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Immature platelet fraction as a systemic inflammation marker in patients with chronic obstructive pulmonary disease 作为慢性阻塞性肺病患者全身炎症标志物的未成熟血小板分数。
IF 2.2 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-05-09 DOI: 10.1111/ijlh.14299
Nasser Absieh, Fatma Arslan, Özlem Doğan, Aslıhan Gürün Kaya, Miraç Öz, Serhat Erol, Aydın Çiledağ, Akın Kaya

Introduction

Recently, there has been an increasing interest to find a simple, low cost, widely available biomarker for outcome predictors in chronic obstructive pulmonary disease (COPD).

Methods

Absolute immature platelet count (AIPC), the percentage of AIPC to the total platelet count (immature platelet fraction [IPF%]), symptoms, spirometry results, age-dyspne-airflow obstruction index, and C-reactive protein tests of COPD patients and control group were recorded. Neutrophil/lymphocyte, monocyte/lymphocyte, and platelet/lymphocyte ratios and Charlson comorbidity index scores were calculated.

Results

One hundred and thirty-four COPD patients and 30 healthy control subjects were included in the study. Eighty-nine patients were in exacerbation (AECOPD) and 45 of them were in stable COPD period. There was a difference between IPF% values and AIPC of COPD group and control group (3.45 ± 2.41 vs. 2.04 ± 1.12, p = 0.01; 5.87 ± 2.45 vs. 5.20 ± 3.02, p = 0.01). A positive correlation was observed between IPF% with white blood cell count and neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio in all patients (r = 0.352, p < 0.001; r = 0.399, p < 0.001; r = 0.186, p = 0.032; r = 0.200, p = 0.021) and AECOPD (r = 0.356, p < 0.001; r = 0.414, p < 0.001; r = 0.239, p = 0.025; r = 0.273, p = 0.010). At a cut-off of 3.4, IPF% showed the highest accuracy in identifying COPD (sensitivity: 80.3%, specificity: 82.5%) using receiver-operating characteristic analysis.

Conclusion

This is the first study to examine the relationship between AIPC, IPF%, and COPD. The higher IPF% values in COPD and the positive correlation between IPF% and other inflammatory markers are suggested that IPF may be an indicator of systemic inflammation in COPD.

简介:最近,人们越来越关注寻找一种简单、低成本、可广泛使用的生物标记物来预测慢性阻塞性肺病(COPD)的结果:最近,人们越来越关注寻找一种简单、低成本、可广泛使用的生物标志物来预测慢性阻塞性肺疾病(COPD)的结果:方法: 记录 COPD 患者和对照组的绝对未成熟血小板计数(AIPC)、AIPC 占总血小板计数的百分比(未成熟血小板分数 [IPF%])、症状、肺活量测定结果、年龄-肾-气流阻塞指数和 C 反应蛋白检测结果。计算中性粒细胞/淋巴细胞、单核细胞/淋巴细胞、血小板/淋巴细胞比率和 Charlson 合并症指数评分:研究共纳入 134 名慢性阻塞性肺病患者和 30 名健康对照组受试者。其中 89 名患者处于病情加重期(AECOPD),45 名患者处于 COPD 稳定期。COPD 组和对照组的 IPF% 值和 AIPC 之间存在差异(3.45 ± 2.41 vs. 2.04 ± 1.12,P = 0.01;5.87 ± 2.45 vs. 5.20 ± 3.02,P = 0.01)。在所有患者中,IPF%与白细胞计数、中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值、单核细胞/淋巴细胞比值之间均呈正相关(r = 0.352,p这是首次研究 AIPC、IPF% 和慢性阻塞性肺病之间的关系。慢性阻塞性肺病患者的 IPF% 值较高,且 IPF% 与其他炎症指标呈正相关,这表明 IPF 可能是慢性阻塞性肺病患者全身炎症的一个指标。
{"title":"Immature platelet fraction as a systemic inflammation marker in patients with chronic obstructive pulmonary disease","authors":"Nasser Absieh,&nbsp;Fatma Arslan,&nbsp;Özlem Doğan,&nbsp;Aslıhan Gürün Kaya,&nbsp;Miraç Öz,&nbsp;Serhat Erol,&nbsp;Aydın Çiledağ,&nbsp;Akın Kaya","doi":"10.1111/ijlh.14299","DOIUrl":"10.1111/ijlh.14299","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Recently, there has been an increasing interest to find a simple, low cost, widely available biomarker for outcome predictors in chronic obstructive pulmonary disease (COPD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Absolute immature platelet count (AIPC), the percentage of AIPC to the total platelet count (immature platelet fraction [IPF%]), symptoms, spirometry results, age-dyspne-airflow obstruction index, and C-reactive protein tests of COPD patients and control group were recorded. Neutrophil/lymphocyte, monocyte/lymphocyte, and platelet/lymphocyte ratios and Charlson comorbidity index scores were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred and thirty-four COPD patients and 30 healthy control subjects were included in the study. Eighty-nine patients were in exacerbation (AECOPD) and 45 of them were in stable COPD period. There was a difference between IPF% values and AIPC of COPD group and control group (3.45 ± 2.41 vs. 2.04 ± 1.12, <i>p</i> = 0.01; 5.87 ± 2.45 vs. 5.20 ± 3.02, <i>p</i> = 0.01). A positive correlation was observed between IPF% with white blood cell count and neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio in all patients (<i>r</i> = 0.352, <i>p</i> &lt; 0.001; <i>r</i> = 0.399, <i>p</i> &lt; 0.001; <i>r</i> = 0.186, <i>p</i> = 0.032; <i>r</i> = 0.200, <i>p</i> = 0.021) and AECOPD (<i>r</i> = 0.356, <i>p</i> &lt; 0.001; <i>r</i> = 0.414, <i>p</i> &lt; 0.001; <i>r</i> = 0.239, <i>p</i> = 0.025; <i>r</i> = 0.273, <i>p</i> = 0.010). At a cut-off of 3.4, IPF% showed the highest accuracy in identifying COPD (sensitivity: 80.3%, specificity: 82.5%) using receiver-operating characteristic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the first study to examine the relationship between AIPC, IPF%, and COPD. The higher IPF% values in COPD and the positive correlation between IPF% and other inflammatory markers are suggested that IPF may be an indicator of systemic inflammation in COPD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"46 5","pages":"822-829"},"PeriodicalIF":2.2,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140890593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of four D-dimer assays in the context of venous thromboembolism in the emergency department 比较急诊科静脉血栓栓塞四种 D-二聚体测定法。
IF 2.2 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-05-08 DOI: 10.1111/ijlh.14302
Fabio Del Ben, Elisabetta Fontanini, Gabriella Azzarini, Marina Arini, Christian Marini, Giovanni Poli, Paola Pradella, Serena Parusso, Liliana Santarossa, Federica Targa, Lorena Zardo, Roberta Giacomello, Benedetto Morelli

