Objective Marvelous advancements have been made in cancer therapies to improve clinical outcomes over last few years. However, therapeutic resistance has always been a major difficulty in cancer therapy, with extremely complicated mechanisms remain elusive. N6-methyladenosine (m6A) RNA modification, a hotspot in epigenetics, has gained growing attention as a potential determinant of therapeutic resistance. As the most prevalent RNA modification, m6A is involved in every links of RNA metabolism, including RNA splicing, nuclear export, translation and stability. Three kinds of regulators, methyltransferase (writer), demethylase (eraser) and RNA binding proteins (reader), together orchestrate the dynamic and reversible process of m6A modification. Herein, we primarily reviewed the regulatory mechanisms of m6A in therapeutic resistance, including chemotherapy and targeted therapy. Then we discussed the clinical potential of m6A modification to overcome resistance and optimize cancer therapy. Additionally, we proposed prospects of m6A modification for future research.

Preoperative Advanced Autologous Apheresis (AAA) is a new type of preoperative autologous blood donation. In recent years, this technology has been introduced in many hospitals across the country. However, there has yet to be a consensus or technical standard for its implementation process and quality control. To address this, the Chinese Blood Transfusion Association Clinical Transfusion Management Committee organized experts from related fields nationwide to extensively and deeply discuss the technical principles, entry requirements, indications, contraindications, operational key points, adverse reaction prevention and treatment, and blood quality evaluation and disposition of preoperative Advanced Autologous Apheresis, and jointly formulated this consensus. The aim is to better manage autologous blood for patients and to provide a basis for medical staff to implement preoperative Advanced Autologous Apheresis more safely and standardized.

Platelets play a crucial role in a variety of physiologic and pathologic processes, especially in hemostasis and wound healing. In recent years platelet-rich plasma, platelet-rich fibrin, platelet-lysate and other platelet-derived products have become a promising treatment in regenerative medicine and have been widely applied clinically. By release a variety of growth factors, cytokines, and chemokines, platelet-derived products induce cell migration, proliferation, differentiation, and chemotaxis, stimulating mitosis in multiple cell types and neovascularization, increasing endothelial cell response to pro-angiogenic factors, and promoting fibroblast migration and proliferation. This article reviews the classification and origin of platelet-derived products, biological characteristics of the main growth factors, and their therapeutic effects in promoting the healing of various wounds, then, also analyzed the possible issues and the future development possibilities.

Cellular immunotherapies, new complementary therapies for tumor patients, are aimed at malignant tumors with low ability of autoimmune cells, including T cell-based chimeric antigen receptor T cell (CAR-T) therapy, tumor infiltrating lymphocytes (TILs) therapy, NK cell-based chimeric antigen receptor NK cell (CAR-NK) therapy, and autologous cell immunotherapy (CIK), as well as infusion therapies based on other immune cells such as mononuclear phagocytes like dendritic cells and macrophages. Among them, nature killer cells (NK cells), important to the body's natural immunity, matter greatly in anti-tumor, antiviral infection and immune regulation. Like T cells, it can be engineered to target tumor treatment, and can also be transfused with allogeneic NK cells, making up for the shortcomings of limited T cell source and allogeneic immune rejection. No evidence shows that patients tansfused with allogeneic NK cells may develop severe Graft Versus Host Disease (GVHD). NK cells not only expand the types of cells used in cellular immunotherapy, but also provide a broad application prospect for the formation of low-cost cellular immunotherapy products. However, there are still problems such as unstable quality of NK cells and lack of unified quality standards in the preparation process. Although some NK cell immunotherapy products have been approved by the Food and Drug Administration (FDA) or the National Medical Products Administration (NMPA), there is still no clear and publicly available standardized production system for NK cell immunotherapy products. Starting from the unique immunomodulatory mechanism of NK cells, this paper summarizes the therapeutic strategies applied by researchers in the treatment of malignant tumors in recent years and the latest progress of preclinical studies and clinical trials, and finally focuses on the research progress of in vitro expansion methods and maintenance of active function of NK cells, indicating that NK cells promise to be a unified quality of cellular immunotherapy products.

Red blood cell transfusion has been widely used in trauma treatment, surgery, anemia treatment, war wound emergency treatment and other aspects, but there are still problems such as shortage of blood resources, short storage period, cross-matching before transfusion, and possible transmission of pathogens through blood. Hemoglobin-based oxygen carriers (HBOCs) are a class of soluble nano-oxygen carriers prepared by chemical modification of matrix-free hemoglobin, which can replace red blood cells to transport oxygen to organs and tissues in the body. HBOCs have the characteristics of no blood group and virus transmission risk, long storage, and instant use, so they are also known as red blood cell substitutes. This paper aims to review the research progress of HBOCs, and explore their application prospects in organ preservation, cerebral ischemia, tumor treatment and other treatments in addition to the replacement of red blood cell transfusion.

