Characteristics of unexpected antibodies in patients with blood disorders: Evidence in Vietnam

BACKGROUND

In Vietnam, a lack of evidence about the unexpected antibodies hinders the capabilities to prepare the necessary resources and personnel for treating patients with blood disorders. This study aimed to measure the rates of different unexpected antibodies in patients having blood orders in Vietnam.

STUDY DESIGN AND METHODS

A cross-sectional study was conducted at the National Institute of Hematology - Blood Transfusion, Vietnam on 5608 patients with blood disorders. Information was obtained from the medical records, blood transfusion forms, screening test forms.

RESULTS

The prevalence rate of unexpected antibodies in patients with haematological disorders was 9.3%. The most prevalent occurrence was the presence of an atypical antibody type, accounting for 61% of patients. The co-occurrence of this atypical antibody type and other types of antibodies was also observed, with the respective occurrence rates of 23.9%, 10.1%, 3.8%, and 1.2% for the combination of two, three, four, and five unexpected antibody types. The presence of one type of unexpected antibody was predominant, namely anti-E, accounting for the highest proportion (32.9%), followed by anti-Mia (18.4%). Among the 125 patients, the most frequently observed combination of abnormal antibodies was anti-E with anti-c (14.3%) and anti-E with anti-Mia (3.4%). Among the cohort of 53 patients exhibiting three types of unexpected antibodies, the most prevalent combination observed was anti-c, anti-E, and anti-Mia (5.7%).

CONCLUSION

This study revealed a prevalence rate of 9.3% in the presence of unexpected antibodies in patients with blood disorders. The occurrence of individual unexpected antibodies surpasses that of coordinated antibodies.

Forging international collaboration and alliances to establish the largest transplant center in the north of Vietnam

Through collaboration with international experts, our institution established a highly active and successful hematopoietic stem cell transplant program, providing access to this potentially curative treatment modality for patients with a variety of benign and malignant hematological diseases. The initial development of an autologous stem cell transplant program provided our institution with the infrastructure, equipment, and expertise needed for the subsequent development of an allogeneic stem cell transplant program. Key transplant staff received training from international transplant experts at the NHLBI/NIH, the Mayo Clinic, the Johns Hopkins Hospital, and Nagoya Japan, providing them with the expertise to conduct a variety of different transplant approaches, including PBSC transplants from HLA-matched relatives, unrelated cord blood transplants, haploidentical transplants, and CD34 selected stem cell transplants. Patient characteristics were varied among all groups. The number of allogeneic and autologous transplants performed at the NIHBT has increased steadily every year since the initiation of our transplant program. By 2022, 547 transplant procedures had been performed, including 268 autologous and 279 allogeneic transplants. Allogeneic transplants were performed for both malignant and nonmalignant hematological diseases, with acute leukemia (AL) being the most common indication for allogeneic HCT. The majority of recipients undergoing allogeneic transplantation received G-CSF mobilized PBSC allografts from either HLA identical or haplo-identical relatives, with a smaller percentage of patients receiving a UCB transplant or a PBSC allograft that had been CD34+ selected. Amongst the 279 recipients of an allogeneic transplant, mortality rates within day 100 and beyond day 100 were 12.6% and 26.2% respectively. Overall survival (OS) and event-free survival at 5 years in benign and malignant subgroups were 81% and 73% vs 52% and 48% respectively. Through collaboration with international transplant experts, the National Institute of Hematology and Blood Transfusion in Hanoi has stood up the most active transplant center in the northern region of Vietnam. Patients coming from low-income financial backgrounds are now able to receive a variety of different state-of-the-art transplant approaches that are affordable and have been associated with excellent long-term outcomes.

Prevalence and Associated Factors of optrA-Positive-Enterococcus faecalis in Different Reservoirs around Farms in Vietnam