Introduction

This observational study conducted across seven emergency care units compares the efficacy of four D-dimer detection methods, namely HemosIL D-dimer HS (HS), HemosIL D-dimer HS-500 (HS-500), VIDAS D-dimer (VIDAS), and HemosIL AcuStar D-dimer (ACUSTAR). The primary focus is on patients with a clinical suspicion of deep venous thrombosis (DVT) or pulmonary embolism (PE).

Methods

A total of 149 samples were collected from patients with suspected DVT or PE. The confirmation of DVT/PE was based on calf ultrasound or computed tomography-Angiography. Direct comparisons were made between the different detection methods, considering both their analytical performance and clinical utility. Additionally, the impact of an age-adjusted cut-off on the diagnostic accuracy of each method was assessed.

Results

The results revealed comparable negative predictive value, sensitivity, and specificity across the methods, with a notable exception of increased specificity for HS compared with HS-500 (50.8% vs. 41.5%, p = 0.03). Further analysis incorporating an age-adjusted cut-off demonstrated a significant improvement in specificity for HS. When using the age-adjusted cut-off, HS exhibited a substantial increase in specificity compared with HS-500 (63.1% vs. 49.2%, p = 0.004) and demonstrated significantly higher specificity compared with VIDAS (63.1% vs. 53.8%, p = 0.04).

Conclusion

The study emphasizes the nonuniversal effect of an age-adjusted cut-off and discusses the potential necessity for different cut-off values, particularly in the case of HS-500. These findings contribute to the understanding of D-dimer detection methods in the context of DVT and PE, providing insights into their relative performances and the potential optimization through age-adjusted cut-offs.

简介:这项观察性研究在七家急诊室进行,比较了四种 D-二聚体检测方法的疗效:这项观察性研究在七个急诊科进行,比较了四种D-二聚体检测方法的效果,即HemosIL D-dimer HS(HS)、HemosIL D-dimer HS-500(HS-500)、VIDAS D-二聚体(VIDAS)和HemosIL AcuStar D-二聚体(ACUSTAR)。主要针对临床怀疑深静脉血栓(DVT)或肺栓塞(PE)的患者:方法:从疑似深静脉血栓或肺栓塞患者身上共采集了 149 份样本。方法:从疑似深静脉血栓(DVT)或肺栓塞(PE)患者身上共采集了 149 份样本,通过小腿超声波或计算机断层扫描--血管造影术确认深静脉血栓/肺栓塞。考虑到不同检测方法的分析性能和临床实用性,对其进行了直接比较。此外,还评估了年龄调整截断点对每种方法诊断准确性的影响:结果:结果显示各种方法的阴性预测值、灵敏度和特异性相当,但HS的特异性明显高于HS-500(50.8% vs. 41.5%,p = 0.03)。采用年龄调整截断值进行的进一步分析表明,HS 的特异性显著提高。与 HS-500 相比,使用年龄调整临界值时,HS 的特异性大幅提高(63.1% vs. 49.2%,p = 0.004),与 VIDAS 相比,HS 的特异性显著提高(63.1% vs. 53.8%,p = 0.04):该研究强调了年龄调整截断值的非普遍效应,并讨论了不同截断值的潜在必要性,尤其是在 HS-500 的情况下。这些研究结果有助于人们了解 D-二聚体检测方法在深静脉血栓形成和 PE 中的应用,有助于深入了解这些方法的相对性能以及通过年龄调整临界值进行优化的可能性。
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引用次数: 0
Analysis of flow cytometry data from ultrasound-guided lymph node biopsies with two types of needles 使用两种针头对超声引导下的淋巴结活检进行流式细胞术数据分析。
IF 2.2 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-05-07 DOI: 10.1111/ijlh.14306
Xin Jin, Huifang Jiang, Yuxia Jiang, Zhilu Chen, Wenfei Zhou, Qing Pan, Shuyuan Tian

Background

In this study, we combined two techniques, ultrasound-guided needle biopsy and flow cytometry (FCM), to explore their value in patients with enlarged lymph nodes.

