BACKGROUND: Acute myeloid leukemia (AML) is a heterogeneous malignant disease of hematopoietic tissue. It is characterized by accumulation of abnormal blast cells mainly in bone marrow. Hepcidin is a small bioactive peptide hormone produced in many tissues mainly by the liver, macrophage, and adipocyte and it has been proposed as a marker of inflammation. The aims of study were to assess the changes in serum levels of hepcidin, interleukin-6, and ferritin in addition to iron-binding capacity levels in patients with AML before and after chemotherapy treatment and to compare their levels to healthy controls. MATERIALS AND METHODS: This study includes 43 AML patients (24 males and 19 females). They were divided into two groups: Group 1: Patients with AML before starting chemotherapy and Group 2: after chemotherapy. The protocol used was (3 + 7) where doxorubicin was given from day 1 to day 3 and Cytarabine (Ara-C) was given from day 1 to day 7 then evaluation is done on 28th day to evaluate response of patients. The control group (Group 3) included 43 healthy controls (24 males and 19 females) who were matched with patients group in gender and age. RESULTS: Serum samples were investigated before and after treatment and compared with its corresponding data of healthy control group and then statistically analyzed. Results revealed that: the prevalence of AML was higher in males than in females. Hepcidin levels were significantly higher in serum of (AML) patients (Group 2) compared to newly diagnosed (Group 1) and to healthy controls (P < 0.0001). Serum (interleukin-6) levels were higher but not statistically significant in (Group 1) when compared to (Group 2) while it was statistically significantly when compared to healthy controls (P < 0.214 and P < 0.0001, respectively). Regarding serum levels of ferritin and total iron capacity (TIBC) predicted highly significant increase for all patients when compared to controls. CONCLUSION: Hepcidin and interleukin-6 may be used as diagnostic criteria for treatment response of AML and also can utilized as biomarkers for the progression of the AML.
{"title":"Serum hepcidin levels related to interlukin-6 in patients with acute myeloid leukemia before and after treatment","authors":"K. Ali, Hiba Mohammad, A. Naji, A. Alwan","doi":"10.4103/ijh.ijh_16_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_16_22","url":null,"abstract":"BACKGROUND: Acute myeloid leukemia (AML) is a heterogeneous malignant disease of hematopoietic tissue. It is characterized by accumulation of abnormal blast cells mainly in bone marrow. Hepcidin is a small bioactive peptide hormone produced in many tissues mainly by the liver, macrophage, and adipocyte and it has been proposed as a marker of inflammation. The aims of study were to assess the changes in serum levels of hepcidin, interleukin-6, and ferritin in addition to iron-binding capacity levels in patients with AML before and after chemotherapy treatment and to compare their levels to healthy controls. MATERIALS AND METHODS: This study includes 43 AML patients (24 males and 19 females). They were divided into two groups: Group 1: Patients with AML before starting chemotherapy and Group 2: after chemotherapy. The protocol used was (3 + 7) where doxorubicin was given from day 1 to day 3 and Cytarabine (Ara-C) was given from day 1 to day 7 then evaluation is done on 28th day to evaluate response of patients. The control group (Group 3) included 43 healthy controls (24 males and 19 females) who were matched with patients group in gender and age. RESULTS: Serum samples were investigated before and after treatment and compared with its corresponding data of healthy control group and then statistically analyzed. Results revealed that: the prevalence of AML was higher in males than in females. Hepcidin levels were significantly higher in serum of (AML) patients (Group 2) compared to newly diagnosed (Group 1) and to healthy controls (P < 0.0001). Serum (interleukin-6) levels were higher but not statistically significant in (Group 1) when compared to (Group 2) while it was statistically significantly when compared to healthy controls (P < 0.214 and P < 0.0001, respectively). Regarding serum levels of ferritin and total iron capacity (TIBC) predicted highly significant increase for all patients when compared to controls. CONCLUSION: Hepcidin and interleukin-6 may be used as diagnostic criteria for treatment response of AML and also can utilized as biomarkers for the progression of the AML.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"76 - 82"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49207021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Bakırtaş, T. Yiğenoğlu, S. Başcı, B. Ulu, S. Yaman, M. Çakar, M. Dal, F. Altuntaş
BACKGROUND: Febrile neutropenia (FN) is a serious problem, especially in hematologic malignancies, and can cause high mortality rates and it occurs in 10%–20% of patients with lymphoma. The aim of this research is to assess the risk factors for FN, and the impact of FN on overall survival (OS) in patients with diffuse large B-cell lymphoma (DLBCL). MATERIALS AND METHODS: The study included 263 patients who were diagnosed with DLBCL and treated with mostly R-CHOP-based chemotherapy. Data including gender, age, Ann Arbor stage, International Prognostic Index (IPI) score, immunohistologic subtype, treatment regimens, response to treatment, and any FN episode were recorded. The factors predicting FN were analyzed. RESULTS: Significant predictors of FN were the number of chemotherapy lines received and IPI score. The median OS was significantly different between DLBCL patients who had at least one FN episode during the first-line chemotherapy and those who did not (P < 0,001). Significant predictors of OS in the multivariate analysis were the number of chemotherapy lines received, stage, Eastern Cooperative Oncology Group, and disease status. CONCLUSION: Our study reveals that OS is significantly shorter in patients who had an FN episode than those who did not. Therefore, it is crucial to demonstrate all factors related to FN to prevent FN episodes. In our study, the number of chemotherapy lines received and IPI score was found to be significant predictors of FN. Close follow-up should be done in these patients as the risk of FN is higher.
