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BACKGROUND: Donor notification and counseling plays a vital role in both blood safety and comprehensive donor care. This process informs donors about their status as to transfusion-transmitted infections (TTI), modes of transmission of such infections and helps prevent secondary transmission of these infections in the community. AIMS AND OBJECTIVES: This study was initiated to see the response rate of notified reactive donors for counseling and to propose useful recommendations that could probably improve the response rate. MATERIALS AND METHODS: Total of 17025 donations was screened for TTIs, namely, human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis, by serology. All TTI reactive donors were retested and notified of their status by telephone and called for repeat testing followed by face-to-face counseling and referral for treatment. RESULTS: We evaluated 183(1.07%) donors with reactive screening test results, i.e., 106(57.9%) HBV, 38(20.7%) HCV, 29(15.8%) HIV, and 11(0.6%) were syphilis reactive and all (100%) were from replacement blood donations. Only 58.4%(107) of donors could be personally communicated over telephone and only 49 (45.79%) of them returned for counseling. Three (6.1%) among the reactive donors knew their results earlier and 11(22.4%) donors had history of high-risk behavior. CONCLUSION: In spite of strict donor screening and self-exclusion option, donors conceal their high-risk behaviors or their reactive status and continue to donate blood. It reflects the need to implement thorough predonation counseling to extract the history of high-risk factors from the donors.

Waldenstrom’s macroglobulinemia(WM) is a B-cell neoplasm characterized by infiltration of the bone marrow by a lymphoplasmacytic infiltrate and an IgM monoclonal gammopathy. We report a rare case of a 72 year-old male who presented with fever, shortness of breath for one month. Examination revealed cervical and axillary lymphadenopathy with mild hepatomegaly. On evaluation, peripheral smear show significant rouleaux formation & bone marrow aspiration showed lymphoplasmacytic infiltration. Flow cytometry on bone marrow apirate suggestive of B cell neoplasm and serum protein electophoresis & Immunofixation study confirms diagnosis of waldenstroms macroglobulinemia. We report this case to emphasize diagnostic difficulties in diagnosis of waldenstorms macroglobulinemia and application of flow cytometry and immunofixation study for further confirmation and treatment. Bangladesh Journal of Medical Science Vol.18(3) 2019 p.656-659

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