Methods

We compared the results of 198 needle biopsies on FCM and pathology. Forty-two were done by (fine needle aspiration, FNA), and the remaining 156 with (core needle biopsy, CNB), in 36 of 156 patients, a FNA was performed in the same lymph node after completion of the CNB. Except for five types of pathological entities, the rest were differentiated only detected or undetected tumours as the outcome distinction.

Results

Among the 198 needle biopsies, 13 were inadequate specimens, while the remaining 185 had pathological findings, including 47 benign and 138 neoplastic findings. Thirty-six patients underwent puncture with both FNA and CNB, both needles produced identical results by FCM, but more cells were obtained by FNA. Among the pathologically positive results, there were 23 missed diagnoses in FCM, in contrast, evidence of tumours was observed in the FCM images of 15 needle biopsies that reported benign or findings that were inconsistent with pathology, and the final diagnosis was consistent with the FCM in 10 cases. FCM detected haematolymphoid tumours with a sensitivity of 87.8% and a specificity of 91.9%.

Conclusion

The combination of FCM and ultrasound-guided lymph node needle biopsy can quickly provide guidance for clinical decision-making. We recommend that all lymph node needle biopsies be sent for FCM, the specimen can be obtained by the last puncture with FNA.

背景:在这项研究中,我们将超声引导针刺活检和流式细胞术(FCM)这两种技术结合起来,探讨它们在淋巴结肿大患者中的价值:在这项研究中,我们将超声引导下针穿活检和流式细胞术(FCM)这两种技术结合起来,探讨它们在淋巴结肿大患者中的应用价值:我们比较了 198 例针活检的 FCM 和病理结果。在 156 例患者中,有 36 例在完成 CNB 后在同一淋巴结进行了 FNA。除五种病理实体外,其余仅以检测到或未检测到肿瘤作为结果区分:结果:在 198 例针穿活检中,13 例标本不足,其余 185 例均有病理结果,包括 47 例良性肿瘤和 138 例肿瘤。36 名患者同时接受了 FNA 和 CNB 穿刺,两种穿刺针的 FCM 结果相同,但 FNA 获得的细胞更多。在病理阳性结果中,有 23 例在 FCM 中漏诊,相反,在 15 例报告为良性或与病理结果不一致的针刺活检的 FCM 图像中观察到了肿瘤的证据,有 10 例的最终诊断与 FCM 一致。FCM 检测血淋巴肿瘤的灵敏度为 87.8%,特异度为 91.9%:结论:结合 FCM 和超声引导下淋巴结穿刺活检可快速为临床决策提供指导。我们建议将所有淋巴结穿刺活检送去进行 FCM,标本可通过 FNA 最后一次穿刺获得。
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引用次数: 0
Pseudo-NRBC in the Mindray BC-6800Plus analyzer: A clue for diagnostic anticipation of fungemia. Experimental and preliminary clinical reports Mindray BC-6800Plus 分析仪中的假性红细胞:真菌血症诊断预测的线索。实验和初步临床报告。
IF 2.2 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-05-06 DOI: 10.1111/ijlh.14303
Xiaohe Zheng, Antonio La Gioia, Fabiana Fiorini, Dong Wang, Shihong Zhang, Miriam Marsano, Carmine Nicastro, Maurizio Fumi, Jinzhu Luo

Introduction

Candidemia can be a significant cause of death in immunosuppressed or debilitated patients particularly. Abnormalities of the instrumental cytograms of some hematological analyzers, such as Mindray BC-6800Plus, can be related to circulating Candida. We studied the possible diagnostic usefulness of this information.

Methods

A fungal bloodstream infection has been simulated by adding aliquots of Candida albicans, Candida parapsilosis, and Candida glabrata to 75 leftovers and anonymized peripheral blood samples. Cytographic abnormalities like those of experimental samples were used to select patients with possible fungemia. The microscopic review of peripheral blood smears constituted the confirmatory method.

Results

In all experimental samples, the various Candida types caused pseudo-NRBC and morphological abnormalities of WNB and DIFF cytograms. Circulating blastospores, free or engulfed by neutrophils, were the microscopic findings in the peripheral blood smears.

In the clinical verification, 72 patients were recruited based on the presence of an evocative cluster in the WNB and DIFF cytograms. The microscopic review of 39 out of 72 samples was positive for NRBC. According to blood cultures, light microscopy revealed fungal forms of several Candida or non-Candida types in the remaining 33 samples. Nine of these cases were not yet known to suffer from bloodstream infection.

Conclusions

Although further confirmatory clinical studies are required for these diagnostic abilities, the BC 6800Plus cytographic abnormalities related to fungemia have proven helpful in rapidly monitoring persistent fungemia in already diagnosed patients. In unknown or undiagnosed cases, they could be the trigger point for the subsequent diagnostic-therapeutic pathway.

