SARS-CoV-2, an infectious agent behind the ongoing COVID-19 pandemic, induces high levels of cytokines such as IL-1, IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ etc in infected individuals that play a role in the underlying patho-physiology. Nonetheless, exact association and contribution of every cytokine towards COVID-19 pathology remains poorly understood. Delineation of the roles of cytokines during COVID-19 holds the key to efficient patient management in clinics. This study performed a comprehensive meta-analysis to establish association between induced cytokines and COVID-19 disease severity to help in prognosis and clinical care. Main methods: Scientific literature was searched to identify 13 cytokines (IL-

Data on 90 patients (55 adults and 35 children) with chronic idiopathic thrombocytopenic purpura (ITP) and a platelet count of <50 x 10(9)/L treated with dapsone at a dose of 1-2 mg/kg/d are presented. A response was observed in 57 (63.3%) patients. The average time for response was 3.5 months (range 1-9) and the average duration of treatment with dapsone was 10.4 months (range 4-14). Overall response rates of 65.7% and 61.8% were observed in children and adults respectively. Side effects requiring discontinuation of therapy were observed in three (2%) patients. These results demonstrate that dapsone is an effective, inexpensive and well-tolerated treatment for chronic ITP, in both children and adults and could be considered for patients who fail steroid therapy.

Objectives: SARS-CoV-2, an infectious agent behind the ongoing COVID-19 pandemic, induces high levels of cytokines in patients contributing to the disease patho-physiology. Nonetheless, exact association and contribution of particular cytokines towards COVID-19 pathology remains poorly understood. This study performed a comprehensive meta-analysis to establish association between induced cytokines and COVID-19 disease severity to help in prognosis and clinical management. Methods: Scientific literature was searched to identify 18 clinical studies. Standardized mean difference (SMD) for cytokines IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ between severe and non-severe COVID-19 patient groups were summarized using random effects model. A classifier was built using logistic regression model with cytokines having significant SMD as covariates. Results: Out of the 6 cytokines, IL-6 and IL-10 showed statistically significant SMD across the studies synthesized. Classifier with mean values of both IL-6 and IL-10 as covariates performed well with accuracy of ~ 92% that was significantly higher than accuracy reported in literature with IL-6 and IL-10 as individual covariates. Conclusions: Simple panel proposed by us with only two cytokine markers can be used as predictors for fast diagnosis of patients with higher risk of COVID-19 disease deterioration and thus can be managed well for a favourable prognosis.

Flebogamma 10% DIF was effective and safe in patients with primary ITP.

Summary:Major ABO incompatibility in stem cell transplant recipients has been associated with pure red cell aplasia (PRCA). Reduction of incompatible isohaemagglutinin titres pre-transplant by various methods has been thought to reduce the incidence of PRCA. Our data suggest that pre-transplant reduction of incompatible isohaemagglutinin titres by donor group plasma infusion does not reduce the incidence of PRCA. We also failed to find any relationship between pre-transplant ABO isohaemagglutinin titre and the risk of developing PRCA. The ABO blood group system is of critical importance in transfusion medicine, but has a less dramatic impact on haematopoietic transplantation. 1,2 ABO antigens are potently immunogenic and are expressed on multiple tissues in addition to red blood cells. 3 Since ABO and human leukocyte antigens (HLA) are inherited independently, ABO incompatibility may occur in 20-40% of HLA-matched allogeneic haematopoietic stem cell transplants (SCT). 2 Graft failure does not occur with increased frequency, and most studies indicate that the incidence of graft-versus-host disease (GVHD) is not increased following ABO-incompatible transplants. 2,[4][5][6] Major ABO incompatibility in SCTs, defined as incompatibility of donor ABO antigens with the recipient's immune system, has been associated with pure red cell aplasia (PRCA) following conventional myeloablative conditioning. [7][8][9][10][11] The proposed risks for PRCA in this setting include the use of cyclosporine (CsA) as GVHD prophylaxis, 7,8 high initial or persistently elevated host antidonor isohaemagglutinin levels, 7,10 and RBC incompatibility involving donor A antigens. 10,11 Reduction of incompatible isohaemagglutinin titres prior to transplant, either by plasma exchange, immunoadsorption or donortype RBC infusion, has been utilized in the past. [2][3][4][5][6][7][8][9][10][11][12][13][14] However, this practice has been highly variable and there are no specific recommendations. In addition, limited data suggest that this reduction in pre-transplant titres also reduces the incidence of PRCA. 15 We have been using a relatively unusual and rarely reported form of isoagglutinin reduction for major ABOmismatched SCTs. Donor group plasma is infused prior to transplant in order to reduce the incompatible titres in ABO-mismatched transplants, in addition to RBC depletion to prevent severe hemolytic reaction at the time of marrow transfusion. 12,16-21 Hence, we carried out a retrospective analysis to determine whether the reduction in titres reduced the incidence of PRCA. Patients and methodsWe undertook a retrospective analysis to study the incidence of PRCA in 357 patients who had undergone 372 allogeneic transplants between 1986 and 2003 at our centre. Of these, 83 were major ABO-mismatched transplants. The bone marrow harvest was RBC depleted in all patients who underwent bone marrow transplantation (BMT) in contrast to patients who underwent peripheral blood stem cell transplantation (PBSCT), where no such manipulation of the graft was ...