Linezolid is an antibiotic of last resort for the treatment of infections caused by Gram-positive bacteria, including vancomycin-resistant enterococci. Enterococcus faecalis, a member of enterococci, is a significant pathogen in nosocomial infections. E. faecalis resistance to linezolid is frequently related to the presence of optrA, which is often co-carried with fex, phenicol exporter genes, and erm genes encoding macrolide resistance. Therefore, the common use of antibiotics in veterinary might promote the occurrence of optrA in livestock settings. This is a cross-sectional study aiming to investigate the prevalence of optrA positive E. faecalis (OPEfs) in 6 reservoirs in farms in Ha Nam province, Vietnam, and its associated factors and to explore genetic relationships of OPEfs isolates. Among 639 collected samples, the prevalence of OPEfs was highest in flies, 46.8% (51/109), followed by chickens 37.3% (72/193), dogs 33.3% (17/51), humans 18.7% (26/139), wastewater 16.4% (11/67) and pigs 11.3%, (14/80). The total feeding area and total livestock unit of the farm were associated with the presence of OPEfs in chickens, flies, and wastewater. Among 186 OPEfs strains, 86% were resistant to linezolid. The presence of optrA was also related to the resistant phenotype against linezolid and levofloxacin of E. faecalis isolates. Close genotypic relationships identified by Pulsed Field Gel Electrophoresis between OPEfs isolates recovered from flies and other reservoirs including chickens, pigs, dogs, and wastewater suggested the role of flies in the transmission of antibiotic-resistant pathogens. These results provided warnings of linezolid resistance although it is not used in livestock.

Synthesis, Molecular Docking, and Cytotoxic Evaluation of Fluorinated Podophyllotoxin Derivatives

Objective: The study was conducted to evaluate the in vitro and in silico anticancer activity of fluorinated podophyllotoxin derivatives. Methods: Microwave-assisted multicomponent reactions were carried out in an Anton Paar Microwave Synthetic Reactor Monowave 400 in order to synthesize fluorinated podophyllotoxin derivatives. These products were identified by spectral analysis and evaluated for their cytotoxicity against 4 types of human cancer cell lines (KB, HepG2, A549, and MCF7), as well as human embryonic kidney (Hek) 293 cells using MTT protocol. Molecular docking was conducted using 2 crystal structures of tubulin—colchicine (PDB ID: 4O2B) and topoisomerase II—etoposide (PDB ID: 3QX3) complexes. Results: Two potent cytotoxic fluorinated podophyllotoxin–naphthoquinone compounds were synthesized in good yields. They displayed high cytotoxic activity against all the tested cell lines, with IC50 values ranging from 0.58 to 3.17 µM. Notably, product 8a showed low toxicity against the Hek-293 cell line. Molecular docking results showed that products 8a and 8b participated in the same key interactions provided by etoposide with both topoisomerase and DNA chain domains. The binding energy values calculated for 8a and 8b are acceptable. Conclusion: This study revealed that products 8a and 8b exhibited promising in vitro and in silico anticancer activity and could be recognized as promising anticancer agents.

Synthesis and Cytotoxic Evaluation of Fluoro and Trifluoromethyl Substituents Containing Novel Naphthoquinone-Fused Podophyllotoxins

A series of novel naphthoquinone-fused podophyllotoxins containing fluoro and trifluoromethyl substituents were synthesized in a medium with good yields using two different synthetic approaches: microwave-assisted four-component reactions of 2-hydroxy-1,4-naphthoquinone, tetronic acid, fluorinated arylaldehydes, and ammonium acetate, and microwave-assisted three-component reactions of 2-amino-1,4-naphthoquinone, tetronic acid, and fluorinated arylaldehydes. The structures of all products were confirmed by spectral analysis. Together, cytotoxicity assessment of the products against four human cancer cell lines (human carcinoma [KB], human hepatocellular carcinoma [HepG2], lung cancer [A549], breast carcinoma [MCF7], and human embryonic kidney [Hek-293]) was performed by MTT assay. Among the obtained compounds, compound 7f turned out to be the most potent anticancer agent with significant cytotoxic activity against KB, HepG2, and MCF cancer cell lines.

Design and Synthesis of New 2-Aminobenzamide Derivatives Containing Benzothiazole and Phenylamine Moiety and Their Cytotoxicity

Twelve new compounds including 2-aminobenzamide derivatives bearing benzothiazole and phenylamine moiety were designed and synthesized. The synthesized compounds were tested their cytotoxic activity against A549 and SW480 tumor cell lines. Compounds 3a and 3c exhibited cytotoxicity toward A549 cell line with IC50 values of 24.59 and 29.59 µM, respectively.

Bannaxanthone E Induced Cell-Cycle Arrest and Apoptosis in Human Lung Cancer Cell Line

The anti-cancer activity of bannaxanthone E isolated from Garcinia mckeaniana leaves was assessed through a flow cytometric method on human lung SK-LU-1 cancer cells, including cell cycle changes and induction of cell apoptosis. Treatment with bannaxanthone E led to the suppression of cell cycle progression at the G2/M phase to 19.6% at 4 µM, and induced apoptosis via cell morphological changes, increased the fluorescence signal in caspase-3/7 activation, and accumulation of apoptotic cells in the SK-LU-1 line at 4 µM to 25.7%.