导言念珠菌血症是导致免疫抑制或衰弱患者死亡的重要原因之一。一些血液分析仪(如 Mindray BC-6800Plus)的仪器细胞图异常可能与循环念珠菌有关。我们研究了这一信息在诊断中可能起到的作用:方法:通过在 75 份剩血和匿名外周血样本中加入白色念珠菌、副丝状念珠菌和光滑念珠菌的等分,模拟真菌血流感染。细胞学异常与实验样本的细胞学异常类似,用于筛选可能患有真菌血症的患者。外周血涂片的显微镜检查是确诊方法:结果:在所有实验样本中,各种类型的念珠菌都会导致假性红细胞以及 WNB 和 DIFF 细胞图的形态异常。外周血涂片的显微镜下发现了游离或被中性粒细胞吞噬的循环囊孢子。在临床验证中,72 名患者是根据 WNB 和 DIFF 细胞图中出现的诱发团块而被招募的。在 72 份样本中,39 份样本的显微镜检查结果为 NRBC 阳性。根据血液培养结果,光镜下发现其余 33 份样本中存在多种念珠菌或非念珠菌类型的真菌。这些病例中有 9 例尚不知道是否患有血流感染:尽管这些诊断能力还需要进一步的临床确证研究,但 BC 6800Plus 与真菌血症有关的细胞学异常已被证明有助于快速监测已确诊患者的持续真菌血症。在未知或未确诊的病例中,它们可能会成为后续诊断-治疗途径的触发点。
{"title":"Pseudo-NRBC in the Mindray BC-6800Plus analyzer: A clue for diagnostic anticipation of fungemia. Experimental and preliminary clinical reports","authors":"Xiaohe Zheng,&nbsp;Antonio La Gioia,&nbsp;Fabiana Fiorini,&nbsp;Dong Wang,&nbsp;Shihong Zhang,&nbsp;Miriam Marsano,&nbsp;Carmine Nicastro,&nbsp;Maurizio Fumi,&nbsp;Jinzhu Luo","doi":"10.1111/ijlh.14303","DOIUrl":"10.1111/ijlh.14303","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Candidemia can be a significant cause of death in immunosuppressed or debilitated patients particularly. Abnormalities of the instrumental cytograms of some hematological analyzers, such as Mindray BC-6800Plus, can be related to circulating <i>Candida.</i> We studied the possible diagnostic usefulness of this information.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A fungal bloodstream infection has been simulated by adding aliquots of <i>Candida albicans</i>, <i>Candida parapsilosis</i>, and <i>Candida glabrata</i> to 75 leftovers and anonymized peripheral blood samples. Cytographic abnormalities like those of experimental samples were used to select patients with possible fungemia. The microscopic review of peripheral blood smears constituted the confirmatory method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In all experimental samples, the various <i>Candida</i> types caused pseudo-NRBC and morphological abnormalities of WNB and DIFF cytograms. Circulating blastospores, free or engulfed by neutrophils, were the microscopic findings in the peripheral blood smears.</p>\u0000 \u0000 <p>In the clinical verification, 72 patients were recruited based on the presence of an evocative cluster in the WNB and DIFF cytograms. The microscopic review of 39 out of 72 samples was positive for NRBC. According to blood cultures, light microscopy revealed fungal forms of several <i>Candida</i> or non-<i>Candida</i> types in the remaining 33 samples. Nine of these cases were not yet known to suffer from bloodstream infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although further confirmatory clinical studies are required for these diagnostic abilities, the BC 6800Plus cytographic abnormalities related to fungemia have proven helpful in rapidly monitoring persistent fungemia in already diagnosed patients. In unknown or undiagnosed cases, they could be the trigger point for the subsequent diagnostic-therapeutic pathway.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"46 5","pages":"830-836"},"PeriodicalIF":2.2,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Peripheral blood quantitation of CD26 positive leukemic stem cells as a predictor of tyrosine kinase inhibitor response in chronic myeloid leukemia 外周血定量检测 CD26 阳性白血病干细胞,预测慢性髓性白血病患者对酪氨酸激酶抑制剂的反应。
IF 2.2 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-05-06 DOI: 10.1111/ijlh.14301
Nitin Chaudhary, Khaliqur Rahman, Prakhar Gupta, Ruchi Gupta, Manoj K. Sarkar, Manish K. Singh, Dinesh Chandra, Sanjeev Kumar, Rajesh Kashyap

Introduction

Leukemic stem cells (LSCs) are the transcriptionally low/silent cells which are resistant to the tyrosine kinase inhibitor. These have been found to play a pivotal role in disease relapse in chronic myeloid leukemia (CML) cases. The present study evaluated the correlation of absolute CML-LSC count in the peripheral blood (PB) at diagnosis and achievement of major molecular response (MMR) at 12 months in patients of CML-CP.

Methods

This was a prospective, observational, non-interventional single center study including newly diagnosed adult (>18 yrs) CML-CP patients. Absolute CD26 + CML-LSC quantification was done by multiparametric flow cytometry. Patients were treated with Imatinib treatment and subsequently monitored at 3-month intervals for BCR::ABL transcript levels. MMR was defined as a BCR::ABL1 transcript level of less than 0.1% on international scale.

Results

A total of 89 patients were enrolled in the study out of which 40.5% achieved MMR at 12 months. There was a significant difference in the median absolute CML-LSC count of the patients who achieved MMR at 12 months as compared to those who did not (58.5 vs 368.1 cells/μL; p value <0.001). Using a ROC analysis, a count of <165.69 CML LSC/μL was identified to have a sensitivity of 83.8% and specificity of 72.4%, in predicting the MMR at 12 months.