{"title":"Febrile neutropenia risk factors in actively treated diffuse large B-cell lymphoma patients","authors":"M. Bakırtaş, T. Yiğenoğlu, S. Başcı, B. Ulu, S. Yaman, M. Çakar, M. Dal, F. Altuntaş","doi":"10.4103/ijh.ijh_37_21","DOIUrl":"https://doi.org/10.4103/ijh.ijh_37_21","url":null,"abstract":"BACKGROUND: Febrile neutropenia (FN) is a serious problem, especially in hematologic malignancies, and can cause high mortality rates and it occurs in 10%–20% of patients with lymphoma. The aim of this research is to assess the risk factors for FN, and the impact of FN on overall survival (OS) in patients with diffuse large B-cell lymphoma (DLBCL). MATERIALS AND METHODS: The study included 263 patients who were diagnosed with DLBCL and treated with mostly R-CHOP-based chemotherapy. Data including gender, age, Ann Arbor stage, International Prognostic Index (IPI) score, immunohistologic subtype, treatment regimens, response to treatment, and any FN episode were recorded. The factors predicting FN were analyzed. RESULTS: Significant predictors of FN were the number of chemotherapy lines received and IPI score. The median OS was significantly different between DLBCL patients who had at least one FN episode during the first-line chemotherapy and those who did not (P < 0,001). Significant predictors of OS in the multivariate analysis were the number of chemotherapy lines received, stage, Eastern Cooperative Oncology Group, and disease status. CONCLUSION: Our study reveals that OS is significantly shorter in patients who had an FN episode than those who did not. Therefore, it is crucial to demonstrate all factors related to FN to prevent FN episodes. In our study, the number of chemotherapy lines received and IPI score was found to be significant predictors of FN. Close follow-up should be done in these patients as the risk of FN is higher.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"7 - 12"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43046731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Phukan, Hena Kawsar, Jayashree Banerjee, Anuradha Sinha
BACKGROUND: Complete blood count and cell counter generated red blood cell (RBC) parameters help in morphological typing of anemia. Still the importance of microscopic examination of peripheral blood smears (PBSs) cannot be excluded to interpret the cause of anemia. AIMS AND OBJECTIVES: The present study was done to diagnose the type of anemia by examination of PBS and automated cell counter generated parameters and to compare the findings between these two methods. MATERIALS AND METHODS: During the 6-months study, 9981 anemic blood samples were evaluated. PBS findings and cell counter generated RBC parameters and histograms were evaluated and compared. RESULTS: Among 9941 samples, microcytic hypochromic anemia consists of the majority of cases (5048, 50.47%), followed by normocytic normochromic (2187, 21.97%), dimorphic (1297, 12.99%), and lastly, hemolytic anemia (722, 7.24%). Compared with RBC parameters and peripheral smear findings, dimorphic and hemolytic anemia showed significant difference (P < 0.0001). When compared with RBC histogram, 4747 (47.56%) cases showed left shift, 820 (8.21%) cases showed right shift, and 2278 (22.82%) cases showed normal bell-shaped curve suggesting microcytic, macrocytic, and normocytic normochromic anemia, respectively. 635 (6.90%) and 1447 (14.50%) number of cases showed bimodal and broad-base histogram suggesting dimorphic and hemolytic anemia, respectively. CONCLUSION: PBS examination along with RBC histogram study can be able to categorize the type of anemia in the majority of cases. Each method should be used as complementary to each other that increases diagnostic accuracy.