4-(Dimethylamino)pyridine as an Efficient Catalyst for One-Pot Synthesis of 1,4-Pyranonaphthoquinone Derivatives viaMicrowave-Assisted Sequential Three Component Reaction in Green Solvent

Novel 1,4-pyranonaphthoquinone derivatives were successfully synthesized via the microwave-assisted three-component reaction of 1,4-naphthoquinone, malononitrile, and various arylaldehydes in ethanol in the presence of 4-(dimethylamino)pyridine (DMAP) as a catalyst, and subsequently evaluated in terms of their antimicrobial and antifungal activities. This synthetic procedure has the notable advantages of environmental friendliness, short reaction time, good yield, and convenient operation.

DMAP-catalyzed Efficient and Convenient Approach for the Synthesis of 3,3′-(Arylmethylene)bis(2-Hydroxynaphthalene-1,4-Dione) Derivatives

For the first time the 4-dimethylaminopyridine (DMAP) catalyzed straightforward and efficient procedure has been developed for the synthesis of 3,3′-(arylmethylene) bis(2-hydroxynaphthalene-1,4-dione) derivatives starting from lawsone (2-hydroxy-1,4-naphthoquinone) and a variety of (hetero)aromatic aldehydes in ethanol under microwave irradiation. Three of nine synthesized compounds are new. This method provides notable advantages over existing procedures including use of non-traditional basic catalyst and environmentally benign solvent, mild reaction conditions, excellent yields, short reaction time and simple workup.

Design, Synthesis, and Cytotoxic Evaluation of Novel Lupane Triterpenoid Derived Hydroxamates

A series of new hydroxamate derivatives of lupane triterpenoids has been designed and successfully synthesized. The synthesized compounds were evaluated for their in vitro antitumor activity using the 3-[4,5-dimethylthiazol-2-yl]−2,5-diphenyltetrazolium bromide-based assay against the human cancer cell lines KB and HepG2. Most of these derivatives possess at least moderate cytotoxic activity and the hydroxamate derivative compounds 3c, 3e, 7a, and 15b could be lead compounds for further optimization to develop novel anticancer agents.

Synthesis and Cytotoxic Evaluation of Carboxylic Acid-Functionalized Indenoisoquinolines

In order to find out the influence of carboxylic acid functionalities in the N-lactam side chains of indenoisoquinolines on cytotoxic activities, several new compounds have been synthesized and structurally characterized by analytical and spectral methods. The incorporation of a carboxylic acid group into the lactam side chain of indenoisoquinolines results in differences in cytotoxicity. The results indicated that compound 18c displayed substantial cytotoxic specificity toward KB and HepG2 cancer cells.

Synthesis of New Simplified and Racemic Hemiasterlin Derivatives with Extremely High Cytotoxicity

Hemiasterlin is a potent antimitotic agent acting through inhibition of microtubule depolymerization. For this reason, the synthesis of new hemiasterlin derivatives has attracted a lot of interest in the organic chemistry community recently. In this paper, the synthesis and evaluation of the cytotoxicity of new simplified and racemic hemiasterlin derivatives were reported. All of the synthesized analogues were evaluated in vitro for cytotoxic activity against four human cell lines (KB, Hep-G2, LU and MCF7). Most of these analogues possess a strong cytotoxic activity on two human cancer cell lines (KB and Hep-G2) and very weak activity on LU and MCF7 cell lines.

Design, Synthesis and Cytotoxic Evaluation of 4-Anilinoquinazoline– triazole–AZT Hybrids as Anticancer Agents

A series of 4-anilinoquinazoline–triazole–AZT hybrids were designed and synthesized as anticancer agents. Their cytotoxic potential has been evaluated by means of a micro-dilution assay against three human cancer cell lines (KB, epidermoid carcinoma; HepG2, hepatoma carcinoma; SK-Lu-1, non-small lung cancer). The biological results revealed that compounds 4b and 6d showed good anticancer activities against KB, HepG2, and Lu cell lines (IC50 values ranging from 9 μM to 100 μM). Especially, compounds 4b and 6d exhibited up to 3-fold more potent than reference drugs erlotinib hydrochloride and AZT in term of anti-lung cancer activity.

Synthesis and Cytotoxic Evaluation of Artemisinin Derivatives Containing an Aminopropanol Group

Series of novel artemisinin derivatives were designed and synthesized in which the amino propanol group was bonded to the artemisinin nucleus through C-C linkage. Ten new compounds were thus successfully prepared and evaluated as cytotoxic agents, revealing an interesting anticancer activity in KB and HepG2 cancer cell lines.