Conclusion

Absolute CML-LSC count at diagnosis in the PB predicts the MMR achievement at 12 months. An absolute count of less than 165 cells/μL is highly predictive of achieving MMR at 12 months.

导言白血病干细胞(LSCs)是一种对酪氨酸激酶抑制剂具有抗性的低转录/沉默细胞。研究发现,白血病干细胞在慢性髓性白血病(CML)复发中起着关键作用。本研究评估了CML-CP患者诊断时外周血(PB)中CML-LSC绝对计数与12个月后主要分子反应(MMR)的相关性:这是一项前瞻性、观察性、非干预性单中心研究,研究对象包括新诊断的成年(18 岁以上)CML-CP 患者。采用多参数流式细胞术对CD26 + CML-LSC进行绝对定量。患者接受伊马替尼治疗,随后每隔 3 个月监测一次 BCR::ABL 转录物水平。MMR的定义是BCR::ABL1转录本水平低于国际评分标准的0.1%:共有89名患者参与了研究,其中40.5%的患者在12个月时达到了MMR。12个月时达到MMR的患者与未达到MMR的患者相比,CML-LSC绝对计数的中位数存在明显差异(58.5 vs 368.1 cells/μL;P值 结论:研究结果显示,在12个月时达到MMR的患者与未达到MMR的患者相比,CML-LSC绝对计数的中位数存在明显差异:PB 中诊断时的 CML-LSC 绝对计数可预测 12 个月后 MMR 的达标情况。绝对计数低于 165 cells/μL 对 12 个月后实现 MMR 有很高的预测性。
{"title":"Peripheral blood quantitation of CD26 positive leukemic stem cells as a predictor of tyrosine kinase inhibitor response in chronic myeloid leukemia","authors":"Nitin Chaudhary,&nbsp;Khaliqur Rahman,&nbsp;Prakhar Gupta,&nbsp;Ruchi Gupta,&nbsp;Manoj K. Sarkar,&nbsp;Manish K. Singh,&nbsp;Dinesh Chandra,&nbsp;Sanjeev Kumar,&nbsp;Rajesh Kashyap","doi":"10.1111/ijlh.14301","DOIUrl":"10.1111/ijlh.14301","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Leukemic stem cells (LSCs) are the transcriptionally low/silent cells which are resistant to the tyrosine kinase inhibitor. These have been found to play a pivotal role in disease relapse in chronic myeloid leukemia (CML) cases. The present study evaluated the correlation of absolute CML-LSC count in the peripheral blood (PB) at diagnosis and achievement of major molecular response (MMR) at 12 months in patients of CML-CP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a prospective, observational, non-interventional single center study including newly diagnosed adult (&gt;18 yrs) CML-CP patients. Absolute CD26 + CML-LSC quantification was done by multiparametric flow cytometry. Patients were treated with Imatinib treatment and subsequently monitored at 3-month intervals for BCR::ABL transcript levels. MMR was defined as a BCR::ABL1 transcript level of less than 0.1% on international scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 89 patients were enrolled in the study out of which 40.5% achieved MMR at 12 months. There was a significant difference in the median absolute CML-LSC count of the patients who achieved MMR at 12 months as compared to those who did not (58.5 vs 368.1 cells/μL; <i>p</i> value &lt;0.001). Using a ROC analysis, a count of &lt;165.69 CML LSC/μL was identified to have a sensitivity of 83.8% and specificity of 72.4%, in predicting the MMR at 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Absolute CML-LSC count at diagnosis in the PB predicts the MMR achievement at 12 months. An absolute count of less than 165 cells/μL is highly predictive of achieving MMR at 12 months.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"46 5","pages":"862-868"},"PeriodicalIF":2.2,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140875112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Differentiation syndrome in acute promyelocytic leukemia: A leopard cannot change its spots 急性早幼粒细胞白血病分化综合征:豹不换斑。
IF 2.2 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-05-06 DOI: 10.1111/ijlh.14304
Giulia Schiavini, Sabine Blum, Gerasimos Tsilimidos

Auer rods were first observed in 1903 by John Auer at John Hopkins Hospital. Since then, these rod or needle shaped azurophilic cytoplasmic inclusions, became the hallmark of acute promyelocytic leukemia (APL). They derive from the crystallization of myeloperoxidase (MPO) granules and in acute promyelocytic leukemia they can be organized in bundles, called faggot cells. Their presence in other myeloid leukemia is correlated with more differentiated blasts.1

The PML-RARA fusion oncoprotein, found in APL leukemia, is responsible for the accumulation of promyelocytes, by blocking cell differentiation. Arsenic trioxyde (ATO) and all-trans retinoic (ATRA) revolutionized the treatment and prognosis of APL, by triggering cell differentiation from promyelocytes to mature granulocytes.

Auer rods can also be identified in promyelocytes undergoing differentiation and can last until the latest stage of maturation, the neutrophils. This characteristic is specific of APL blasts.2 In fact, Auer rods can be found in blasts of other AML as well as in MDS, where immature cells are targeted by chemotherapies but do not undergo differentiation. In this setting the persistence of blasts with Auer rods post treatment correlates with a poor prognostic value. Nevertheless, only in the case of differentiation syndrome in APL we might detect maturing cells promyelocyte-derived, containing Auer rods. This is not a sign of not response to treatment and does not require a deviation from the ATO-ATRA induction protocol. Clinicians and hematopathologists should keep this in mind in order not to misinterpret the images and continue with the treatment.