{"title":"A comparative study of anemia in peripheral blood smear and automated cell counter generated red cell parameters","authors":"J. Phukan, Hena Kawsar, Jayashree Banerjee, Anuradha Sinha","doi":"10.4103/ijh.ijh_3_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_3_22","url":null,"abstract":"BACKGROUND: Complete blood count and cell counter generated red blood cell (RBC) parameters help in morphological typing of anemia. Still the importance of microscopic examination of peripheral blood smears (PBSs) cannot be excluded to interpret the cause of anemia. AIMS AND OBJECTIVES: The present study was done to diagnose the type of anemia by examination of PBS and automated cell counter generated parameters and to compare the findings between these two methods. MATERIALS AND METHODS: During the 6-months study, 9981 anemic blood samples were evaluated. PBS findings and cell counter generated RBC parameters and histograms were evaluated and compared. RESULTS: Among 9941 samples, microcytic hypochromic anemia consists of the majority of cases (5048, 50.47%), followed by normocytic normochromic (2187, 21.97%), dimorphic (1297, 12.99%), and lastly, hemolytic anemia (722, 7.24%). Compared with RBC parameters and peripheral smear findings, dimorphic and hemolytic anemia showed significant difference (P < 0.0001). When compared with RBC histogram, 4747 (47.56%) cases showed left shift, 820 (8.21%) cases showed right shift, and 2278 (22.82%) cases showed normal bell-shaped curve suggesting microcytic, macrocytic, and normocytic normochromic anemia, respectively. 635 (6.90%) and 1447 (14.50%) number of cases showed bimodal and broad-base histogram suggesting dimorphic and hemolytic anemia, respectively. CONCLUSION: PBS examination along with RBC histogram study can be able to categorize the type of anemia in the majority of cases. Each method should be used as complementary to each other that increases diagnostic accuracy.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"51 - 55"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42198836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ihsan Al-Badran, Haithem A Al-Rubaie, Tamara Al-Assadi
BACKGROUND: Childhood acute lymphoblastic leukemia (ALL) is the most prevalent malignant disease (25%–30%) and the most common type of leukemia (75%–80%) among children. It is not a single disease with significant phenotypic and genotypic variability that has diagnostic and prognostic implications. This study aims to provide the immunophenotypic profile of childhood ALL in Iraqi patients and to explore the frequency of aberrant myeloid antigen expression and their association with hematological parameters. PATIENTS, MATERIALS AND METHODS: The records of 67 pediatric patients diagnosed as ALL were reviewed for their flow cytometric immunophenotyping results at presentation. RESULTS: B-ALL constituted 76.1% of the cases and 23.9% were T-ALL. There was a highly significant statistical relation between higher age interval and T-ALL phenotypes (P = 0.001). Higher hemoglobin (Hb) level and white blood cell count were significantly related with T-ALL subtype (P = 0.039 and < 0.001, respectively). CD34, HLA-DR, CD10, and CD79a were significantly correlated with B-ALL compared to T-ALL (P = 0.007, <0.001, <0.001, and <0.001, respectively). With no significant differences, aberrant myeloid antigen expression was found in 51% of B-ALL and in 25% of T-ALL cases; however, CD34 expression was substantially related with aberrant myeloid antigen expression (P = 0.001). CONCLUSION: Aberrant myeloid antigens were expressed in 44.9% of ALL patients with insignificant differences between B- and T-ALL phenotypes. CD34 was significantly associated with B-lineage ALL and with aberrant myeloid antigen expression. T-ALL children are older and have significantly higher Hb concentration and white blood cell count. No correlation was found between aberrant myeloid expression and hematological parameters in B-ALL.
