Allison presented the results of one of her PhD project studies on changing red cell and platelet transfusion needs in patients with myelodysplastic syndromes: A 15-year Australian population data linkage study. The award is supported by ANZSBT and the National Blood Authority.

At the BLOOD 2021 conference, held virtually from 20-23 September, the TRU team contributed to more than 25 invited, oral abstract and poster presentations, including in the ANZSBT Presidential and the HSANZ Baikie Young Investigator sessions. These covered the spectrum from transfusion medicine (including a plenary lecture on convalescent plasma for COVID-19, results from the Australian/NZ Massive Transfusion Registry, and use of immunoglobulins for patients with blood cancers – the RATIONAL trial) to results of projects from our lymphoma, myeloma, myelodysplasia, aplastic anaemia and other bone marrow failure syndromes, and haemoglobinopathy registries. Many were presented by TRU students or other young investigators. Congratulations to all involved!

Professor Erica Wood joined colleagues from around the world at the annual Serious Hazards of Transfusion (SHOT) symposium on 14-15 July 2021, in a panel discussion on the impact of COVID-19 on haemovigilance for hospitals, blood centres and others.

The annual SHOT report for 2020 was launched at the meeting, and is available at shotuk.org

A/Prof Zoe McQuilten was invited to speak at the Royal College of Pathologists of Australasia (RCPA) Pathology Update – this year held virtually. Zoe joined Dr James Daly of Australian Red Cross Lifeblood in a plenary session on 4 July 2021 to discuss the use of convalescent plasma for COVID-19.

The Blood Synergy program is seeking expressions of interest from potential PhD candidates to join the Blood Synergy research that focuses on improving patient outcomes and making better use of blood products. PhD projects should be aligned with the objectives of the Blood Synergy, and in one of the target areas of critical bleeding, critical illness, or blood diseases or immunoglobulin use.

Candidates will ideally have a background in medicine or clinical sciences, and an interest in haematology, transfusion medicine, critical care, emergency/trauma, surgery, and/or health economics.

More information on the Blood Synergy is available at bloodsynergy.org/news

Expressions of interest should be sent to sphpm.bloodsynergy@monash.edu by 1 August 2021.

On behalf of the Lymphoma and Related Diseases Registry (LaRDR), A/Prof Eliza Hawkes and colleagues contributed to an analysis by the International Prospective T-cell project 2.0, presented at the 16th International Congress on Malignant Lymphoma.

LaRDR contributed 159 cases to the total of 594 included in the analysis of these rare and important types of lymphoma.

See: Federico M, Chiattone CS, Prince HM…Hawkes EA… Luminari S: Subtypes of mature T and NK cell lymphomas according to 2016 WHO Classification: Preliminary report of the International Prospective T‐Cell Project 2.0. Available at: doi: 10.1002/hon.135_2880.

More information on the Prospective Observational International Registry of Patients With Newly Diagnosed Peripheral T Cell Lymphoma is available at clinicaltrials.gov/ct2/show/NCT03964480

TRU researchers are delighted that their grant application “Diagnosis, discovery and novel phenotype characterisation using multimodal genomics in patients with inherited bone marrow failure and related disorders” has received $2.997 million from the MRFF Genomics Health Futures Mission. This research is a collaboration between many investigators, led by Dr Piers Blombery at the University of Melbourne/Peter MacCallum Cancer Centre, and institutions around Australia, including Prof Erica Wood (CIB) and Dr Lucy Fox (CIC) at Monash University.

The Aplastic Anaemia and other Bone Marrow Failure Syndromes Registry (AAR) will contribute to this important project to improve diagnosis and management for patients with inherited bone marrow failure syndromes and related disorders.

aaregistry.org.au

Prof Erica Wood joined celebrations for World Blood Donor Day on 14-15 June, conveying greetings to the WBDD opening session in Rome in her role as president of the International Society of Blood Transfusion, and attending the WBDD Scientific Symposium.

More information is available at: www.who.int/campaigns/world-blood-donor-day/2021

A/Prof Zoe McQuilten presented the preliminary results of the RATIONAL feasibility trial at the European Hematology Association Congress on 13 June 2021. The results showed that similar proportions of patients receiving immunoglobulin or prophylactic antibiotics were alive and on their assigned treatment arm at 12 months (the study’s primary outcome) and there were no significant differences in time to first major infection, or adverse events.

The trial was funded by the National Blood Authority and supported by the Australasian Leukaemia and Lymphoma Group.