A 40-year-old woman, presented with pancytopenia and was diagnosed of APL. Bone marrow showed a massive infiltration of promyelocytes with Auer rods. The PML-RARA gene fusion confirmed the diagnosis and ATRA-ATO induction therapy was started. She developed a differentiation syndrome starting from day 12 after the beginning of ATRA and ATO, with immature cells in peripheral blood. The peripheral blood smear showed different stages of cells on differentiation, such as myelocytes (Figure 1A–D), metamyelocyte (Figure 1C), and neutrophils (Figure 1B), containing Auer rods. These immature circulating forms derive from the maturation of leukemic promyelocytes, having lost their ability to replicate, but still presenting some morphological characteristics of blasts, such as Auer rods.3

The authors declare no conflicts of interest.

Informed consent has been obtained from the patient.

1903 年,约翰-奥尔(John Auer)在约翰-霍普金斯医院首次观察到奥尔棒状细胞。从那时起,这些棒状或针状的嗜氮细胞质包涵体就成为急性早幼粒细胞白血病(APL)的标志。这些内含物来自髓过氧化物酶(MPO)颗粒的结晶,在急性早幼粒细胞白血病中,这些内含物可以组织成束,被称为 "绒毛细胞"。1 在 APL 白血病中发现的 PML-RARA 融合肿瘤蛋白会阻碍细胞分化,从而导致早幼粒细胞聚集。三氧化二砷(ATO)和全反式维甲酸(ATRA)可促使细胞从原核细胞分化为成熟的粒细胞,从而彻底改变了 APL 的治疗和预后。2 事实上,在其他急性髓细胞性白血病(AML)和骨髓增生性白血病(MDS)的囊泡中也能发现 Auer 棒,在这些疾病中,化疗药物会靶向未成熟细胞,但这些细胞不会发生分化。在这种情况下,治疗后持续存在带有 Auer 杆状病毒的囊泡与预后不良有关。不过,只有在 APL 出现分化综合征的情况下,我们才有可能检测到含有 Auer 棒的成熟前骨髓细胞衍生细胞。这并不是对治疗无反应的迹象,也不需要偏离 ATO-ATRA 诱导方案。临床医生和血液病理学家应牢记这一点,以免误读图像并继续治疗。一名 40 岁的女性患者出现全血细胞减少,被诊断为 APL。骨髓显示大量原骨髓细胞浸润,并伴有奥氏杆。PML-RARA基因融合确诊后,开始了ATRA-ATO诱导治疗。从开始使用 ATRA 和 ATO 的第 12 天起,她出现了分化综合征,外周血中出现未成熟细胞。外周血涂片显示了不同分化阶段的细胞,如骨髓细胞(图 1A-D)、偏骨髓细胞(图 1C)和中性粒细胞(图 1B),其中含有 Auer 棒。这些未成熟的循环形式来源于白血病原骨髓细胞的成熟,它们已经失去了复制能力,但仍呈现出一些囊泡的形态特征,如 Auer 棒。
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引用次数: 0
Stable measurement of chemistry, immunochemistry, and hematology analytes in a heparin-based anticoagulant with iloprost additive: A promising candidate for the polyvalent blood collection tube 在以肝素为基础、添加伊洛前列素的抗凝剂中稳定测量化学、免疫化学和血液学分析物:多价采血管的理想候选产品
IF 2.2 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-05-02 DOI: 10.1111/ijlh.14291
Elias Frost Wiwe, Laura Emilie Schmidt, Emilie Zeuthen, Ida Maria Storm Engelstoft, Buris Brinch Christiansen, Thomas Steen Hansen, Melanie A. Burkhardt, Claus Antonio Juel Jensen

Introduction

A polyvalent blood collection tube could potentially reduce the number and volume of blood samples drawn from patients and reduce the risk of tube mix-ups in a point-of-care setting in the emergency department and the intensive care unit.

Methods

Four different concentrations of our experimental heparin anticoagulant with iloprost additive (HEP-ILOP 50 nM, 150 nM, 1000 nM, and 10 μM, respectively) were tested for significant differences and bias performance specifications against EDTA for 29 hematology analytes, and the highest concentration (HEP-ILOP 10 μM) against lithium heparin for 14 chemistry and immunochemistry analytes. Samples were drawn from 79 consenting subjects from the Oncology Department (n = 38) and the Intensive and Intermediary Care Unit (n = 41).

Results

For hematology analytes, the HEP-ILOP formulation generally provided stable measurement within optimal requirements within 5 h after sampling (mean 104 ± 56 min), with very little difference between the four HEP-ILOP concentrations. Because of differences in platelet and red blood cell swelling between EDTA and HEP-ILOP, all size-dependent analytes required proportional factorization to produce similar results. Platelet count by impedance similarly required factorization, whereas the fluorescent method provided results identical with EDTA. Chemistry and immunochemistry analytes were within optimal requirements except for potassium, lactate dehydrogenase, and glucose, indicating a cytoprotective effect of iloprost reducing cell metabolism and rupture, thereby producing results closer to in vivo conditions.