{"title":"Childhood acute lymphoblastic leukemia: Immunophenotypic profile and aberrant expression of CD13, CD33, CD117, CD11b, CD16, and CD64","authors":"Ihsan Al-Badran, Haithem A Al-Rubaie, Tamara Al-Assadi","doi":"10.4103/ijh.ijh_36_21","DOIUrl":"https://doi.org/10.4103/ijh.ijh_36_21","url":null,"abstract":"BACKGROUND: Childhood acute lymphoblastic leukemia (ALL) is the most prevalent malignant disease (25%–30%) and the most common type of leukemia (75%–80%) among children. It is not a single disease with significant phenotypic and genotypic variability that has diagnostic and prognostic implications. This study aims to provide the immunophenotypic profile of childhood ALL in Iraqi patients and to explore the frequency of aberrant myeloid antigen expression and their association with hematological parameters. PATIENTS, MATERIALS AND METHODS: The records of 67 pediatric patients diagnosed as ALL were reviewed for their flow cytometric immunophenotyping results at presentation. RESULTS: B-ALL constituted 76.1% of the cases and 23.9% were T-ALL. There was a highly significant statistical relation between higher age interval and T-ALL phenotypes (P = 0.001). Higher hemoglobin (Hb) level and white blood cell count were significantly related with T-ALL subtype (P = 0.039 and < 0.001, respectively). CD34, HLA-DR, CD10, and CD79a were significantly correlated with B-ALL compared to T-ALL (P = 0.007, <0.001, <0.001, and <0.001, respectively). With no significant differences, aberrant myeloid antigen expression was found in 51% of B-ALL and in 25% of T-ALL cases; however, CD34 expression was substantially related with aberrant myeloid antigen expression (P = 0.001). CONCLUSION: Aberrant myeloid antigens were expressed in 44.9% of ALL patients with insignificant differences between B- and T-ALL phenotypes. CD34 was significantly associated with B-lineage ALL and with aberrant myeloid antigen expression. T-ALL children are older and have significantly higher Hb concentration and white blood cell count. No correlation was found between aberrant myeloid expression and hematological parameters in B-ALL.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"1 - 6"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41713454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Acute lymphoblastic leukemia (ALL) is a heterogeneous disorder characterized by the proliferation of immature lymphoid cells that accumulate in the bone marrow, peripheral blood, and extramedullary sites, causing the clinical manifestations of the disease. Lymphoid enhancer-binding factor-1 (LEF1) is a target gene and central mediator for the Wingless-type signaling pathway, and it has an important role in normal hematopoiesis. High LEF1 expression was reported as a prognostic marker in many types of hematological and nonhematological malignancies. AIM OF THE STUDY: To evaluate the serum level of LEF1 in pediatric patients with ALL and its correlation with other hematological and clinical prognostic factors (white blood cells [WBC] count, age, gender, central nervous system involvement, and response to treatment). PATIENTS, MATERIALS, AND METHODS: This cross-sectional study was conducted on 60 children; 20 patients with newly diagnosed ALL before starting induction therapy, 20 patients with ALL during remission (postinduction), and 20 healthy controls. Measurement of serum LEF1 level was done by enzyme-linked immunosorbent assay. RESULTS: Serum level of LEF1 was higher in newly diagnosed patients than in either patients at remission or controls with highly significant differences. There is a significant positive correlation with total WBC count and no significant correlation between LEF1 level and other hematological and clinical parameters or with immunophenotypic subtypes. There was no significant correlation between LEF1 serum level and response to remission induction. CONCLUSION: A high serum concentration of LEF1 is found in newly diagnosed patients with ALL and showed a significant positive correlation with total WBC count.
{"title":"Evaluation of serum level of lymphoid enhancer-binding factor-1 and its relation with clinico-hematological and prognostic parameters in pediatric patients with acute lymphoblastic leukemia","authors":"Zeena Ahmed, A. Ahmed","doi":"10.4103/ijh.ijh_1_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_1_22","url":null,"abstract":"BACKGROUND: Acute lymphoblastic leukemia (ALL) is a heterogeneous disorder characterized by the proliferation of immature lymphoid cells that accumulate in the bone marrow, peripheral blood, and extramedullary sites, causing the clinical manifestations of the disease. Lymphoid enhancer-binding factor-1 (LEF1) is a target gene and central mediator for the Wingless-type signaling pathway, and it has an important role in normal hematopoiesis. High LEF1 expression was reported as a prognostic marker in many types of hematological and nonhematological malignancies. AIM OF THE STUDY: To evaluate the serum level of LEF1 in pediatric patients with ALL and its correlation with other hematological and clinical prognostic factors (white blood cells [WBC] count, age, gender, central nervous system involvement, and response to treatment). PATIENTS, MATERIALS, AND