Design, Synthesis and Cytotoxic Evaluation of Novel Lupane Triterpenoid and Ursolic Acid Derived 2-Aminobenzamides

Series of novel triterpenoid hybrids were designed and synthesized by introducing 2-aminobenzamide moiety at C28 position of triterpenoid derivatives. Thirteen new conjugates were thus successfully prepared and evaluated as cytotoxic agents, revealing an interesting anticancer activity in KB and HepG2 cancer cell lines.

Synthesis and Cytotoxic Evaluation of Betulin–Triazole–AZT Hybrids

Betulin was converted to the corresponding alkyne-functionalized esters and amides and subsequently deployed as substrates for a ‘click’ chemistry-mediated coupling with 3'-azido-3'-deoxythydimine (AZT) to furnish a novel betulin–triazole–AZT hybrid compounds. Eleven new hybrids were thus successfully prepared and evaluated as cytotoxic agents, revealing an interesting anticancer activity in KB and HepG2 cancer cell lines.

Synthesis and Cytotoxic Evaluation of Novel Ester Derivatives of Betulin with AZT, d4T, and 3TC

Novel ester derivatives of betulin with AZT, d4T, and 3TC were synthesized and assessed for antitumor activities against the KB and HepG2 human cancer cell lines in vitro by MTT assay. Some derivatives displayed high anticancer properties, with IC50 values between 1 and 21 μM on the two cancer cell lines.

Preliminary experiences with the CIR casting system for transtibial prosthetic sockets

A sand-casting technique for transtibial sockets was applied to 28 amputees in 2005. Although this meant an improvement in the quality of fitting as compared to historical reports with plaster of Paris casting, a total contact required three (two to five) stump socks. Continuing research leads the inventor, Dr Y. Wu, to replace the sand with micro polystyrene beads and simplify the equipment by eliminating the need for fluidization of silica sand by an air compressor during casting of the amputation stump. In a pilot series of 10 transtibial amputees, socket casting was performed with the new CIR casting technique and compared with the former sand-casting technique conducted by the same Category-I prosthetist. It was possible to obtain a good fit in eight out of 10 cases, which is an improvement from 19 out of 28 in the old series. Furthermore, there was a highly significant reduction in circumference measurements on the positive model with the new technique as compared to sand-casting.

Clinical field testing of polyurethane feet for trans-tibial amputees in tropical low-income countries

In a prospective controlled study, 172 polyurethane feet of different designs were fitted to 155 amputees with trans-tibial prostheses. These were followed in respect of their durability. The amputee compliance was in general good, and 87% were satisfied with their device. After 18 months the failure rate of 20% with the CIREC spring-blade foot was significantly better than the others, but poorer craftsmanship, higher complaint rate and lower compliance rate cast some doubt on the results. The results with the conventional SACH foot constructions with polyurethane as filling and covering materials were so poor after 18 months that their use cannot be recommended in tropical areas of the developing world.

Sand-casting technique for trans-tibial prostheses

A sand-casting technique for trans-tibial sockets was applied to 28 amputees, and the prosthetic fit observed through transparent check sockets. The results were better than historical reports of fittings with plaster of Paris casting by qualified prosthetists. The fit was consistently and evenly larger than the stump, but total contact could be achieved by applying three (two to five) stump socks. This would normally be considered on the high side of a good fit.

Circulation of type 1 wild poliovirus in northern Vietnam during 1991-1994

From 1991 to 1994, 143 polioviruses were isolated from patients with acute flaccid paralysis in northern Vietnam. Of these 143 isolates, 133 were type 1 and five of each were type 2 and type 3. These isolates were intratypically differentiated by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Of the 133 type 1 isolates, 113 were wild strains and only 20 isolates were of Sabin vaccine-like strains. These 113 isolates were divided into seven groups by PCR-RFLP patterns and were also classified into three genomic groups by nucleotide sequencing and phylogenetic analysis. One of the three genomic groups accounted for the majority (75) of these isolates. The isolates belonging to the predominant group were found during 1991-1993. The second group, which included 17 isolates, were detected only in 1993. These isolates had genome sequence similar to isolates in southern Vietnam in the same year. The third group of isolates were detected only in 1991 and were considered to be Mahoney-like wild strains. All isolates examined were different from those obtained in other countries. In 1994, however, no wild-type polioviruses were isolated in our study. These results reveal that three unique strains were circulating in northern Vietnam in recent years, and indicate that the incidence of poliomyelitis due to wild poliovirus is decreasing.