41.4% in the CT group, while two-year PFS was 37.0% and 41.4%, respectively. GRFS was similarly low in both groups (12.7% vs. 13.8%). Neutrophil engraftment occurred significantly earlier with TBI-based conditioning (median Day +13 vs. Day +14; p=0.032), whereas platelet engraftment was comparable. TRM (38.1% vs. 41.4%), NRM (14.3% vs. 13.7%), relapse (14.3% vs. 13.7%), and acute or chronic GvHD rates were similar between groups. Primary engraftment failure occurred only in the TBI group (9.5%).

Conclusion: TBI- and CT-based conditioning regimens produced comparable survival outcomes following Haplo-HSCT. Although TBI-based conditioning resulted in significantly faster neutrophil engraftment, it was associated with a higher incidence of primary engraftment failure. Larger prospective multicenter studies are needed to confirm these findings.

Treatment Patterns and Responses in Adult Primary Immune Thrombocytopenia Patients: A Single-Centre Study

Tue, 19 May 2026 00:00:00 +0000

Objective: This study aimed to characterize real-world treatment patterns and outcomes of adults with primary immune thrombocytopenia (ITP) treated at a tertiary care hospital.

Methods: We retrospectively analyzed electronic medical records of 56 adult patients with primary ITP. Platelet count changes following treatment were assessed using the Wilcoxon signed-rank test. Multiple linear regression was used to identify predictors of treatment response, including age, sex, baseline platelet count, comorbidities, and blood group. Treatment response was defined as a platelet count ?50 × 10?/L or a doubling of baseline platelet count.

Results: Our study included 56 adult patients with primary ITP with mean age 37.25± 16.37 years. Male were 21 (37.5%) and female 35 (62.5%). After first-line therapy, median pre-treatment platelet count 40 × 10?/L (range 8–92) increased to 98 × 10?/L (range 30–210), p <0 .001. The overall response rate was 82%. After second-line therapy, median pre-treatment platelet count 52.5 × 10?/L (range 10–85) increased to 94 × 10?/L (range 45–180), p < .005. The overall response rate was 75%. After third-line therapy, median pre-treatment platelet count 40 × 10?/L (range 25–55) increased to 101 × 10?/L (range 70–150), p = 0.12. Response rate was 67%. Regression analysis identified older age (B = 1.92, p = 0.004) and blood group B (B = 10.60, p = 0.01) as predictors of favorable response, whereas higher baseline platelet count (B = –0.77, p = 0.008) and presence of comorbidities (B = –48.930, p =0.01) were associated with poorer outcomes. Sex was not a significant predictor.

Conclusion: This single-center study underscores the stepwise treatment approach for ITP: corticosteroids followed by thrombopoietin receptor agonists and splenectomy. Patient-specific factors such as age, baseline platelet count, comorbidities, and blood group may help tailor individualized treatment strategies. Larger, prospective studies are warranted to validate these findings.

Keywords: Purpura, Thrombocytopenic, Idiopathic; Platelet Count; Corticosteroids/therapeutic use; Eltrombopag/therapeutic use; Azathioprine/therapeutic use; Splenectomy; Thrombopoietin Receptor Agonists; Treatment Outcome; Retrospective Studies; Predictive Value of Tests

Use of Social Media (Facebook) to Mobilise Voluntary Blood Donors During Disasters: A Case of Suicide Bombing Attack in Peshawar, Pakistan

Tue, 19 May 2026 00:00:00 +0000

Objective:Social media has emerged as a powerful tool in shaping public behaviour and is now a key component in healthcare outreach. Following a suicide bombing at a mosque in Peshawar in January 2023, this study evaluated the effectiveness of Facebook in encouraging voluntary blood donations.

Materialsand Methods:Within half an hour of the attack, a blood donation appeal was posted on the Regional Blood Centre’s (RBC) Facebook page. Public responses through likes, comments, and messages were tracked and managed in real-time. Blood collection efforts were promptly expanded both at the RBC and at the Lady Reading Hospital (LRH) Blood Bank, located near the blast site.

Statistical Analysis:The collected data were assessed using t-tests and ANOVA.

Results:In the 24 hours after the incident, 209 blood donations were collected at LRHmore than triple the usual daily average of 62. A total of 441 individuals donated, with 56.23% (n = 248) being first-time donors. Female participation was notable at 27.89% (n = 123). First-time donors showed a slightly higher rate of transfusion-transmitted infections (4.61%) compared to repeat donors (4.23%). Facebook was the primary source of information for 70.06% (n = 309) of donors, followed by TV (20.18%), mosque announcements (6.57%), and personal contacts (3.17%).

