{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T13:58:01Z","timestamp":1781186281886,"version":"3.54.1"},"reference-count":67,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:00:00Z","timestamp":1780099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hematology Reports"],"abstract":"<jats:p>The COVID-19 pandemic exposed vulnerabilities in global blood supply systems and accelerated the adoption of patient blood management (PBM) strategies aimed at optimizing transfusion practices in surgical care. Perioperative anemia is a key contributor to adverse outcomes and is frequently treated with allogeneic blood transfusion (ABT), which carries infectious and immunologic risks. Iron deficiency remains the most common and potentially correctable cause of perioperative anemia. This narrative review examines various approaches to perioperative anemia, strategies to minimize reliance on ABT, and alternatives within the PBM paradigm. Evidence supports the use of iron therapy, erythropoiesis-stimulating agents, antifibrinolytic strategies, and blood conservation techniques to reduce transfusion requirements and improve clinical outcomes. Lessons from the COVID-19 pandemic highlight PBM as a framework to enhance transfusion safety and sustainability. Broader implementation of PBM may improve patient outcomes, reduce unnecessary transfusions, and preserve scarce blood resources.<\/jats:p>","DOI":"10.3390\/hematolrep18030037","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T17:11:01Z","timestamp":1780333861000},"page":"37","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative Anemia, Transfusion Practices, and Patient Blood Management: Lessons from the COVID-19 Pandemic"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9560-5595","authenticated-orcid":false,"given":"Alin","family":"Ionescu","sequence":"first","affiliation":[{"name":"Research Center in Anesthesia and Intensive Care (CCATITM), \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timi\u0219oara, Romania"},{"name":"Doctoral School, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Mih\u0103ilescu","sequence":"additional","affiliation":[{"name":"Centre of Genomic Medicine, Genetics Discipline, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1790-8130","authenticated-orcid":false,"given":"Raluca","family":"Dumache","sequence":"additional","affiliation":[{"name":"Center for Ethics in Human Genetic Identifications, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3781-0335","authenticated-orcid":false,"given":"Alexandru","family":"Capcelea","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander Dean","family":"Turceanu","sequence":"additional","affiliation":[{"name":"Medical School, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolae","family":"Albulescu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Division of Cardiology, Centre for Molecular Research in Nephrology and Vascular Disease, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihai Alexandru","family":"S\u0103ndesc","sequence":"additional","affiliation":[{"name":"Teodor \u0218ora Research Center, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1111\/anae.15095","article-title":"Patient blood management during the COVID-19 pandemic: A narrative review","volume":"75","author":"Baron","year":"2020","journal-title":"Anaesthesia"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3063","DOI":"10.2147\/JMDH.S337039","article-title":"The impact of COVID-19 pandemic on blood transfusion services: A perspective from health professionals and donors","volume":"14","author":"Miskeen","year":"2021","journal-title":"J. Multidiscip. Healthc."},{"key":"ref_3","unstructured":"GBD 2021 Anaemia Collaborators (2023). Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990\u20132021: Findings from the Global Burden of Disease Study 2021. Lancet Haematol., 10, e713\u2013e734."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"COVIDSurg Collaborative (2020). Elective surgery cancellations due to the COVID-19 pandemic: Global predictive modelling to inform surgical recovery plans. Br. J. Surg., 107, 1440\u20131449.","DOI":"10.1002\/bjs.11746"},{"key":"ref_5","unstructured":"World Health Organization (2017). Patient Blood Management to Improve Patient Safety, World Health Organization."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1182\/hematology.2019000063","article-title":"Patient blood management as the standard of care","volume":"2019","author":"Murphy","year":"2019","journal-title":"Hematol. Am. Soc. Hematol. Educ. Program"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1097\/ALN.0000000000003198","article-title":"Patient blood management: Effectiveness and future potential","volume":"133","author":"Spahn","year":"2020","journal-title":"Anesthesiology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1213\/ANE.0000000000002549","article-title":"Perioperative patient blood management to improve outcomes","volume":"127","author":"Desai","year":"2018","journal-title":"Anesth. Analg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.tmrv.2011.02.001","article-title":"Appropriateness of allogeneic red blood cell transfusion: The international consensus conference on transfusion outcomes","volume":"25","author":"Shander","year":"2011","journal-title":"Transfus. Med. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Ackfeld, T., Schmutz, T., Guechi, Y., and Le Terrier, C. (2022). Blood transfusion reactions\u2014A comprehensive review of the literature including a Swiss perspective. J. Clin. Med., 11.","DOI":"10.3390\/jcm11102859"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1093\/bja\/aet068","article-title":"Inflammatory response, immunosuppression, and cancer recurrence after perioperative blood transfusions","volume":"110","author":"Cata","year":"2013","journal-title":"Br. J. Anaesth."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.bja.2021.05.031","article-title":"Association between perioperative allogeneic red blood cell transfusion and infection after clean-contaminated surgery: A retrospective cohort study","volume":"127","author":"Xu","year":"2021","journal-title":"Br. J. Anaesth."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"637","DOI":"10.4103\/0019-5049.144675","article-title":"Blood transfusion practices in cancer surgery","volume":"58","author":"Cata","year":"2014","journal-title":"Indian J. Anaesth."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1097\/01.TA.0000022460.21283.53","article-title":"Allogeneic blood transfusion increases the risk of postoperative bacterial infection: A meta-analysis","volume":"54","author":"Hill","year":"2003","journal-title":"J. Trauma."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1007\/s12262-012-0427-6","article-title":"Impact of blood transfusions on survival and recurrence in colorectal cancer surgery","volume":"75","author":"Gunka","year":"2013","journal-title":"Indian J. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.arth.2016.08.026","article-title":"Allogeneic blood transfusion is a significant risk factor for surgical-site infection following total hip and knee arthroplasty: A meta-analysis","volume":"32","author":"Kim","year":"2017","journal-title":"J. Arthroplast."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.aan.2017.07.008","article-title":"Complications of allogeneic blood product administration","volume":"35","author":"Friedman","year":"2017","journal-title":"Adv. Anesth."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Liu, H., Kaye, A.D., and Jahr, J.S. (2022). Allogeneic blood transfusion: Complications and side effects. Blood Substitutes and Oxygen Biotherapeutics, Springer.","DOI":"10.1007\/978-3-030-95975-3"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1016\/S0140-6736(12)62197-7","article-title":"Transfusion-related acute lung injury: A clinical review","volume":"382","author":"Vlaar","year":"2013","journal-title":"Lancet"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1080\/17474086.2019.1640599","article-title":"Risk factors, management and prevention of transfusion-related acute lung injury","volume":"12","author":"Kuldanek","year":"2019","journal-title":"Expert Rev. Hematol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2185","DOI":"10.1182\/blood-2014-11-567750","article-title":"Established and theoretical factors to consider in assessing the red cell storage lesion","volume":"125","author":"Zimring","year":"2015","journal-title":"Blood"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1111\/tme.12981","article-title":"Re-examining the transfusion-transmitted risk of SARS-CoV-2 virus during a major COVID-19 outbreak in 2022","volume":"33","author":"Ng","year":"2023","journal-title":"Transfus. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1213\/ANE.0000000000004727","article-title":"Perioperative anemia: Prevention, diagnosis, and management throughout the spectrum of perioperative care","volume":"130","author":"Warner","year":"2020","journal-title":"Anesth. Analg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1097\/SLA.0000000000005721","article-title":"Recommendations from the International Consensus Conference on Anemia Management in Surgical Patients (ICCAMS)","volume":"277","author":"Shander","year":"2023","journal-title":"Ann. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1182\/blood-2018-05-815944","article-title":"Iron deficiency","volume":"133","author":"Camaschella","year":"2019","journal-title":"Blood"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.transci.2019.06.011","article-title":"Perioperative anemia: Prevalence, consequences and pathophysiology","volume":"58","year":"2019","journal-title":"Transfus. Apher. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1053\/j.seminhematol.2015.07.006","article-title":"Anemia in clinical practice\u2014Definition and classification: Does hemoglobin change with aging?","volume":"52","author":"Cappellini","year":"2015","journal-title":"Semin. Hematol."