News in Brief: Familial aggregation of haematological malignancies; Australian VIIPT registry; TGA consults on regulations for human cell and tissue products, blood and blood components


Familial aggregation of early-onset haematological malignancies

Familial clustering of early-onset haematological malignancy (HM) was detected in all of the most common blood cancers of children and adolescents and young adults, a large national registry study shows.

Hodgkin’s Lymphoma (HL) was the one that aggregated most say investigators from Finland who investigated more than 8700 patients aged  ≤40 years from the Finnish Cancer Registry and their 75 774 family members.

Siblings of patients with HL had the highest familial risk of concordant early-onset HM with a standardised incidence ratio (SIR) of 9.09.

The risk for any first-degree relatives was over five-fold. Also, the cumulative risk of HL in siblings until ≤40 years of age was much higher than in the population (0.92% vs. 0.11%), they said,

Meanwhile first-degree relatives of patients with non Hodgkin’s Lymphoma (NHL) had a significantly increased risk of developing the malignancy and the risk was again highest (over 45-fold) for siblings.

For acute leukaemias the risk of early-onset concordant cancer for siblings was high – with the risk ‘almost comparable’ to lymphoma’s, investigators noted.

In acute lymphoblastic leukaemia/lymphoma (ALL/LBL) the risk was over four-fold, and in acute myeloid leukaemia (AML) over eight-fold, although the number of AML cases in siblings was small.

Affected siblings with familial early-onset ALL/LBL were all children (aged 2– 14 years) whereas siblings with AML were mainly diagnosed in young adulthood (at 20–40 years).

Writing in British Journal of Haematology the team say the significantly elevated SIRs indicate a role of shared aetiologies in some families, which should be noted in the clinical setting when caring for patients with early-onset HM.

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New VIITP registry for Australia

An Australian registry has been established to capture data on thrombocytopenia following COVID vaccination.

The REDCap registry, run by THANZ, is now live and will collect de-identified data on the presentation and clinical outcome of cases that clinicians believe may represent an immune thrombocytopenia (Vaccine Induced ITP) following any COVID vaccination (Pfizer, AstraZeneca, etc).

“Some of these cases may occur as a relapse in patients with a prior history of ITP. Many cases may be de novo. Some patients may even share features with VITT/TTS (Vaccine Induced Immune Thrombosis and Thrombocytopenia). We would like to collect information on any of these presentations,” say Dr Phil Choi and Professor Robert Bird on behalf of the THANZ Vaccine Induced Immune Thrombocytopenia Working Group, and ISTH Platelet Immunology Subcommittee

The registry can be accessed here.

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TGA consults on regulations for HCT  products and blood components

The TGA has proposed several changes to regulations for human cell and tissue (HCT) products, including updates to requirements for donor selection and testing.

Among the list of proposed changes is a widening of ineligibility criteria for plasma donors who have received an injection of any substance that is not a therapeutic use to include cosmetic use.

There is also a proposal for HBV nucleic acid testing for plasma donors and a proposal to decrease the ineligibility period for high risk sexual behaviour donors to three months from last sexual contact.

Other items up for review are labelling requirements for biologicals and standard for biologicals.

The regulator is seeking feedback on the proposed changes by July 11.

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