Conclusion:There was a substantial increase in blood donations post-disaster, particularly among ‘first-time’ voluntary blood donors. This altruistic behavior needs to be capitalized by converting these first-time donors into regular voluntary donors.

Aberrant Antigen Expression in Acute Lymphoblastic Leukemia and Its Correlation with Post-Induction Remission

Tue, 19 May 2026 00:00:00 +0000

Objective: To determine the aberrant expression of antigens in newly diagnosed patients of Acute Lymphoblastic Leukemia and its correlation with post induction remission

Methodology: This Descriptive cross-sectional study was carried out at department of Hematology, Armed Forces Institute of Pathology (AFIP), from April 2024 to August 2025. A total of 183 newly diagnosed patients with ALL of all ages and both genders were enrolled. Morphology, cytochemistry and flow cytometric immunophenotyping were used to analyze bone marrow and peripheral blood samples to identify lineage and aberrant antigen expression. Induction chemotherapy was given to patients over a period of 29 days and the remission was assessed by bone marrow biopsy. Analysis of the data was done by SPSS 22.0, Chi-square test was used; a p-value of ? 0.05 was taken as significant.

Results: Aberrant antigen expression was identified in 36 (19.7%) of 183 ALL patients (median age 13 years; 69.9% male). B-ALL and T-ALL comprised 152 (83.1%) and 31 (16.9%) cases respectively. CD33 and CD13 were most frequently expressed aberrant antigens. The total number of patients who achieved remission were 149 (81.4%), however, it was significantly less among patients who had aberrant antigen expression (24 (66.7%) vs. 125 (85.0%), p = 0.011). Persistent thrombocytopenia, increased residual blasts and persistently raised WBC counts were also linked to aberrant antigen expression.

Conclusions: Aberrant antigen expression in ALL was associated with sub-optimal treatment response and poor post-induction outcome, highlighting its significance as a prognostic variable in the therapeutic decision-making.

Keywords: Acute Lymphoblastic Leukemia, Aberrant antigen expression, Immunophenotyping, Remission, Flow Cytometry.

Correlation Between Pulmonary Functions and Iron Overload in Transfusion Dependent Thalassemia Patients Registered in Chughtai Thalassemia Center: A Cross-Sectional Study

Mahnoor Mumtaz, Ayisha Imran, Maheen Rana, Iqra Rasool, Saleem Uz Zaman Adhami — Tue, 19 May 2026 00:00:00 +0000

Objective: To find correlation between pulmonary function abnormalities with raised serum ferritin levels and Pattern of pulmonary dysfunction in patients with Transfusion Dependent Thalassemia.

Methodology: A Cross-sectional study was Conducted at Thalassemia Centre, Chughtai Institute of pathology, Lahore, Pakistan from March 2025 to September 2025. Fifty patients aged between 7–38 years with transfusion-dependent ?-thalassemia who had received ?20 blood transfusions or had serum ferritin levels greater 1000 ng/mL were enrolled. Patients with known pulmonary disease, acute infection, or inflammatory conditions were excluded. Serum ferritin levels were measured to assess iron overload, and C-reactive protein was used to exclude inflammation. Pulmonary function was evaluated using spirometry, measuring forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC ratio. Patterns and severity of pulmonary dysfunction were correlated with serum ferritin levels.

Results: Out of 50 patients, 52% exhibited a restrictive pattern of pulmonary dysfunction, 8% had an obstructive pattern, and 40% had normal pulmonary function. Mean serum ferritin levels increased progressively with the severity of restrictive lung disease (normal: 1888 ng/mL; mild: 3685 ng/mL; moderate: 5289 ng/mL; severe: 9206 ng/mL; p = 0.003). Patients with obstructive patterns also demonstrated significantly elevated ferritin levels. A significant correlation was observed between higher serum ferritin levels and impaired pulmonary function.

Conclusion: Restrictive pulmonary dysfunction is the most common respiratory abnormality in patients with transfusion-dependent thalassemia and is significantly associated with iron overload. Regular pulmonary function monitoring and strict adherence to iron chelation therapy are recommended to reduce iron-related pulmonary complications.

Diagnostic Utilization of Serum Protein Electrophoresis and Serum Immunofixation in Detection of Monoclonal Gammopathy

Nimra Mazhar, Ayisha Imran, Ghazala Qamar, Mahnoor Mumtaz — Tue, 19 May 2026 00:00:00 +0000

Objective: the aim of our study was detection of monoclonal bands in serum protein electrophoresis followed by their characterization with the help of serum immunofixation electrophoresis. Moreover, comparison between the two techniques in order to detect any discrepant findings was done as well.