METHODS: This cross-sectional study was conducted on 60 children; 20 patients with newly diagnosed ALL before starting induction therapy, 20 patients with ALL during remission (postinduction), and 20 healthy controls. Measurement of serum LEF1 level was done by enzyme-linked immunosorbent assay. RESULTS: Serum level of LEF1 was higher in newly diagnosed patients than in either patients at remission or controls with highly significant differences. There is a significant positive correlation with total WBC count and no significant correlation between LEF1 level and other hematological and clinical parameters or with immunophenotypic subtypes. There was no significant correlation between LEF1 serum level and response to remission induction. CONCLUSION: A high serum concentration of LEF1 is found in newly diagnosed patients with ALL and showed a significant positive correlation with total WBC count.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"45 - 50"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47403697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Sickle cell disease (SCD) is the second-most common hemoglobin disorder in Duhok governorate. Health-related quality of life (HRQoL) instrument provides physicians with the patient's perspectives of their disease and thus more patient-oriented care. MATERIALS AND METHODS: In this case–control study, a total of 70 adults (≥18 years old) registered as SCD at the center for blood diseases in Duhok as well as 70 age- and sex-matched healthy controls were enrolled. Enrolled patients had their records and treatment reviewed, were clinically assessed, and appropriately investigated. All patients and controls had their HRQoL scored using the SF36 questionnaire, which consists of eight domains, namely physical function, role limitation physical, role limitation emotional, vitality, emotional well-being, social function, bodily pain, and general health perception. RESULTS: The mean standard deviation age of the SCD patients enrolled was 26.2 (8.9) years and included 32 males and 38 females. The patients had significantly lower HRQoL scores in all eight domains when compared to their matched controls. The most affected domain was general health. Within the patients' group, it was noted that HRQoL scores were negatively correlated with age in several domains, most significantly with general health (P = 0.011). On the other hand, there was no significant difference in HRQoL in relevance to gender, marital status, education, or employment. The most significant negative correlations of HRQoL scores were documented with the annual number of pain episodes and hospital admissions observed with all eight domains. CONCLUSIONS: The current study documented that in adults with SCD, HRQoL in all domains was significantly worse than in healthy controls and that it gets worse with age. The most significant contributors to the worse HRQoL are pain episodes and hospital admissions. The study underscores the importance of HRQoL assessments to enable attending physicians provide more patient-centered management.
{"title":"Health-related quality of life in adults with sickle cell disease in Duhok-Iraq","authors":"Naz Tahir, N. Al-Allawi","doi":"10.4103/ijh.ijh_15_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_15_22","url":null,"abstract":"BACKGROUND: Sickle cell disease (SCD) is the second-most common hemoglobin disorder in Duhok governorate. Health-related quality of life (HRQoL) instrument provides physicians with the patient's perspectives of their disease and thus more patient-oriented care. MATERIALS AND METHODS: In this case–control study, a total of 70 adults (≥18 years old) registered as SCD at the center for blood diseases in Duhok as well as 70 age- and sex-matched healthy controls were enrolled. Enrolled patients had their records and treatment reviewed, were clinically assessed, and appropriately investigated. All patients and controls had their HRQoL scored using the SF36 questionnaire, which consists of eight domains, namely physical function, role limitation physical, role limitation emotional, vitality, emotional well-being, social function, bodily pain, and general health perception. RESULTS: The mean standard deviation age of the SCD patients enrolled was 26.2 (8.9) years and included 32 males and 38 females. The patients had significantly lower HRQoL scores in all eight domains when compared to their matched controls. The most affected domain was general health. Within the patients' group, it was noted that HRQoL scores were negatively correlated with age in several domains, most significantly with general health (P = 0.011). On the other hand, there was no significant difference in HRQoL in relevance to gender, marital status, education, or employment. The most significant negative correlations of HRQoL scores were documented with the annual number of pain episodes and hospital admissions observed with all eight domains. CONCLUSIONS: The current study documented that in adults with SCD, HRQoL in all domains was significantly worse than in healthy controls and that it gets worse with age. The most significant contributors to the worse HRQoL are pain episodes and hospital admissions. The study underscores the importance of HRQoL assessments to enable attending physicians provide more patient-centered management.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"70 - 75"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46591031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Basophil counting by hematology analyzers in cases of suspected chronic myeloid leukemia","authors":"Johannes Hoffmann","doi":"10.4103/ijh.ijh_44_21","DOIUrl":"https://doi.org/10.4103/ijh.ijh_44_21","url":null,"abstract":"","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"89 - 90"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47855353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. SakthiKannamma, B. Srinivasamurthy, S. Sinhasan, R. Bhat