},{"key":"ref_28","first-page":"241","article-title":"Management of iron deficiency anemia","volume":"11","author":"Jimenez","year":"2015","journal-title":"Gastroenterol. Hepatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"18403","DOI":"10.1038\/s41598-020-75535-2","article-title":"Intravenous iron infusion as an alternative to minimize blood transfusion in peri-operative patients","volume":"10","author":"Ionescu","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_30","unstructured":"Centre for Perioperative Care (2022). Guideline for the Management of Anaemia in the Perioperative Pathway, CPOC."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Arynov, A., Kaidarova, D., and Kabon, B. (2024). Alternative blood transfusion triggers: A narrative review. BMC Anesthesiol., 24.","DOI":"10.1186\/s12871-024-02447-3"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.xjon.2020.12.020","article-title":"Preoperative anemia management in the coronavirus disease (COVID-19) era","volume":"5","author":"Perelman","year":"2021","journal-title":"JTCVS Open"},{"key":"ref_33","first-page":"CD011588","article-title":"Iron therapy for preoperative anaemia","volume":"12","author":"Ng","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"763576","DOI":"10.1155\/2015\/763576","article-title":"Intravenous iron therapy in patients with iron deficiency anemia: Dosing considerations","volume":"2015","author":"Koch","year":"2015","journal-title":"Anemia"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1182\/hematology.2019000034","article-title":"Management of iron deficiency","volume":"2019","author":"Ning","year":"2019","journal-title":"Hematol. Am. Soc. Hematol. Educ. Program"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1093\/bjaed\/mkw061","article-title":"Patient blood management and perioperative anaemia","volume":"17","author":"Thakrar","year":"2017","journal-title":"BJA Educ."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"461","DOI":"10.5581\/1516-8484.20110123","article-title":"Intravenous iron therapy: How far have we come?","volume":"33","year":"2011","journal-title":"Rev. Bras. Hematol. Hemoter."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e212","DOI":"10.1097\/SLA.0000000000003643","article-title":"Effectiveness of preoperative iron supplementation in major surgical patients with iron deficiency: A prospective observational study","volume":"274","author":"Triphaus","year":"2021","journal-title":"Ann. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Blum, L.V., Zierentz, P., Hof, L., Kloka, J.A., Messroghli, L., Zacharowski, K., Meybohm, P., and Choorapoikayil, S. (2022). The impact of intravenous iron supplementation in elderly patients undergoing major surgery. BMC Geriatr., 22.","DOI":"10.1186\/s12877-022-02983-y"},{"key":"ref_40","first-page":"188","article-title":"The impact of timing of intravenous iron supplementation on preoperative haemoglobin in patients scheduled for major surgery","volume":"20","author":"Neef","year":"2022","journal-title":"Blood Transfus."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1056\/NEJMcp1113996","article-title":"Vitamin B12 deficiency","volume":"368","author":"Stabler","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_42","unstructured":"(2012). Kidney Disease: Improving Global Outcomes (KDIGO) Anemia Work Group. KDIGO clinical practice guideline for anemia in chronic kidney disease. Kidney Int. Suppl., 2, 279\u2013335."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"5004","DOI":"10.4103\/jfmpc.jfmpc_2209_21","article-title":"A review of perioperative anemia: A modifiable and not so benign risk factor","volume":"11","author":"Pan","year":"2022","journal-title":"J. Fam. Med. Prim. Care"},{"key":"ref_44","first-page":"CD012451","article-title":"Erythropoietin plus iron versus control treatment including placebo or iron for preoperative anaemic adults undergoing non-cardiac surgery","volume":"8","author":"Kaufner","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_45","first-page":"e17835","article-title":"Efficacy and cardiovascular adverse effects of erythropoiesis stimulating agents in the treatment of cancer-related anemia: A systematic review of randomized controlled trials","volume":"13","author":"Rao","year":"2021","journal-title":"Cureus"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1503\/cmaj.071055","article-title":"Erythropoietin-receptor agonists in critically ill patients: A meta-analysis of randomized controlled trials","volume":"177","author":"Zarychanski","year":"2007","journal-title":"Can. Med. Assoc. J."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"4699","DOI":"10.1182\/blood-2012-05-423228","article-title":"Perioperative management of patients on chronic antithrombotic therapy","volume":"120","author":"Ortel","year":"2012","journal-title":"Blood"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e26","DOI":"10.1002\/bjs.11393","article-title":"Strategies to minimize intraoperative blood loss during major surgery","volume":"107","author":"Shah","year":"2020","journal-title":"Br. J. Surg."},{"key":"ref_49","first-page":"144","article-title":"Perioperative management of anticoagulant therapy","volume":"4","author":"Wagner","year":"2019","journal-title":"Innov. Surg. Sci."