Methodology: This is a prospective study carried out at Chughtai Institute of Pathology from January 2025 to June 2025. Eighty three samples revealing a distortion in gamma region on SPE were selected. Both male and female patients above 18 years of age were included in the study. Patients who had any history of renal or liver disease were excluded from the study. After selection, the samples were run for SPE and SIFE, which was followed by the statistical analysis with the help of SPSS software

Results: A total of 83 samples were analysed on SPE, out of which a monoclonal band was detected in 81 cases, two cases revealed hypogammaglobulinemia. This was followed by SIFE for characterization of the monoclonal proteins which aided in detection of monoclonal bands in the cases which revealed hypogammaglobulinemia on SPE.

Conclusion: Study revealed that SIFE has a greater sensitivity as compared to serum protein electrophoresis for detection of M bands. SPE serves as a good screening tool, SIFE acts as a gold standard as it can help in detection of monoclonal bands which might be missed if SPE was performed alone.

Comparative Analysis of Corrected Total Nucleated Cells (TNC) versus CD34 Counts and Their Impact on Graft Outcomes in Allogeneic Bone Marrow Transplant: A Study in a Resource-Limited Setting

Tue, 19 May 2026 00:00:00 +0000

Background: Bone marrow transplantation (BMT) is considered the standard of care for many hematological malignant and nonmalignant diseases. It involves infusing of hematopoietic stem cells (HSCs) of a compatible donor to a patient after the administration of conditioning therapy with the objective of reconstructing the patient’s hematopoietic system.

Objective: To evaluate whether TNC counts can serve as a viable alternative to CD34+ enumeration for predicting transplant outcomes in settings lacking advanced cell selection technologies.

Study Design: This is a retrospective design study.

Duration and Place of the study: This research was conducted at a Gambat Institute of Medical Sciences between 2^nd, January 2019 to 1^st, February 2024.

Material and Methods: This retrospective study analyzed 84 consecutive allogeneic bone marrow transplant recipients (55 males, 29 females; age range 7-62 years) at Gambat Institute of Medical Sciences between January 2019 and February 2024, comparing outcomes between CD34-selected (n=44) and TNC-based (n=40) grafts. Using complete clinical records, we evaluated engraftment kinetics (time to ANC >500/?L for 3 consecutive days), GVHD incidence (graded by Glucksberg and NIH criteria), and survival outcomes (1- and 3-year overall and disease-free survival), with statistical analysis performed using SPSS version 26.0 (?² and t-tests for categorical and continuous variables respectively; significance at p<0.05)

Results: The study comprised of 84 patients, of which 55 were male and 29 were female, with the mean age in CD34 and TNC group were 35.2 years, and 36.1 years (p=0.68), respectively with similar distribution according to prescribed range of ages (p=0.56).

The CD34 count was 5.1 x 10^6/kg in the CD34 group, and the corrected TNC count was 3.5 x 10^8/kg, with no differences between the groups (p=0.75). Infusion volumes were similar, with 250 mL in the CD34 group and 245 mL in the TNC group (p=0.62). Time to neutrophil and platelet engraftment was also comparable between the groups (p=0.58 and p=0.66, respectively). Rates of graft-versus-host disease (GVHD) were similar in both groups. The incidence of acute GVHD (Grade I-II) was 22.7% for the CD34 group and 35.0% in the TNC group, while chronic GVHD occurred at rates of 18.2% and 25.0% respectively (p=0.42). The CD34 cohort had longer median GVHD-free survival (59.1% vs. 40.0%, p=0.09). Engraftment outcomes showed successful engraftment in 86.4% of the CD34 group and 80.0% in the TNC group (p=0.42). The median time to engraftment was 16 days in the CD34 group and 17 days in the TNC group (p=0.55) . Primary graft failure occurred in 9.1% of the CD34 group and 15.0% of the TNC group (p=0.42), while secondary graft failure occurred at similar rates (4.5% vs. 5.0%, p=0.91). Overall survival and disease-free survival rates were similar between the groups. The 1-year overall survival was 79.5% in the CD34 group and 70.0% in the TNC group (p=0.31), while the 3-year overall survival rates were 68.2% and 60.0% respectively (p=0.40). The 1-year disease-free survival rates were 75.0% and 65.0% in the CD34 and TNC groups (p=0.33), with 3-year rates of 63.6% and 55.0% respectively (p=0.44). The median follow-up durations were 24 months for the CD34 group and 22 months for the TNC group (p=0.58).