BACKGROUND: Global pandemic COVID-19 is an acute respiratory illness with a high rate of hospitalization and death rate. Red cell distribution width coefficient of variation (RDW-CV), a routine component of complete blood count (CBC) automatically generated by most hematology analyzers is a useful predictor of clinical outcomes in critically ill patients and in those with infection and sepsis. RDW will provide information for early risk stratification of COVID-19 patients, thereby enabling timely intervention for reducing morbidity and mortality. In such a massive pandemic, early stratification of cases based on routinely available biomarkers can be of great help inefficient utilization of critical care and laboratory assets. MATERIALS AND METHODS: We retrospectively studied the significance and correlation of RDW (CV) (admission) with the severity of clinical illness in 800 confirmed cases of COVID-19 between August 2020 and October 2020 at our hospital. Demographic and clinical details were obtained from medical records; data pertaining to CBC were retrieved through electronic records of our fully automated hematology analyzer (NihonKoden 5 part auto analyzer Model-MEK– 7300K). Statistical workup was done and results were analyzed. RESULTS: Of 800 patients, 60% were male. RDW (CV) >14.5 (elevated) seen in 52% males and 47% females. Elevated RDW was noted in 43.6% (300/688) nonsevere illnesses (mild and moderate), 82% (92/112) in the severe illness group. The mean RDW (CV) for mild, moderate, and severe cases was found to be 14.21 ± 0.61, 15.32 ± 0.67, and 16.34 ± 1.64, respectively. The number of survivors was 704 (88%). The number of people who died was 96 (12%). Elevated RDW was seen in 74% (71/96) who died and 45% (321/704) of people who survived. To determine the efficacy of RDW (CV) in identifying the severity of disease, a ROC curve was used in which a cutoff value of 13.65 is obtained with a sensitivity of 97.3% and specificity of 85%. CONCLUSION: Higher RDW (CV) was found to have a significant association with clinical severity and mortality prediction. Hence, it can be considered as one of the important hematological parameters in the workup to efficiently stratify the patients at the earliest in COVID-19.
{"title":"A study on significance and correlation of red cell distribution width with severity of clinical illness in COVID-19 patients","authors":"M. SakthiKannamma, B. Srinivasamurthy, S. Sinhasan, R. Bhat","doi":"10.4103/ijh.ijh_45_21","DOIUrl":"https://doi.org/10.4103/ijh.ijh_45_21","url":null,"abstract":"BACKGROUND: Global pandemic COVID-19 is an acute respiratory illness with a high rate of hospitalization and death rate. Red cell distribution width coefficient of variation (RDW-CV), a routine component of complete blood count (CBC) automatically generated by most hematology analyzers is a useful predictor of clinical outcomes in critically ill patients and in those with infection and sepsis. RDW will provide information for early risk stratification of COVID-19 patients, thereby enabling timely intervention for reducing morbidity and mortality. In such a massive pandemic, early stratification of cases based on routinely available biomarkers can be of great help inefficient utilization of critical care and laboratory assets. MATERIALS AND METHODS: We retrospectively studied the significance and correlation of RDW (CV) (admission) with the severity of clinical illness in 800 confirmed cases of COVID-19 between August 2020 and October 2020 at our hospital. Demographic and clinical details were obtained from medical records; data pertaining to CBC were retrieved through electronic records of our fully automated hematology analyzer (NihonKoden 5 part auto analyzer Model-MEK– 7300K). Statistical workup was done and results were analyzed. RESULTS: Of 800 patients, 60% were male. RDW (CV) >14.5 (elevated) seen in 52% males and 47% females. Elevated RDW was noted in 43.6% (300/688) nonsevere illnesses (mild and moderate), 82% (92/112) in the severe illness group. The mean RDW (CV) for mild, moderate, and severe cases was found to be 14.21 ± 0.61, 15.32 ± 0.67, and 16.34 ± 1.64, respectively. The number of survivors was 704 (88%). The number of people who died was 96 (12%). Elevated RDW was seen in 74% (71/96) who died and 45% (321/704) of people who survived. To determine the efficacy of RDW (CV) in identifying the severity of disease, a ROC curve was used in which a cutoff value of 13.65 is obtained with a sensitivity of 97.3% and specificity of 85%. CONCLUSION: Higher RDW (CV) was found to have a significant association with clinical severity and mortality prediction. Hence, it can be considered as one of the important hematological parameters in the workup to efficiently stratify the patients at the earliest in COVID-19.