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Pelagalli M, Tomassetti F, Nicolai E, Giovannelli A, Codella S, Iozzo M, Massoud R, Secchi R, Venditti A, Pieri M, Bernardini S. The Role of Erythrocyte Sedimentation Rate (ESR) in Myeloproliferative and Lymphoproliferative Diseases: Comparison between DIESSE CUBE 30 TOUCH and Alifax Test 1. Diseases 2023; 11:169. [PMID: 37987280 PMCID: PMC10660727 DOI: 10.3390/diseases11040169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/18/2023] [Accepted: 11/10/2023] [Indexed: 11/22/2023] Open
Abstract
(1) Background: The erythrocyte sedimentation rate (ESR) is widely diffused in hematology laboratories to monitor inflammatory statuses, response to therapies (such as antibiotics), and oncologic diseases. However, ESR is not a specific diagnostic marker but needs to be contextualized and compared with clinical and other laboratory findings. This study aimed to investigate the performance of two automated instruments, namely the DIESSE CUBE 30 TOUCH (DIESSE, Siena, Italy) and the Alifax Test 1 (Alifax Srl, Polverara, Italy), in comparison with the gold standard, the Westergren method, in lymphoproliferative and myeloproliferative patients. (2) Methods: 97 EDTA samples were selected from the hematology department of Roma Tor Vergata Hospital and analyzed. Statistical analysis was applied. (3) A good correlation between CUBE 30 TOUCH and the gold standard was observed in the overall sample (R2 = 0.90), as well as in patients with lymphoproliferative diseases (R2 = 0.90) and myeloproliferative diseases (R2 = 0.90). The correlation between Test 1 and the gold standard was observed in the overall sample (R2 = 0.68), as well as in patients with lymphoproliferative diseases (R2 = 0.79) and myeloproliferative diseases (R2 = 0.53). (4) Conclusions: The CUBE 30 TOUCH appears to be a more trustworthy tool for evaluating ESR in these pathologies.
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Affiliation(s)
- Martina Pelagalli
- Department of Experimental Medicine, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (M.P.); (F.T.); (E.N.); (A.G.); (S.C.); (R.M.); (S.B.)
- Department of Laboratory Medicine, “Tor Vergata” University Hospital, Viale Oxford 81, 00133 Rome, Italy;
| | - Flaminia Tomassetti
- Department of Experimental Medicine, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (M.P.); (F.T.); (E.N.); (A.G.); (S.C.); (R.M.); (S.B.)
- Department of Laboratory Medicine, “Tor Vergata” University Hospital, Viale Oxford 81, 00133 Rome, Italy;
| | - Eleonora Nicolai
- Department of Experimental Medicine, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (M.P.); (F.T.); (E.N.); (A.G.); (S.C.); (R.M.); (S.B.)
| | - Alfredo Giovannelli
- Department of Experimental Medicine, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (M.P.); (F.T.); (E.N.); (A.G.); (S.C.); (R.M.); (S.B.)
- Department of Laboratory Medicine, “Tor Vergata” University Hospital, Viale Oxford 81, 00133 Rome, Italy;
| | - Silvia Codella
- Department of Experimental Medicine, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (M.P.); (F.T.); (E.N.); (A.G.); (S.C.); (R.M.); (S.B.)
- Department of Laboratory Medicine, “Tor Vergata” University Hospital, Viale Oxford 81, 00133 Rome, Italy;
| | - Mariannina Iozzo
- Department of Laboratory Medicine, “Tor Vergata” University Hospital, Viale Oxford 81, 00133 Rome, Italy;
| | - Renato Massoud
- Department of Experimental Medicine, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (M.P.); (F.T.); (E.N.); (A.G.); (S.C.); (R.M.); (S.B.)
- Department of Laboratory Medicine, “Tor Vergata” University Hospital, Viale Oxford 81, 00133 Rome, Italy;
| | - Roberto Secchi
- Department of Biomedicine and Prevention, Hematology, University Tor Vergata, 00133 Rome, Italy; (R.S.); (A.V.)
| | - Adriano Venditti
- Department of Biomedicine and Prevention, Hematology, University Tor Vergata, 00133 Rome, Italy; (R.S.); (A.V.)
| | - Massimo Pieri
- Department of Experimental Medicine, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (M.P.); (F.T.); (E.N.); (A.G.); (S.C.); (R.M.); (S.B.)