1. Mo A, Stanworth SJ, Shortt J, Wood EM, McQuilten ZK. Red cell transfusions: Is less always best?: How confident are we that restrictive transfusion strategies should be the standard of care default transfusion practice? Transfusion. 2021 Jun 1. doi: 10.1111/trf.16429.
2. Boyle S, Wellard C, Moore EM, Blacklock H, Harrison SJ, Ho PJ, Hocking J, McQuilten ZK, Quach H, Spearing R, Wood EM, Spencer A, Mollee P; Myeloma and Related Diseases Registry investigators. Receiving four or fewer cycles of therapy predicts poor survival in newly diagnosed transplant-ineligible patients with myeloma who are treated with bortezomib-based induction. Eur J Haematol. 2021 Jun 15. doi: 10.1111/ejh.13677.
3. Saadah NH, Wood EM, Bailey MJ, Cooper DJ, French CJ, Haysom HE, Sparrow RL, Wellard CJ, McQuilten ZK; Australian and New Zealand Massive Transfusion Registry Steering Committee. Age of red blood cells is not associated with in-hospital mortality in massively transfused patients. J Trauma Acute Care Surg. 2021 Apr 8. doi: 10.1097/TA.0000000000003192.
4. Winearls J, Reade MC, McQuilten Z, Curry N. Fibrinogen in traumatic haemorrhage. Curr Opin Anaesthesiol. 2021 Aug 1;34(4):514-520. doi: 10.1097/ACO.000000000000102

The RATIONALISE investigators are delighted that the phase II/III trial (Role of antibiotic therapy or Ig on infections in haematology – Ig Stopping or Extension) was successful with both the MRFF as part of the 2020 Rare Cancers, Rare Diseases and Unmet Need General Grant Opportunity, and with the NHMRC Clinical Trials and Cohort Studies scheme. The trial will be going ahead funded by the NHMRC.

This important trial, part of the Blood Synergy research program, will help address questions about immunoglobulin use, and alternative therapies such as oral antibiotics, for patients with blood cancers in the novel therapies era.

Read more at nhmrc.gov.au/funding/find-funding/clinical-trials-and-cohort-studies-grants-2021

The TRU team was well represented at the Symposium, 27-29 May, with updates on the Aplastic Anaemia and Other Bone Marrow Failure Syndromes Registry (AAR) presented by Dr Lucy Fox, and an update on the DIAAMOND trial of avatrombopag for patients with severe aplastic anaemia presented by A/Prof Stephen Ting. Professor Melissa Southey provided an introduction to the new Australian Marrow Failure Biobank, which is in development through Biobanking Victoria and will link closely with the AAR.

Prof Erica Wood chaired the session on aplastic anaemia, which featured a keynote presentation by Professor Neal Young from the NHLBI.

This study was conducted by Dr Brenton Sanderson, anaesthetist at Westmead Hospital and PhD student in the Centre for Health Informatics at the Australian Institute of Health Innovation, as part of his program of work to develop a clinical decision support tool for managing massive transfusions. Most anaesthetists responding to the survey reported that they managed relatively few massive transfusions each year, and would welcome and use a clinical decision support tool for this purpose. Dr Sanderson is supervised by Prof Enrico Coiera, Prof Erica Wood and Dr Lise Estcourt.

Ref: Sanderson BJ, Field JD, Estcourt LJ, Wood EM, Coiera EW. Massive transfusion experience, current practice and decision support: A survey of Australian and New Zealand anaesthetists. Anaesth Intensive Care. 2021 May 5:310057X20974035. doi: 10.1177/0310057X20974035.

TRU researchers and collaborators were delighted to receive news of funding by the National Blood Authority for two important studies.

The funding application led by A/Prof Zoe McQuilten and Dr Andrew Flint will support Australian and NZ participation in the International Point Prevalence Study of Intensive Care Unit Transfusion Practices – the InPUT study. This study is led from the Netherlands by Prof Alexander Vlaar and colleagues and endorsed by the ANZICS Clinical Trials Group. The results will provide the most up-to-date and comprehensive description of current transfusion practice in ICUs across the country.

Prof Biswadev (Dev) Mitra and colleagues secured funding for a pilot study of prehospital lyophilised (freeze-dried) plasma in the setting of major haemorrhage from trauma.