Conclusion: There were no statistically significant differences between the CD34 and TNC groups in terms of demographics, clinical characteristics; grafts used for transplantation; incidence of acute, and chronic GVHD, engraftment outcomes and survival metrics. For countries where CD34 selection facilities are not available, our findings provide reassuring evidence that corrected TNC transplants can achieve similar outcomes to CD34 selected transplants. This suggests that TNC transplants are a viable and effective alternative, ensuring that patients receive high-quality care and comparable clinical benefits even without access to CD34 selection technology.

TRENDS IN WHOLE BLOOD AND BLOOD COMPONENT UTILIZATION: A MULTICENTER STUDY FROM TWO TERTIARY CARE HOSPITALS IN LAHORE, PAKISTAN

riffat, Nasrullah, Tooba Fateen, Nazish Saqlain, Sonia — Tue, 19 May 2026 00:00:00 +0000

Background: Efficient blood components utilization is essential for patient care and safety and resource optimization.

Objective: To analyze trends in blood and blood component practices in tertiary care hospitals in Lahore, in order to provide a pooled assessment of transfusion practices.

Methods: This cross-sectional study was conducted using six-months transfusion records from two major tertiary care hospitals in Lahore. Data of 8,624 transfusion units was taken from Lahore General Hospital (LGH) and 10,445 from Jinnah Hospital (JHL), totaling 19,069 units. It included patient demographics, clinical indication, blood component used and departments that ordered the transfusions. Data was analyzed using SPSS 26.

Results: Males used 7,136 units and females used 11,933 units. Around 37.2% units were issued to patients aged 21-30 years. The highest demand was from Labor room and Gynecology department (24.4%) Emergency department (20.6%). Blood group distribution showed a predominance of B RhD+ (31.8%) followed by O RhD+ (30.1%). Most used components in order were Packed Red Blood Cells (PRBCs, 26.8%), Fresh Frozen Plasma (FFP, 12.7%), Platelets (7.9%) and a combination of PRBC + FFP (3.5%). Whole blood utilization was 31.2%. Leading indications for transfusion were Labor/childbirth (16.9%) and anemia (16.3%). Multiple transfusions were more in females than in males.

Conclusion: This study concluded that young adults particularly females were major transfusion recipients. Obstetrics/Gynecology and Emergency departments requested the most transfusions. Whole blood and PRBCs were the most utilized units which emphasizes the need to optimize component therapy and implement patient blood management strategies.

Evaluation of Gastrointestinal Complications in Patients Undergoing Auto HSCT Using Melphalan-Based Conditioning Regimen

Tue, 19 May 2026 00:00:00 +0000

Objective :
The aim of this study is to study the relation ship between Gastrointestinal toxicities secondary to conditioning regimens and transplant outcomes in patients with hematological malignancies unndergoing autologus hematopoietic stem cell transplantation (HSCT) with a focus on understanding the impact of melphalan-based conditioning.
Method:
A prospective cohort study was conducted on 100 patients undergoing auto HSCT from January 2024 to January 2025 with different hematologic malignancies. Patient demographics, disease statistics, conditioning regimens, and gastrointestinal toxicity profiles were collected from electronic medical records and follow-up outpatient department (OPD) visits through non-probability convenience sampling. Gastrointestinal (GI) toxicities were categorized into diarrhea, mucositis, and nausea/vomiting, with severity graded using the Common Terminology Criteria for Adverse Events (CTCAE). Descriptive statistics summarized patient and disease characteristics along with toxicity rates. Univariate analysis was done by using the Chi-square test and independent t-test, while overall survival (OS) and disease-free survival (DFS), and their association with GI toxicities were analyzed using Kaplan-Meier and Log Rank test.
Result:
Out of the 100 patients with a mean age of 44 years undergoing auto-HSCT, 61 (61%) were male and 39% were female, 49 (49%) had Plasma cell disorders (PCD), 45 (45%) had lymphoma, and 3 (3%) had other malignancies, including AML. High-dose melphalan was the conditioning regimen for all PCD, while BEAM (BCNU-Etoposide-high-dose cytarabine and carmustine) was the most common regimen among lymphomas. The mean CD34 count was 5.2 ± 2.6 ×10^6/kg and mean MNC dose was 7.2 ± 2.9 ×10^8/kg. Mean days to neutrophil and platelet engraftment were 11.6 ± 1.7 and 15.5 ± 7.9 days, respectively. Gastrointestinal toxicity was prevalent with all conditioning regimens, with any of the gut toxicities occurring in 77% of patients, diarrhea in 82%, and mucositis in 57%. A significant correlation was identified between the severity of diarrhea and overall survival (P=0.01) and between the severity of diarrhea and weight loss (P=0.00). Vomiting was significantly associated with a patient's diagnosis, specifically lymphoma (P=0.05). The mean hospital stay from infusion was 15 days. The median overall survival (OS) was 21 months with an overall survival rate of 89%; the median disease-free survival (DFS) was 21 months with an overall disease-free survival rate of 90%; non-relapse mortality was 6%.