- Department of Laboratory Medicine, “Tor Vergata” University Hospital, Viale Oxford 81, 00133 Rome, Italy;
| | - Sergio Bernardini
- Department of Experimental Medicine, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (M.P.); (F.T.); (E.N.); (A.G.); (S.C.); (R.M.); (S.B.)
- Department of Laboratory Medicine, “Tor Vergata” University Hospital, Viale Oxford 81, 00133 Rome, Italy;
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Kanduła Z, Janowski M, Więckowska B, Paczkowska E, Mroczkowska-Bękarciak A, Sobas M, Lewandowski K. High molecular risk variants, severe thrombocytopenia and large unstained cells count affect the outcome in primary myelofibrosis. J Appl Genet 2023; 64:479-491. [PMID: 37507589 PMCID: PMC10457229 DOI: 10.1007/s13353-023-00771-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/10/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
Apart from the driver mutations, high molecular risk (HMR) variants and other factors have been reported to influence the prognosis of primary myelofibrosis (PMF). The aim of our study was to investigate the impact of laboratory and molecular characteristics at the time of diagnosis (TOD) on the PMF outcome. The study group consisted of 82 patients recruited from three Polish university centers. Among the driver mutations, only CALR type 1 positively influenced the overall survival (OS). The risk of progression to accelerated or blastic disease phase (AP/BP) did not depend on the driver mutation type, but was closely associated with the presence of HMR variants (p = 0.0062). The risk of death (ROD) was higher in patients with HMR variants (OR[95%CI] = 4.33[1.52;12.34], p = 0.0044) and in patients with a platelet count at the TOD between 50-100 G/L (HR[95%CI] = 2.66[1.11;6.35]) and < 50 G/L (HR[95%CI] = 8.44[2.50;28.44]). Median survival time was 7.8, 2.2 and 1.4 years in patients with large unstained cells (LUC) count of [0.0-0.2], (0.2-0.4] and > 0.4 G/L at the TOD, respectively. We found an unexpected, hitherto undescribed, association between LUC count at the TOD and PMF prognosis. Our analysis led to the following conclusions: in PMF patients at the TOD 1) the presence of HMR variants, especially combined, is associated with an increased risk of progression to the AP and BP, and shorter OS, 2) severe thrombocytopenia confers worse prognosis than the moderate one, 3) LUC count is closely related with the disease phase, and associated with the ROD and OS.
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Affiliation(s)
- Zuzanna Kanduła
- Department of Hematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznan, Poland
| | - Michał Janowski
- Department of General Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Barbara Więckowska
- Department of Computer Science and Statistics, Poznań University of Medical Sciences, Poznan, Poland
| | - Edyta Paczkowska
- Department of General Pathology, Pomeranian Medical University, Szczecin, Poland
| | | | - Marta Sobas
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Medical University, Wrocław, Poland
| | - Krzysztof Lewandowski
- Department of Hematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznan, Poland
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Merter M, Sahin U, Uysal S, Dalva K, Yuksel MK. Role of large unstained cells in predicting successful stem cell collection in autologous stem cell transplantation. Transfus Apher Sci 2023; 62:103517. [PMID: 35963811 DOI: 10.1016/j.transci.2022.103517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Sufficient stem cell collection is mandatory for Autologous stem cell transplantation (ASCT). Peripheral CD34+ stem CD34 + stem cell counting by flow cytometry is the gold standard method in both the predicting and timing of successful stem cell collection. Large unstained cells (LUC) are large peroxidase-negative cells that are displayed on certain automatic cell counters and present large lymphocytes, virocytes, blasts, abnormal cells and hematopoietic stem cells. In this study, we evaluated the role of LUC parameters in the timing and prediction of successful stem cell collection. METHODS Patients with a diagnosis of multiple myeloma, lymphoma and testis tumor who proceed to ASCT were included in this study. Preapheresis LUC parameters were analyzed with Siemens ADVIA® 2120i system., Kruskal Wallis, Mann-Whitney U, Spearman Rho and receiver-operator curve (ROC) tests were used for analyses. RESULTS Ninety patients were evaluated. Peripheral CD34 + cell count was positively correlated with both LUC count (p = 0014) and LUC percentage (p = 0,01). LUC percentage in peripheral blood was positively correlated with mobilized stem cell count in the yield (p = 0.003). We found a LUC count of > 0.485 × 109/L as a cut-off value for detecting > 20 × 106/L CD34 +cells in the peripheral blood with a sensitivity of 64.6% and specificity of 75%. We defined > 2.15% as a cut-off value for LUC percentage to collect > 5 × 106/kg of stem cells with a sensitivity of 64% and specificity of 63%. Additionally, total nucleated cell (TNC) count was negatively correlated with LUC percentage (p = 0.014) and positively correlated with LUC count (p = 0.001). CONCLUSION LUC parameters are readily available, simple and cheap tools that can be useful in both timing of CD34 count by flow cytometry in peripheral blood and in the prediction of successful mobilization. LUCs can also be an indicator of graft composition.