Details at blood.gov.au/Round-5

1. Myles PS, Richards T, Klein A, Smith J, Wood EM, Heritier S, McGiffin D, Zavarsek S, Symons J, McQuilten ZK, Baker RA, Karkouti K, Wallace S; ANZCA Clinical Trials Network. Rationale and design of the intravenous iron for treatment of anemia before cardiac surgery (ITACS) trial. Am Heart J. 2021 May 22:S0002-8703(21)00137-X. doi: 10.1016/j.ahj.2021.05.008.
2. Piechotta V, Iannizzi C, Chai KL, Valk SJ, Kimber C, Dorando E, Monsef I, Wood EM, Lamikanra AA, Roberts DJ, McQuilten Z, So-Osman C, Estcourt LJ, Skoetz N. Convalescent plasma or hyperimmune immunoglobulin for people with COVID-19: a living systematic review. Cochrane Database Syst Rev. 2021 May 20;5(5):CD013600. doi: 10.1002/14651858.CD013600.pub4.
3. Bergin K, Wellard C, Augustson B, Cooke R, Blacklock H, Harrison SJ, Ho J, King T, Quach H, Mollee P, Walker P, Moore E, McQuilten Z, Wood E, Spencer A; Australian and New Zealand Myeloma and Related Diseases Registry. Real-world utilisation of ASCT in multiple myeloma: a report from the Australian and New Zealand myeloma and related diseases registry. Bone Marrow Transplant. 2021 May 19. doi: 10.1038/s41409-021-01308-8.
4. Sanderson BJ, Field JD, Estcourt LJ, Wood EM, Coiera EW. Massive transfusion experience, current practice and decision support: A survey of Australian and New Zealand anaesthetists. Anaesth Intensive Care. 2021 May 5:310057X20974035. doi: 10.1177/0310057X20974035.
5. Solves P, Lozano M, Zhiburt E, Anguita Velasco J, Maria Pérez-Corral A, Monsalvo-Saornil S, Yamazaki S, Okazaki H, Selleng K, Aurich K, Krüger W, Buser A, Holbro A, Infanti L, Stehle G, Pierelli L, Matteocci A, Rigacci L, De Vooght KMK, Kuball JHE, Fielding KL, Westerman DA, Wood EM, Cohn CS, Johnson A, Koh MBC, Qadir D, Cserti-Gazdewich C, Daguindau E, Angelot-Delettre F, Tiberghien P, Wendel-Neto S, Fachini RM, Morton S, Craddock C, Lumley M, Antoniewicz-Papis J, Hałaburda K, Łętowska M, Dunbar N. International Forum on transfusion practices in haematopoietic stem cell transplantation. Vox Sang. 2021 Apr 18. doi: 10.1111/vox.13021.
6. Skrifvars MB, Bailey M, Moore E, Mårtensson J, French C, Presneill J, Nichol A, Little L, Duranteau J, Huet O, Haddad S, Arabi YM, McArthur C, Cooper DJ, Bendel S, Bellomo R; Erythropoietin in traumatic brain injury (EPO-TBI) Investigators and the Australian and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group. A post hoc analysis of osmotherapy use in the Erythropoietin in Traumatic Brain Injury Study-Associations with acute kidney injury and mortality. Crit Care Med. 2021 Apr 1;49(4):e394-e403. doi: 10.1097/CCM.0000000000004853

Prof Erica Wood joined the 3RRR Radiotherapy team  to discuss how blood is made, why we have blood groups, and who needs a blood transfusion, including why we need trials of convalescent plasma for COVID-19 in order to know whether this treatment works. Listen via the 3RRR website.

Convalescent plasma has been in the news recently. Prof Erica Wood and A/Prof Zoe McQuilten were pleased to write a review article for Blood, the journal of the American Society of Hematology, and invited Dr Lise Estcourt from NHS Blood and Transplant/University of Oxford to join them.
doi: 10.1182/blood.2020008903

Dr Khaili Chai presented the preliminary results from the IMPROVE study at the 21st ICHS Symposium of the International Immunocompromised Host Society (ICHS). Thanks to the organisers and to the participants for some good discussion in the virtual poster session!

IMPROVE (Immunoglobulins in myeloma patients: research into outcomes, variation in practice and epidemiology) is using the Myeloma and Related Diseases Registry (MRDR) to capture data on measures to prevent and manage infection in patients with myeloma. Final follow-up and analysis is now underway.

TRU welcomes Dr Fiona Chen as Data Officer to contribute to our expanding number of registry projects and analyses.

Dr Adam Irving joins TRU as part of our collaboration with the Monash Centre for Health Economics through the Blood Synergy program.