Conclusions

Our novel dry-sprayed anticoagulant formulation, HEP-ILOP, is a promising candidate for a polyvalent blood collection tube, enabling the analysis of hematology, chemistry, and immunochemistry analytes in the same tube.

导言多价采血管有可能减少从患者身上抽取血液样本的数量和体积,并降低急诊科和重症监护室护理点环境中混管的风险。方法针对 29 种血液学分析物,测试了我们试验性肝素抗凝剂与伊洛前列素添加剂的四种不同浓度(HEP-ILOP 分别为 50 nM、150 nM、1000 nM 和 10 μM)与 EDTA 的显著差异和偏差性能指标;针对 14 种化学和免疫化学分析物,测试了最高浓度(HEP-ILOP 10 μM)与肝素锂的显著差异和偏差性能指标。结果对于血液学分析物,HEP-ILOP 配方通常在取样后 5 小时内(平均 104 ± 56 分钟)提供稳定的测量,符合最佳要求,四种 HEP-ILOP 浓度之间的差异很小。由于 EDTA 和 HEP-ILOP 在血小板和红细胞膨胀方面的差异,所有依赖于大小的分析物都需要进行比例因式分解才能得出相似的结果。通过阻抗法进行的血小板计数同样需要因式分解,而荧光法得出的结果与 EDTA 相同。除了钾、乳酸脱氢酶和葡萄糖之外,化学和免疫化学分析物都在最佳要求范围内,这表明伊洛前列素具有细胞保护作用,可减少细胞代谢和破裂,从而产生更接近体内条件的结果。结论我们的新型干喷抗凝剂配方 HEP-ILOP 是一种很有前途的多价采血管候选产品,可在同一采血管中分析血液学、化学和免疫化学分析物。
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引用次数: 0
Erythrocytosis: Diagnosis and investigation 红细胞增多症诊断和调查
IF 3 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-05-02 DOI: 10.1111/ijlh.14298
Iman Noumani, Claire N. Harrison, Mary Frances McMullin

An absolute erythrocytosis is present when the red cell mass is greater than 125% of the predicted. This is suspected when the hemoglobin or hematocrit is above the normal range. An erythrocytosis can be classified as primary or secondary and congenital or acquired. The commonest primary acquired disorder is polycythemia vera. The diagnostic criteria for PV have evolved over time and this is the main diagnosis managed in hematology clinics. There are a variety of rare congenital causes both primary and secondary. In particular in young patients and/or those with a family history a congenital cause is suspected. There remains a larger cohort with acquired erythrocytosis mainly with non-hematological pathology. In order to explore for a cause of erythrocytosis, measurement of the erythropoietin level is a first step. A low erythropoietin level indicates a primary cause and a normal or elevated level indicates a secondary etiology. Further investigation is then dictated by initial findings and includes mutational testing with PCR and NGS for those in whom a congenital cause is suspected. Following this possibly bone marrow biopsy, scans, and further investigation as indicated by history and initial findings. Investigation is directed toward the identification of those with a hematological disorder which would be best managed following guidelines in hematology clinics and referral elsewhere in those for whom there are non-hematological reasons for the elevated hemoglobin.

当红细胞质量超过预测值的 125% 时,就会出现绝对红细胞增多症。当血红蛋白或血细胞比容高于正常范围时,就有可能是绝对红细胞增多症。红细胞增多症可分为原发性和继发性,先天性和后天性。最常见的原发性后天性疾病是红细胞增多症。随着时间的推移,红细胞增多症的诊断标准也在不断演变,这也是血液病诊所的主要诊断方法。有多种罕见的先天性原因,包括原发性和继发性。尤其是年轻患者和/或有家族史的患者,更应怀疑其先天性病因。后天性红细胞增多症的患者人数较多,主要与非血液病病理有关。为了寻找红细胞增多症的病因,首先要测量促红细胞生成素水平。红细胞生成素水平过低说明是原发性病因,水平正常或升高说明是继发性病因。然后根据初步结果进行进一步检查,包括对怀疑是先天性原因的患者进行 PCR 和 NGS 基因突变检测。之后可能进行骨髓活检、扫描,并根据病史和初步检查结果进行进一步检查。检查的目的是确定哪些患者患有血液病,最好按照血液病诊所的指导原则进行治疗,哪些患者的血红蛋白升高不是由血液病引起的,则应转诊到其他医院。
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引用次数: 0
Improving platelet function following prophylactic platelet transfusion in patients with hematological malignancies 改善血液恶性肿瘤患者预防性血小板输注后的血小板功能
IF 2.2 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-04-29 DOI: 10.1111/ijlh.14283
Yi-Feng Wu, Chih-Lung Shen, Wei-Han Huang, Sung-Chao Chu, Chi-Cheng Li, Chao-Zong Liu, Tso-Fu Wang

Introduction

Platelet transfusion is a standard treatment to prevent bleeding in patients with hematological malignancies. Although transfusions can improve platelet count, their impact on platelet function remains controversial.

Methods

We conducted flow cytometry to assess platelet function before and after transfusion and performed subgroup analyses to examine differences based on blood type, corrected count increment (CCI), and platelet microparticles.