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Affiliation(s)
- Mustafa Merter
- Firat University, School of Medicine, Hematology Department, Elazıg, Turkey.
| | - Ugur Sahin
- Ankara University, School of Medicine, Hematology Department, Ankara, Turkey
| | - Serhat Uysal
- Firat University School of Medicine, Department of Infectious Diseases, Elazıg, Turkey
| | - Klara Dalva
- Ankara University, School of Medicine, Hematology Department, Ankara, Turkey
| | - Meltem Kurt Yuksel
- Ankara University, School of Medicine, Hematology Department, Ankara, Turkey
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Leng B, Leng M, Ge M, Dong W. Knowledge distillation-based deep learning classification network for peripheral blood leukocytes. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2022.103590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Shimoni Z, Froom P, Benbassat J. Parameters of the complete blood count predict in hospital mortality. Int J Lab Hematol 2022; 44:88-95. [PMID: 34464032 DOI: 10.1111/ijlh.13684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 07/25/2021] [Accepted: 08/10/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Mortality rates are used to evaluate the quality of hospital care after adjusting for disease severity and, commonly also, for age, comorbidity, and laboratory data with only few parameters of the complete blood count (CBC). OBJECTIVE To identify the parameters of the CBC that predict independently in-hospital mortality of acutely admitted patients. POPULATION All patients were admitted to internal medicine, cardiology, and intensive care departments at the Laniado Hospital in Israel in 2018 and 2019. VARIABLES Independent variables were patients' age, sex, and parameters of the CBC. The outcome variable was in-hospital mortality. ANALYSIS Logistic regression. In 2018, we identified the variables that were associated with in-hospital mortality and validated this association in the 2019 cohort. RESULTS In the validation cohort, a model consisting of nine parameters that are commonly available in modern analyzers had a c-statistics (area under the receiver operator curve) of 0.86 and a 10%-90% risk gradient of 0%-21.4%. After including the proportions of large unstained cells, hypochromic, and macrocytic red cells, the c-statistic increased to 0.89, and the risk gradient to 0.1%-29.5%. CONCLUSION The commonly available parameters of the CBC predict in-hospital mortality. Addition of the proportions of hypochromic red cells, macrocytic red cells, and large unstained cells may improve the predictive value of the CBC.
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Affiliation(s)
- Zvi Shimoni
- Department of Internal Medicine B, Laniado Hospital, Netanya, Israel
- Ruth and Bruce Rappaport School of Medicine, Haifa, Israel
| | - Paul Froom
- Clinical Utility Department, Sanz Medical Center, Laniado Hospital, Netanya, Israel
- School of Public Health, University of Tel Aviv, Tel Aviv, Israel
| | - Jochanan Benbassat
- Department of Medicine (retired), Hadassah University Hospital Jerusalem, Jerusalem, Israel
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Inoue D, Nishijima K, Takahashi J, Yoshida Y. A delayed diagnosis of acute myeloid leukaemia during pregnancy using an old blood cell analyser. J OBSTET GYNAECOL 2019; 39:1173-1174. [PMID: 31220969 DOI: 10.1080/01443615.2019.1600480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Daisuke Inoue
- Department of Obstetrics and Gynaecology, University of Fukui , Fukui , Japan
| | - Koji Nishijima
- Department of Obstetrics and Gynaecology, University of Fukui , Fukui , Japan
| | - Jin Takahashi
- Department of Obstetrics and Gynaecology, University of Fukui , Fukui , Japan
| | - Yoshio Yoshida
- Department of Obstetrics and Gynaecology, University of Fukui , Fukui , Japan