Conclusion:
Our study highlights a concession in melphalan-based therapy. While higher doses improve overall survival rates, they also significantly increase the risk of severe gastrointestinal toxicity (grade 3–4 mucositis). Clinicians must weigh these risks carefully when planning conditioning regimens.

Critical Value Matters: A Study of Critical Value Identification and Notification to Clinicians in the Hematology Section of the Pathology Laboratory at a Tertiary Care Hospital

Noorulain, Maliha Sumbul, Aiman Ishtiaq, Muhammad Nadeem — Tue, 19 May 2026 00:00:00 +0000

Objective: To analyze the critical value (CV) data in the hematology section of the laboratory

Methodology: A retrospective analysis of 5 months (June-October 2024). All consecutive samples (169,667) received for investigations were included. We aim to analyze the critical value data in the hematology section and compare the frequencies of critical values for various parameters, including Hemoglobin, White cell count, Platelet count, Malaria parasite infestation, Prothrombin time (PT), International normalized ratio (INR), and Activated partial thromboplastin time (APTT). The test requests were received from outpatient departments (OPDs), inpatient departments (IPD), and the emergency department (ER).

Results: Out 402 of the total critical values, 250 (62.1%) coagulation abnormalities, including prolonged prothrombin time (PT) & Activated partial thromboplastin (APTT) followed by 61(15.1%) were decreased platelet count, 52 (12.9%) were the malarial parasites on peripheral smears, 33(8.2%) reduced hemoglobin levels, 05(1.2%) deranged leucocyte count, 01(0.2%) leukemia. Critical values constituted 0.2% of the total test results reported. The mean total turnaround time (TAT) for all tests ranged from 1.3 to 2.1 hours. The success rate of critical result reporting within 1 hour was 25.3%

Conclusion: This study suggests that the mean TAT in this teaching hospital is slightly longer than the benchmark. Further research is needed to determine the causes of delays and develop interventions to solve this problem

Genotypic Distribution of MNS Red Blood Cell Antigens Among Healthy Blood Donors in Northern Pakistan

NOOR UL HUDA ALHADI — Tue, 19 May 2026 00:00:00 +0000

INTRODUCTION: Blood transfusion is a life-saving measure but the body may react to the new blood, causing more harm than good. Matching donor red blood cells to recipient antigens prevents allo-immunization. In MNS, anti-M, anti-N antibodies are mostly clinically benign, anti-S and anti-s antibodies cause transfusion reactions. Our objective was to establish a genotypic profile of the MNS blood group in Pakistani population. METHODS: This study was conducted at Armed Forces Institute of Transfusion, Rawalpindi from March - August 2022, on 385 blood donors after approval by Institutional Review Board. Written informed consent was taken, ABO and Rh phenotyping was performed with commercially available antisera, Genotyping was done using PCR-SSP for different antigens, along with positive and negative controls. RESULTS: Mean age of participants was 29.4 years with ? 7.11; 98.4%(379) males,1.6%(6) females. ABO and RhD phenotyping revealed: A = 23.4% (90), B = 40.3% (155), AB = 6.2% (24), O = 30.1% (116), RhD +ve = 88.1% (339) and RhD -ve = 11.9% (46). The genotypic prevalence of MNS antigens was M = 75.6%(291), N = 43.6%(168), S = 60.5%(233) and s = 75.6%(291) respectively. The most common genotypes were N/N (n=41, 73.2%) and S/s was (n= 193, 82.8%). CONCLUSION: This research showed high genetic prevalence of N/N and S/s antigens in donors. Therefore, blood banks should routinely start antigen typing for MNS blood groups in addition to ABO and RhD. The outcomes of our study may assist them in establishing an extended phenotyping/ genotyping protocol to prevent any adverse transfusion event.

HAEMCON 2026: Advancing Hematology in Pakistan Through Local Relevance and Global Engagement

Shahtaj Khan — Tue, 19 May 2026 00:00:00 +0000