Autoimmune hemolytic anemia (AIHA) is a hemolytic disease caused by its own red blood cell antibodies, which is mainly characterized by accelerated destruction of red blood cells. The diagnosis of AIHA is based on direct antiglobulin test (DAT) and hemolysis related indexes.And the treatment for AIHA based on the type and etiology includes blood transfusion,symptomatic supportive care and immunotherapy. In immunotherapy, glucocorticoids are the main first-line therapy, rituximab the second-line therapy, and splenectomy and cytotoxic immunosuppressants the third-line therapy for warm-antibody type; rituximab is the main first-line therapy, rituximab plus bendamustine the second-line therapy and complement inhibitor the third-line therapy for cold-antibody type. The current treatment regimens are not specific and poor efficacy, and there are side effects. New drugs including foctatinib , orilanolimab ( SYNT 001) , rozanolixizumab (UCB7665), nipocalimab (M281) , PI3K inhibitors, venetoclax, ofamulimab, alemtumab and daratumab are undergoing in clinical trials. In addition, traditional Chinese medicine treatment regimens may bring a new potential breakthrough point for the treatment of AIHA.

Objective To discuss the identification method of polyagglutination of red blood cells by T-antigen exposure in children with necrotizing enterocolitis (NEC) to formulate transfusion strategies to provide reference for clinical guidance and scientific and rational use of blood in children. Methods ABO and Rh blood group identification, direct antiglobulin test (DAT), antibody screening test and cross-matching test were performed in 2 NEC children with difficult cross-matching difficulty in our center. Erythrocyte polyagglutination was found in 3 ABO donor plasma, 3 AB donor plasma and 3 umbilical cord blood plasma. The polyagglutination was further identified by Peanut Agglutinin, MN Blood Group Reagent and Polybrene test. Results The erythrocyte antibody screening test, DAT and major cross-matching test were negative in 2 cases. The minor cross-matching test using saline and anti-human globulin test were positive. The red blood cells of the children were positive with plasma from donor of the same blood type and AB plasma, and negative with cord blood plasma of the same blood type. MN blood group antigen was negative in children who were positive with Peanut Agglutinin. No expected agglutination was observed with Polybrene test. Conclusion NEC children with polyagglutinated erythrocytes showed negative DAT tests and positive minor cross-matching tests. At this time, multiple methods should be used to identify the phenomenon of erythrocyte polyagglutination to choose appropriate blood products to avoid delayed transfusion.

Plasma, as the common blood components, has been widely used to supplement coagulation factors, which can prevent or treat bleeding or bleeding tendency caused by coagulation factor deficiency. Although the concept of rational and scientific transfusion has been implemented for many years, the majority of plasma transfusions are still sub-optimal, and achieving optimal plasma utilization is an ongoing challenge. Based on the domestic and international blood transfusion guidelines and published relevant clinical studies, this article reviews the current status, applications and challenges of plasma transfusion, looks forward to the future development, and update and expand the existing guidelines.

Objective To analyze the quality control indexes of national clinical blood use in 2020 and provide reference for the management of clinical blood use. Methods A retrospective investigation was carried out to collect and analyze the data of blood quality control indexes of medical institutions in 2020. Results We collected 438 clinical blood quality control data, 1 673 (68.62%) of which were from tertiary hospitals, 594 (24.37%) from secondary hospital, and 171 (7.01%) from the hospitals below secondary or other ungraded ones. There were significant differences in clinical blood quality control indexes such as the number of professional and technical personnel for blood transfusion per thousand units, reported cases of adverse transfusion reactions per thousand transfusion times, average blood consumption of third and fourth level operating tables, and average blood consumption of discharged patients among hospitals at all levels (P<0.05). Except for the indoor quality control rate of transfusion compatibility test items and the autotransfusion rate of surgical patients, the other quality control index data had significant differences between regions (P<0.05). Conclusion The quality control indexes of blood for clinical use vary in different grades of hospitals and in different regions, suggesting that there is still room for improvement in the management of blood for clinical use.