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Stephens L, Bevins NJ, Bengtsson HI, Broome HE. Comparison of Different Small Clinical Hematology Laboratory Configurations With Focus on Remote Smear Imaging. Arch Pathol Lab Med 2019; 143:1234-1245. [PMID: 30969157 DOI: 10.5858/arpa.2018-0277-oa] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Stand-alone clinical sites (eg, infusion centers) are becoming increasingly common. These sites require timely hematology analysis. Here we compare performance and costs of currently available analysis configurations with special focus on a proposed alternative using a minimal hematology analyzer plus a digital imaging device, allowing for remote oversight and interpretation. OBJECTIVES.— To determine whether low-volume laboratories might realize savings while gaining function by substituting commonly used configurations with a proposed alternative. DESIGN.— To evaluate the performance of the proposed alternative configuration, blood counts with automated differentials produced by a Sysmex XE5000 (complete blood count reference method) were compared with cell counts from the Sysmex pocH-100i, CellaVision DM96 preclassified differentials, and DM96 reclassified differentials (differential reference method) by using standard regression analyses, 95% CIs, and truth tables. Financial cost modeling used staffing practices, test volumes, and smear production rates observed at remote clinics performing on-site hematology analysis within the University of California at San Diego Health system. RESULTS.— Differential blood count parameters showed excellent correlation between the XE5000 and preclassification DM96 with R2 > 0.95. For blasts/abnormal cells, immature granulocytes, and nucleated red blood cells, the DM96 showed higher sensitivity and similar specificity to the XE5000. Cost modeling revealed that decreased personnel costs through remote monitoring of results facilitated by the DM96 would lead to lower operational costs relative to more conventional analysis configurations. CONCLUSIONS.— A digital imaging instrument with an inexpensive hematology analyzer provides similar information to a complex hematology analyzer and allows remote review of the blood smear findings by experts, leading to significant cost savings.
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Affiliation(s)
- Laura Stephens
- From the Department of Pathology, University of California, San Diego/University of California San Diego Health, La Jolla (Drs Stephens, Bevins, and Broome); the Department of Scientific Affairs, CellaVision AB, Lund, Sweden (Mr Bengtsson); and the University of California San Diego Moores Cancer Center, La Jolla (Dr Broome)
| | - Nicholas J Bevins
- From the Department of Pathology, University of California, San Diego/University of California San Diego Health, La Jolla (Drs Stephens, Bevins, and Broome); the Department of Scientific Affairs, CellaVision AB, Lund, Sweden (Mr Bengtsson); and the University of California San Diego Moores Cancer Center, La Jolla (Dr Broome)
| | - Hans-Inge Bengtsson
- From the Department of Pathology, University of California, San Diego/University of California San Diego Health, La Jolla (Drs Stephens, Bevins, and Broome); the Department of Scientific Affairs, CellaVision AB, Lund, Sweden (Mr Bengtsson); and the University of California San Diego Moores Cancer Center, La Jolla (Dr Broome)
| | - H Elizabeth Broome
- From the Department of Pathology, University of California, San Diego/University of California San Diego Health, La Jolla (Drs Stephens, Bevins, and Broome); the Department of Scientific Affairs, CellaVision AB, Lund, Sweden (Mr Bengtsson); and the University of California San Diego Moores Cancer Center, La Jolla (Dr Broome)
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Shin D, Lee MS, Kim DY, Lee MG, Kim DS. Increased large unstained cells value in varicella patients: A valuable parameter to aid rapid diagnosis of varicella infection. J Dermatol 2015; 42:795-9. [DOI: 10.1111/1346-8138.12902] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 03/05/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Dongyun Shin
- Department of Dermatology; Severance Hospital; Cutaneous Biology Research Institute; Yonsei University College of Medicine; Seoul Korea
| | - Min Seok Lee
- Department of Dermatology; Severance Hospital; Cutaneous Biology Research Institute; Yonsei University College of Medicine; Seoul Korea
| | - Do Young Kim
- Department of Dermatology; Severance Hospital; Cutaneous Biology Research Institute; Yonsei University College of Medicine; Seoul Korea
| | - Min-Geol Lee
- Department of Dermatology; Severance Hospital; Cutaneous Biology Research Institute; Yonsei University College of Medicine; Seoul Korea
- Brain Korea 21 Plus Project for Medical Science; Yonsei University College of Medicine; Seoul Korea
| | - Dae Suk Kim
- Department of Dermatology; Severance Hospital; Cutaneous Biology Research Institute; Yonsei University College of Medicine; Seoul Korea
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