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"25 - 31"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43558012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Iron overload certainly will develop in β-thalassemia major. Iron homeostasis was mostly regulated by hepcidin that synthesized in the liver and encoded by the hepcidin antimicrobial peptide (HAMP) gene. HAMP and HFE genes, respectively, encode iron-regulating proteins (Hepcidin and HFE). The iron overload's possibility will increase if there is an interaction between β-thalassemia and HAMP-HFE gene mutations. AIM OF STUDY: In β-thalassemia major patients, we need to identify mutations in iron-regulating genes (HAMP and HFE genes), their impact on the iron overload, and their association with some clinicopathological parameters. PATIENTS AND METHODS: During a period of 5 months from (November 2020 to March 2021), a case–control study was conducted. It included 80 patients and controls aged ≥14 years and divided into two groups: thalassemic patient group included 40 patients who were diagnosed by complete blood count, blood film, and hemoglobin – electrophoresis as β-thalassemia major and control group included 40 unrelated, apparently healthy controls that were age and gender matched with thalassemic patient group. Complete blood count, liver and renal function tests, serum ferritin, and DNA extraction were performed. RESULTS: There was a statistically significant difference between study groups by H63D mutations. The proportion of CG genotype was significantly higher among thalassemic patient group than that in controls. There was no statistically significant difference (P = 0.082) between study groups by G71D mutations. Serum ferritin and Alanine transaminase (ALT) levels were significantly higher in patients with CG and GG genotypes compared to that in patients with CC genotype of H63D. CONCLUSION: H63D is associated with iron overload in β-thalassemia patients with unapparent effect on biochemical and hematological data except for ALT and serum ferritin. This could allow early diagnosis and proper treatment to overcome the complications of iron overload in those patients.
{"title":"Comparison between H63D and G71D gene mutation effects on iron overload in Iraqi patients with β-thalassemia major: A case–control study","authors":"Samar Maatooq, M. Alwash, A. Ahmed","doi":"10.4103/ijh.ijh_10_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_10_22","url":null,"abstract":"BACKGROUND: Iron overload certainly will develop in β-thalassemia major. Iron homeostasis was mostly regulated by hepcidin that synthesized in the liver and encoded by the hepcidin antimicrobial peptide (HAMP) gene. HAMP and HFE genes, respectively, encode iron-regulating proteins (Hepcidin and HFE). The iron overload's possibility will increase if there is an interaction between β-thalassemia and HAMP-HFE gene mutations. AIM OF STUDY: In β-thalassemia major patients, we need to identify mutations in iron-regulating genes (HAMP and HFE genes), their impact on the iron overload, and their association with some clinicopathological parameters. PATIENTS AND METHODS: During a period of 5 months from (November 2020 to March 2021), a case–control study was conducted. It included 80 patients and controls aged ≥14 years and divided into two groups: thalassemic patient group included 40 patients who were diagnosed by complete blood count, blood film, and hemoglobin – electrophoresis as β-thalassemia major and control group included 40 unrelated, apparently healthy controls that were age and gender matched with thalassemic patient group. Complete blood count, liver and renal function tests, serum ferritin, and DNA extraction were performed. RESULTS: There was a statistically significant difference between study groups by H63D mutations. The proportion of CG genotype was significantly higher among thalassemic patient group than that in controls. There was no statistically significant difference (P = 0.082) between study groups by G71D mutations. Serum ferritin and Alanine transaminase (ALT) levels were significantly higher in patients with CG and GG genotypes compared to that in patients with CC genotype of H63D. CONCLUSION: H63D is associated with iron overload in β-thalassemia patients with unapparent effect on biochemical and hematological data except for ALT and serum ferritin. This could allow early diagnosis and proper treatment to overcome the complications of iron overload in those patients.