And as part of TRU’s collaboration with RMIT Pharmaceutical Sciences program, we’re delighted to welcome Fazla Fawwaz for her professional placement with us in 2021.

1. Chai KL, Wood EM. What is clinically significant bleeding? Transfusion. 2021 Feb;61(2):340-343. doi: 10.1111/trf.16277.
2. Chapalain X, Ozier Y, Le Niger C, McQuilten Z, Huet O, Aubron C. Is there an optimal trade-off between anaemia and red blood cell transfusion in surgical critically ill patients after oncologic surgery? Vox Sang. 2021 Jan 25. doi:10.1111/vox.13068.
3. Hughes CM, Gregory GP, Pierce AB, Druce JD, Catton M, Chong B, Sherry NL, Graham M, Chen M, Salvaris R, Eise N, Lee JY, McQuilten Z, Crouch S, Looker C, Korman TM, Stuart RL. Clinical illness with viable SARS-CoV-2 virus presenting 72 days after infection in an immunocompromised patient. Infect Control Hosp Epidemiol. 2021 Mar 19:1-12. doi: 10.1017/ice.2021.120.
4. Alves D, Sparrow R, Garnier G. Rapidly freeze-dried human red blood cells for pre-transfusion alloantibody testing reagents. J Biomed Mater Res B Appl Biomater. 2021 Mar 10. doi: 10.1002/jbm.b.34825.
5. Goel R, Bloch EM, Pirenne F, Al-Riyami AZ, Crowe E, Dau L, Land K, Townsend M, Jecko T, Rahimi-Levene N, Patidar G, Josephson CD, Arora S, Vermeulen M, Vrielink H, Montemayor C, Oreh A, Hindawi S, van den Berg K, Serrano K, So-Osman C, Wood E, Devine DV, Spitalnik SL; ISBT COVID-19 Working Group. ABO blood group and COVID-19: a review on behalf of the ISBT COVID-19 working group. Vox Sang. 2021 Feb 12. doi: 10.1111/vox.13076.
6. Bergin K, Wellard C, Moore E, McQuilten Z, Augustson B, Blacklock H, Harrison S, Ho PJ, King T, Quach H, Mollee P, Walker P, Wood E, Spencer A, Australian and New Zealand MRDR investigators: The myeloma landscape in Australia and New Zealand: The first eight years of the Myeloma and Related Diseases Registry. Clinical Lymphoma, Myeloma and Leukemia. Clin Lymphoma Myeloma Leuk. 2021 Jan 30:S2152-2650(21)00034-3. doi: 10.1016/j.clml.2021.01.016.

Thanks and congratulations to all the patients and sites participating in LaRDR and supporters of the registry on this wonderful achievement. More information is available at: lardr.org

Dr Jasmine Singh is a haematologist and has recently commenced her PhD studies into risk factors for development of clonal haematopoiesis of indeterminate potential (CHIP) and the role of inflammation and its consequences with the ASPirin in Reducing Events in the Elderly (ASPREE) CHIP study.

The NHMRC-funded ASPREE-CHIP study is being led by A/Prof Zoe McQuilten and Prof Erica Wood of TRU, and Prof David Curtis of the Australian Centre for Blood Diseases at Monash University.

A new national transfusion dataset to collect information on transfusion practice and clinical outcomes will be developed as a collaboration between the Australian and New Zealand Massive Transfusion Registry, Ambulance Victoria, Blood Synergy and national registries for myeloma, lymphoma, bone marrow failure diseases, and critical care. This project (doi: 10.47486/DP708) received investment from the Australian Data Research Commons through the Australian Data Partnerships Program. The ARDC is funded by the National Collaborative Research Infrastructure Strategy (NCRIS).

A/Prof Hawkes is an NHMRC fellow and Lymphoma Lead at the Olivia Newton-John Cancer Centre, Austin Health and Eastern Health in Melbourne. After completing Medical Oncology training in Melbourne, she undertook a fellowship at the Royal Marsden Hospital, UK and doctoral studies at Melbourne University. She founded the Australasian Lymphoma Alliance, chairs the ALLG Lymphoma Working Party, and is a member of Steering Committees for Australian National Lymphoma Registry, international Women in Lymphoma group, and EviQ Haematology. Eliza has over 70 publications, and regularly presents at international conferences. She runs a large research program focusing on immune targets in lymphoma.

A/Prof Hawkes has joined the team to provide additional clinical support and expertise to the Lymphoma and Related Diseases Registry.