Convalescent plasma therapy for severe Covid-19 in patients with hematological malignancies

BackgroundData on convalescent plasma therapy (CPT) in patients of hematological malignancies with severe Covid-19 is scarce.ObjectiveTo study 14-day mortality in patients who received CPT.Patients & methodsRetrospective multicentre observational study conducted in 4 centres treating haematological malignancies across Delhi-national capital region. Total 33 haematological malignancies patients with severe Covid-19 who received CPT were analysed.ResultsThe median age of the study cohort was 62 years (18–80 years). Twenty one percent patients had 1 comorbidity, 18 % had 2 comorbidities and 6% patients had 3 and 5 comorbidities each. Twenty four patients were on active therapy. Sixty nine percent of patients required ICU stay. Twenty five patients received plasma therapy within 7 days (early) of diagnosis of Covid-19 infection. Median day of plasma infusion from date of diagnosis of Covid-19 infection was 4 days (range: 2–25 days). Patient who had early initiation of plasma therapy had shorter duration of hospitalisation (12.7 vs 24.3 days, p = 0.000). Overall mortality in the cohort was 45.5%. There was no effect of disease status, active therapy, presence of comorbidity on mortality. There was no difference in the mortality in patients receiving early vs late initiation of plasma therapy or in patients receiving one versus two plasma therapy.ConclusionsWe provide a large series of patients with hematological malignancies and role of CPT in this group.     

Safety of oral iron chelator deferiprone in young thalassaemics

Deferiprone is now widely used for iron chelation in patients with thalassaemia. Studies on its efficacy and safety have largely included older children and adults. OBJECTIVE: To assess the safety of deferiprone in children <6 yr of age. METHODS: The study is based on scrutiny of follow-up data of 44 patients of age <6 yr receiving deferiprone for a variable period of time. Occurrence of various side effects including gastrointestinal, osteoarticular were noticed and complete blood counts were performed every 2-4 wk. RESULTS: Nausea and vomiting were noticed in 12 (27.2%), joint symptoms were reported by four (9.1%) and neutropenia was observed in only two patients (4.5%). None of the patient had agranulocytosis. Thrombocytopenia was observed in 20 patients (45.45%), which occurred 3 months to 1 yr after deferiprone therapy. Interruption of deferiprone for 2-4 wk led to reversal of symptoms in all but two patients. CONCLUSION: Thrombocytopenia is one of the major side effects in young thalassaemics and necessitates frequent close monitoring of blood counts but its resolution after discontinuation and absence of clinical evidence of bleeding does not preclude its use.     

An evaluation of residual organochlorine pesticides in popular Indian herbal teas

Herbal preparations are gaining popularity worldwide because of their history of use and the belief that they are free of harmful side effects. Among the most popular products are herbal teas, which are marketed extensively with emphasis on their medicinal properties. At the same time, the World Health Organization has been emphasizing the need for quality assurance of herbal products, including testing for inadvertent contamination. The authors conducted a quality-assurance evaluation of residual organochlorine pesticides in some popular brands of Indian herbal teas. Organochlorine pesticide residue build-up from agricultural or storage practices was estimated with gas-liquid chromatography. The results revealed scant presence of dichlorodiphenyltrichloroethane (DDT) or its metabolites; endosulfan--a highly toxic pesticide--was absent in all 8 brands of herbal teas studied. Hexachlorocyclohexane isomers were detected in 2 samples, but levels were below the permissible limit for pesticide residue in foods, as promulgated by the Codex Alimentarius Commission. The authors believe that all herbal preparations should be checked for toxic chemical residues to allay consumer fears of exposure to known neurotoxicant pesticides and to aid in promoting global acceptance of these products.