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"60 - 64"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45901402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Anemia of β thalassemia results from a combination of ineffective erythropoiesis and hemolysis. This stimulates erythropoietin (EPO) production, which causes expansion of the bone marrow and may lead to serious deformities of the skull and long bones. Ineffective erythropoiesis also induces the release of growth differentiation factor 15 (GDF-15) and transforming growth factor-beta (TGF-β) which have been identified as regulators of hepcidin expression. OBJECTIVE: The objective is to evaluate the level of TGF-β, GDF-15, and EPO in patients with thalassemia syndrome. PATIENTS, MATERIALS AND METHODS: Patient samples were collected from Thalassemia Center of Ibn Al-Baladi Hospital. This study included 35 patients with thalassemia, 18 patients with beta-thalassemia major and 17 patients with beta-thalassemia intermedia. The age of studied group was 3–17 years. Twenty control healthy subjects were included for comparison who were age- and sex-matched with the patients group. Gel tube was used for collection of serum for enzyme-linked immunosorbent assay test for GDF-15, TGF-β, and EPO). RESULTS: There was a highly significant difference in GDF-15 and EPO levels among studied groups (P < 0.001). In addition, there was no significant difference in TGF-β level among studied groups (P > 0.05). TGF-β, GDF-15, and EPO were not significantly correlated to splenomegaly, hepatosplenomegaly, and frequency of blood transfusion duration in patients with beta-thalassemia major (P > 0.05), while TGF-β and EPO were significantly correlated to splenomegaly, hepatosplenomegaly in patients with beta-thalassemia intermedia but GDF-15 was not significantly correlated. In patients with beta-thalassemia major, EPO was negatively correlated to hemoglobin, packed cell volume, mean corpuscular volume, and red blood cells (RBC) count whereas GDF-15 significantly correlated to lymphocyte and neutrophil counts. TGF-β was significantly correlated to platelet count. In patients with beta-thalassemia intermedia, EPO and GDF-15 were not correlated to any hematological parameters whereas TGF-β was significantly correlated to RBC counts. CONCLUSION: Marker of erythropoiesis GDF-15, EPO was highly expressed in patient with beta-thalassemia major and beta-thalassemia intermedia as compared to the control group and this can be used as a future therapeutic goal for the suppression of ineffective erythropoiesis.
{"title":"Evaluation of the levels of the markers of ineffective erythropoiesis (transforming growth factor-beta, growth differentiation factor 15 and erythropoietin) in patient with ß-thalassemia syndrome and its correlation to clinical and hematological parameters","authors":"M. Yousif, H. Al-Mamoori","doi":"10.4103/ijh.ijh_39_21","DOIUrl":"https://doi.org/10.4103/ijh.ijh_39_21","url":null,"abstract":"BACKGROUND: Anemia of β thalassemia results from a combination of ineffective erythropoiesis and hemolysis. This stimulates erythropoietin (EPO) production, which causes expansion of the bone marrow and may lead to serious deformities of the skull and long bones. Ineffective erythropoiesis also induces the release of growth differentiation factor 15 (GDF-15) and transforming growth factor-beta (TGF-β) which have been identified as regulators of hepcidin expression. OBJECTIVE: The objective is to evaluate the level of TGF-β, GDF-15, and EPO in patients with thalassemia syndrome. PATIENTS, MATERIALS AND METHODS: Patient samples were collected from Thalassemia Center of Ibn Al-Baladi Hospital. This study included 35 patients with thalassemia, 18 patients with beta-thalassemia major and 17 patients with beta-thalassemia intermedia. The age of studied group was 3–17 years. Twenty control healthy subjects were included for comparison who were age- and sex-matched with the patients group. Gel tube was used for collection of serum for enzyme-linked immunosorbent assay test for GDF-15, TGF-β, and EPO). RESULTS: There was a highly significant difference in GDF-15 and EPO levels among studied groups (P < 0.001). In addition, there was no significant difference in TGF-β level among studied groups (P > 0.05). TGF-β, GDF-15, and EPO were not significantly correlated to splenomegaly, hepatosplenomegaly, and frequency of blood transfusion duration in patients with beta-thalassemia major (P > 0.05), while TGF-β and EPO were significantly correlated to splenomegaly, hepatosplenomegaly in patients with beta-thalassemia intermedia but GDF-15 was not significantly correlated. In patients with beta-thalassemia major, EPO was negatively correlated to hemoglobin, packed cell volume, mean corpuscular volume, and red blood cells (RBC) count whereas GDF-15 significantly correlated to lymphocyte and neutrophil counts. TGF-β was significantly correlated to platelet count. In patients with beta-thalassemia intermedia, EPO and GDF-15 were not correlated to any hematological parameters whereas TGF-β was significantly correlated to RBC counts. CONCLUSION: Marker of erythropoiesis GDF-15, EPO was highly expressed in patient with beta-thalassemia major and beta-thalassemia intermedia as compared to the control group and this can be used as a future therapeutic goal for the suppression of ineffective erythropoiesis.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"13 - 18"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43907390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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