Results

Overall, 50 patients who received prophylactic platelet transfusion were enrolled. CD42b expression increased, whereas CD41 expression decreased after transfusion. Apheresis platelets exhibited the lowest expression of PAC-1 and P-selectin when exposed to agonist stimulations. PAC-1 expression increased under high adenosine diphosphate (ADP) stimulation, while P-selectin expression increased under both high ADP and thrombin receptor-activating peptide stimulation. In the subgroup analysis, patients with a CCI >4500 and those with the same blood types exhibited a more significant increase in PAC-1 and P-selectin expression under agonist stimulation. When comparing apheresis platelets collected on different days, only the percentage of platelet-derived microparticles showed a significant increase.

Conclusion

Prophylactic transfusion improved platelet function. Platelet function significantly improved in patients with a CCI >4500, those with the same blood types as that of apheresis platelets, or those with platelet-derived microparticle levels <4.7%. No significant improvement in platelet function was noted after the transfusion of different blood types with acceptable compatibility or the transfusion of incompatible blood types. Our results suggest that transfusing platelets with the same blood type remains the optimal choice.

导言输注血小板是预防血液恶性肿瘤患者出血的标准治疗方法。方法 我们采用流式细胞术评估输血前后的血小板功能,并根据血型、校正计数增量(CCI)和血小板微颗粒进行亚组分析,以研究其差异。结果 共纳入 50 名接受预防性血小板输注的患者。输血后 CD42b 表达增加,而 CD41 表达减少。在激动剂刺激下,分离血小板的 PAC-1 和 P-选择素表达量最低。在高二磷酸腺苷(ADP)刺激下,PAC-1的表达增加,而在高ADP和凝血酶受体活化肽刺激下,P-选择素的表达增加。在亚组分析中,CCI>4500 和血型相同的患者在激动剂刺激下,PAC-1 和 P-选择素表达量的增加更为显著。在比较不同天收集的无创血小板时,只有血小板衍生微粒的百分比出现了显著增加。CCI>4500、血型与无细胞血小板相同或血小板衍生微粒水平<4.7%的患者血小板功能明显改善。在输注相容性可接受的不同血型或输注不相容血型后,血小板功能均无明显改善。我们的研究结果表明,输注相同血型的血小板仍是最佳选择。
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引用次数: 0
DNA methyltransferases-associated long non-coding RNA PRKCQ-AS1 regulate DNA methylation in myelodysplastic syndrome DNA 甲基转移酶相关长非编码 RNA PRKCQ-AS1 在骨髓增生异常综合征中调控 DNA 甲基化
IF 2.2 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-04-28 DOI: 10.1111/ijlh.14297
Jian Wen, Yongbin Wu, Quanfang Luo

Introduction

Myelodysplastic syndrome (MDS) is a group of clonal hematopoietic stem cell disorders. DNA hypermethylation is considered to be the key mechanism of pathogenesis for MDS. Studies have demonstrated that DNA methylation can be regulated by the co-effect between long non-coding RNAs (lncRNAs) and DNA methyltransferases (DNMTs). The aim of this study was to identify DNMTs-associated differentially expressed (DE) lncRNAs, which may be a novel diagnostic and therapeutic target for MDS.

Methods

Two gene expression profile datasets (GSE4619 and GSE19429) were downloaded from the Gene Expression Omnibus (GEO) database. Systematic bioinformatics analysis was conducted. Then we verified the expression of PRKCQ-AS1 in MDS patients and features in SKM-1 cells.

Results

Bioinformatics analysis revealed that the DNMT-associated DE-lncRNA PRKCQ-AS1 was functionally related to DNA methylation. The target genes of PRKCQ-AS1 associated with DNA methylation are mainly methionine synthetase (MTR) and ten-eleven-translocation 1 (TET1). Moreover, the high expression of PRKCQ-AS1 was verified in real MDS cases. Further cellular analysis in SKM-1 cells revealed that overexpressed PRKCQ-AS1 promoted methylation levels of long interspersed nuclear element 1 (LINE-1) and cell proliferation, and apparently elevated both mRNA and protein levels of MTR and TET1, while knockdown of PRKCQ-AS1 showed opposite trend in SKM-1 cells.

Conclusion

DNMT-associated DE-lncRNA PRKCQ-AS1 may affects DNA methylation levels by regulating MTR and TET1.

导言骨髓增生异常综合征(MDS)是一组克隆性造血干细胞疾病。DNA甲基化过高被认为是MDS发病的关键机制。研究表明,DNA甲基化可受长非编码RNA(lncRNAs)和DNA甲基转移酶(DNMTs)的共同作用调控。本研究的目的是鉴定与DNMTs相关的差异表达(DE)lncRNAs,这些lncRNAs可能是MDS的新型诊断和治疗靶点。我们进行了系统的生物信息学分析。结果生物信息学分析表明,DNMT相关DE-lncRNA PRKCQ-AS1在功能上与DNA甲基化有关。PRKCQ-AS1与DNA甲基化相关的靶基因主要是蛋氨酸合成酶(MTR)和十七转位1(TET1)。此外,PRKCQ-AS1的高表达也在真实的MDS病例中得到了验证。在SKM-1细胞中的进一步细胞分析表明,过表达的PRKCQ-AS1促进了长间隔核元素1(LINE-1)的甲基化水平和细胞增殖,并明显升高了MTR和TET1的mRNA和蛋白水平,而敲除PRKCQ-AS1在SKM-1细胞中显示出相反的趋势。
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引用次数: 0
期刊
International Journal of Laboratory Hematology
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