Objective To analyze the effectiveness of the R-CHOP regimen in the treatment of double-expression diffuse large B-cell lymphoma (DEL). Methods A retrospective analysis of the clinical data of the DEL patients admitted to the Second Affiliated Hospital of Anhui Medical University from December 2017 to December 2022. The clinical characteristics, survival and prognostic factors were analyzed, and non-DEL patients admitted in the same period were selected as the control group. Results A total of 243 DLBCL patients were collected, including 63 cases of DEL patients (25.9%). There were no differences in the clinical characteristics between DEL patients and non-DEL patients. The complete remission (CR) rate of DEL patients was significantly lower than that of non-DEL patients (P=0.033).The non-DEL and DEL groups had a progression-free (PFS) rate of 74.5% and 41.7% respectively at 3 years, with median PFS was 38.6 (95％CI:33.3~43.9)month and 30.2 (95％CI:22.3~38.2) month (P=0.003). The overall survival (OS) rate at 3 years was 80.3% in the non-DEL group and 60.4% in the DEL group, with median OS of 49.2(95％CI:44.6~53.8) month and 34.2 (95％CI:28.1~40.4) month respectively (P=0.031), the difference were statistically significant. Multivariate COX regression analysis of DEL patients showed that only the IPI score affected the PFS (HR=51.695, P=0.001) and OS (HR=6.513, P=0.001). Conclusion There is no significant difference between DEL and non-DEL patients in clinical characteristics. DEL patients undergoing first-line treatment with R-CHOP regimen have poor prognosis.

Objective This study aimed to explore the early clinical efficacy and safety of cladribine combined with venetoclax and low-dose cytarabine in elderly patients with acute myeloid leukemia (AML) by small sample analysis. Methods From September 2022 to March 2023, 12 newly diagnosed and refractory elderly AML patients in our center were selected as the study subjects. All patients were treated with cladribine combined with venetoclax+low-dose cytarabine for the first induction chemotherapy. The clinical efficacy was evaluated after 1~2 cycles of chemotherapy; the safety data was collected and analyzed during the first induction chemotherapy process, and the bone marrow suppression and non hematological toxicity of this protocol were evaluated in elderly AML patients undergoing induction therapy. Results After 1~2 cycles of treatment, 12 patients achieved complete clinical remission (CR+CRi 83.3%,10/12), except for 2 patients who did not follow up with bone marrow due to the epidemic and personal reasons after the first course of treatment. No deaths occurred during the induction chemotherapy period; During that period, the patient had good tolerance and was hospitalized for an average of 27.8 days. During the hospitalization period, the main manifestations were hematological toxicity and bone marrow suppression. The average days of neutrophil ratio below 0.5×10 ⁹/L, platelet count below 20×10 ⁹/L, and hemoglobin below 60 g/L were 12.7 days, 10.6 days, and 10.8 days, respectively. Among them, 2 patients had severe pulmonary infections before induction chemotherapy, and after actively and stably controlling the infection, this regimen was administered for induction chemotherapy, During chemotherapy, the infection did not worsen on the basis of continuous treatment. Conclusion This protocol has a better therapeutic effect in the induction therapy of elderly AML, and has a significant improvement compared to the current demethylation combined with Vineclavone protocol in elderly AML patients. The efficacy is basically consistent with recent reports abroad, with a high early clinical remission rate and tolerability. There are no deaths during the initial induction chemotherapy period, and all patients have controllable hematological and non hematological toxicity, which is worthy of further clinical promotion and application.

Plasma transfusion is clinically used to replenish clotting factors and correct coagulopathy, playing an important role in the treatment of massive hemorrhage. Universal plasma and low titer group O whole blood can improve the timeliness and accessibility of urgent transfusions in patients with major bleeding. The strategy of ABO non-identical plasma transfusion, in the form of active and passive transfusion, has been extensively adopted in clinical practice. Active transfusion mainly includes group AB and A plasma; passive transfusion, on the other hand, involves the transfusion of low titer group O whole blood and ABO non-identical platelets. However, hemolysis and circulating immune complex formation are recognized to be the risks associated with transfusion of ABO non-identical plasma. Together, the risk-benefit trade-off with transfusion of non-ABO identical plasma deserves more attention and further exploration.

Fetomaternal hemorrhage (FMH) is a series of reactions in which fetal red blood cells enter the maternal circulation before or during delivery, and the mother produces antibodies against fetal red blood cells, which in combination with red blood cell surface antigens cause fetal red blood cells to undergo varying degrees of hemolysis. Accurate quantification of fetalmaternal hemorrhage is crucial for the prevention of neonatal birth defects including neonatal hemolytic disease. Based on the latest relevant literature at home and abroad, this article analyzes the new and traditional detection methods for FMH, elucidates the advantages and shortcomings of various detection methods, and briefly outlines the correlation between FMH and various perinatal fetal clinical disorders, in order to provide a basis for standardization of testing techniques for fetalmaternal hemorrhage and further prevention and treatment of related diseases.