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1016\/j.jvir.2019.04.017","article-title":"Society of Interventional Radiology consensus guidelines for the periprocedural management of thrombotic and bleeding risk","volume":"30","author":"Patel","year":"2019","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"10760296231165056","DOI":"10.1177\/10760296231165056","article-title":"Perioperative outcomes of patients with bleeding disorders undergoing major surgery","volume":"29","author":"Rhoades","year":"2023","journal-title":"Clin. Appl. Thromb. Hemost."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1111\/anae.12899","article-title":"Surgery in patients with inherited bleeding disorders","volume":"70","author":"Mensah","year":"2015","journal-title":"Anaesthesia"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"6593172","DOI":"10.1155\/2020\/6593172","article-title":"Early and ultraearly administration of tranexamic acid in traumatic brain injury","volume":"2020","author":"Acar","year":"2020","journal-title":"Emerg. Med. Int."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Hong, P., Liu, R., Rai, S., Liu, J., Ding, Y., and Li, J. (2022). Does tranexamic acid reduce blood loss in various surgeries?. Front. Pharmacol., 13.","DOI":"10.3389\/fphar.2022.887386"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1055\/s-0041-1736166","article-title":"The impact of SARS-CoV-2 infection on blood coagulation","volume":"48","author":"Bahraini","year":"2022","journal-title":"Semin. Thromb. Hemost."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1097\/TA.0000000000003859","article-title":"Is perioperative COVID-19 associated with worse surgical outcomes?","volume":"94","author":"Argandykov","year":"2023","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1093\/bja\/aex205","article-title":"The ACTA PORT-score for predicting perioperative risk of blood transfusion","volume":"119","author":"Klein","year":"2017","journal-title":"Br. J. Anaesth."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.bjae.2020.11.007","article-title":"Intraoperative cell salvage","volume":"21","author":"Carroll","year":"2021","journal-title":"BJA Educ."},{"key":"ref_59","first-page":"CD001888","article-title":"Cell salvage for minimising perioperative allogeneic blood transfusion","volume":"4","author":"Carless","year":"2010","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_60","first-page":"CD001888","article-title":"Cell salvage for minimising perioperative allogeneic blood transfusion in adults","volume":"9","author":"Lloyd","year":"2023","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1213\/ANE.0000000000001609","article-title":"Acute normovolemic hemodilution reduces allogeneic red blood cell transfusion in cardiac surgery: A systematic review and meta-analysis of randomized trials","volume":"124","author":"Barile","year":"2017","journal-title":"Anesth. Analg."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"109871","DOI":"10.1016\/j.jclinane.2020.109871","article-title":"Acute normovolemic hemodilution for major cancer surgeries during the COVID-19 pandemic","volume":"65","author":"Ni","year":"2020","journal-title":"J. Clin. Anesth."},{"key":"ref_63","first-page":"e21222","article-title":"Cardiac surgery and blood-saving techniques: An update","volume":"14","author":"Yousuf","year":"2022","journal-title":"Cureus"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1590\/S1807-59322007000400019","article-title":"Blood transfusion in critically ill patients: State of the art","volume":"62","author":"Hajjar","year":"2007","journal-title":"Clinics"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"e112910","DOI":"10.5812\/aapm.112910","article-title":"Evaluating the importance of patient blood management during COVID-19 pandemic","volume":"11","author":"Chegini","year":"2022","journal-title":"Anesth. Pain Med."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Hofmann, A., Spahn, D.R., and Holtorf, A.-P. (2021). Making patient blood management the new norm(al) as experienced by implementors in diverse countries. BMC Health Serv. Res., 21.","DOI":"10.21203\/rs.3.rs-88248\/v2"},{"key":"ref_67","first-page":"1073","article-title":"The impact of COVID-19 on health and health systems","volume":"31","author":"Haileamlak","year":"2021","journal-title":"Ethiop. J. Health Sci."}],"container-title":["Hematology Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2038-8330\/18\/3\/37\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T13:12:13Z","timestamp":1781183533000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2038-8330\/18\/3\/37"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,30]]},"references-count":67,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["hematolrep18030037"],"URL":"https:\/\/doi.org\/10.3390\/hematolrep18030037","relation":{},"ISSN":["2038-8330"],"issn-type":[{"value":"2038-8330","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,30]]}}}