Prognostic value of pre-treatment routine hematological parameters in breast carcinoma: Advantageous or deleterious?

Diagnostic utility of haematological parameters in predicting the severity of HIV infection in southwestern Ethiopia: a comparative cross-sectional study

OBJECTIVES

This study aimed to evaluate the diagnostic utility of haematological parameters as a predictive marker of the severity of HIV infection in southwestern Ethiopia.

DESIGN

Comparative cross-sectional study.

SETTING

This study was conducted in southwestern Ethiopia.

PARTICIPANTS

Venous blood samples were collected from 344 participants (172 HIV, 172 healthy controls (HC)) and haematological parameters were determined using the automated haematology analyser. The diagnostic utility of haematological parameters was determined by a receiver operating curve analysis. Data were analysed using SPSS V.21 and the p value was set at less than 0.05 for the statistical significance.

RESULTS

In this study, red cell count (RCC) distinguishes HIV-infected patients from HC at a threshold value of 4.05×109/L with sensitivity, specificity and an area under the curves (AUC) of 73.8%, 78.5% and 0.87, respectively. At a cut-off value of 4.25×109/L, RCC significantly distinguishes non-severe HIV-infected patients from HC with a sensitivity of 72.7%, specificity of 81.7% and an AUC of 0.86. Haemoglobin (Hgb) significantly differentiates severe HIV-infected patients from HC with sensitivity, specificity and an AUC of 95.9%, 86.7% and 0.96, respectively. Platelet count (PLT) significantly discriminates HC from non-severe and severe HIV-infected patients with an AUC of 0.74 and 0.963, respectively.

CONCLUSION

RCC, PLT and Hgb demonstrated better diagnostic performance in predicting the severity of HIV infection and have been identified as the best haematological markers in predicting the presence and severity of HIV infection. Thus, the haematological profiles (RCC, PLT and Hgb) should be used as an alternative marker to predict the severity of HIV infection and may provide supportive information for evidence-based interventions and early diagnosis of infections.

Effects of Adriamycin-Cytoxan chemotherapy on hematological and electrolyte parameters among breast cancer patients

Background

Adriamycin-Cytoxan (AC) is a common chemotherapy treatment for breast cancer (BC) patients. Its electrolyte and hematological adverse effects have not been addressed adequately.

Objective

This study aimed to assess the effect of AC on hematological and electrolyte parameters among BC patients.

Methods

A hospital-based comparative cross-sectional study design was conducted from March to November 2022. Randomly selected AC-treated (n=100) and untreated (n=100) patients were included. Structured questionnaire and medical records were used to collect sociodemographic data. Anthropometric parameters, hematological indices, and serum electrolytes were measured. Cobas Integra 400⁺and SYSMEX-XT-4000i were used to analyze serum electrolytes and hematological indices respectively. The data were analyzed using SPSS version 25. Independent t-test and chi-square test were used. p-value <0.05 was considered statistically significant.

Results

AC-treated patients' mean total white blood cell (TWBC), neutrophil (NE), lymphocyte (LY), red blood cell (RBC), hemoglobin (Hgb), hematocrit (HCT), and sodium(Na⁺) values were significantly reduced (p<0.05) than patients with no treatment. However, mean eosinophils (EO), platelet (PLT) counts, red cell distribution-width (RDW), potassium (K⁺), and plateletcrit (PCT values were significantly increased (p<0.05).

Conclusion

The majority of blood cells and serum sodium were affected by AC treatment. Incorporating these parameters in the routine analysis and further studies on the detailed mechanism of action of this drug is required.

Association of systemic immune-inflammation index with long-term all-cause mortality in pancreatic cancer patients after pancreaticoduodenectomy

Aim: Systemic immune-inflammation (SII) index may provide more promising prognostic information in patients with cancer surgery. However, to the best of our knowledge, the prognostic value of SII index in patients with pancreatic cancer who underwent pancreaticoduodenectomy has not been studied. Thus, this study aimed to evaluate and compare the prognostic value of SII index in patients with pancreatic cancer who underwent pancreaticoduodenectomy. Materials and Methods: All patients over 18 years-old that underwent successful pancreaticoduodenectomy due to pancreatic cancer between February 20, 2019 and June 30, 2021 at Ankara City Hospital Department of General Surgery were included. The main predictor of interest was SII index which was measured by neutrophil*platelet / lymphocyte count. The main outcome of the study was long-term all-cause mortality. Results: A total of 223 patients were included in the current study. Multivariable cox regression analysis revealed that history of congestive heart failure [HR (95%CI): 3.682 (1.140-11.892)], and SII index [HR (95%CI): 1.001 (1.001-1.001)] were independently associated with all cause long-term mortality. The accuracy of predicting mortality for SII index was assessed by the area under the ROC curve which was = 0.77. A higher value of 1305 of SII index was found with 76% sensitivity and 67% specificity for predicting all-cause long-term mortality. Conclusions: The results of the study suggest that measurement of the SII index, an easily available and relatively cheap marker, is an independent predictor of long-term survival after pancreaticoduodenectomy in patients with pancreatic cancer.

Hematological abnormalities before and after initiation of cancer treatment among breast cancer patients attending at the University of Gondar comprehensive specialized hospital cancer treatment center

Background

Breast cancer is the most frequent and fatal cancer type globally. The fatality rate of breast cancer is mostly due to disease complications like hematological alterations. Therefore, this study aimed to assess the hematological abnormalities before, during, and after the initiation of cancer treatment in breast cancer patients at the University of Gondar comprehensive specialized hospital.

Methodology

Hematological profiles were collected from 267 breast cancer patients who attended the cancer treatment center from September 2017 to August 2021. A data extraction sheet was used to extract data from the patient’s medical chart, including sociodemography, clinical, and hematological profiles. EPI info version 3.5.1 and SPSS Version 25 softwares were used for data entrance and analysis, respectively. Descriptive statistics were summarized using frequency and percentage. The Friedman test followed by a Wilcoxon signed rank test was used to compare the mean difference between the hematological profiles at zero and after the 4^th and 8^th cycles of treatment.

Result

Of the total participants, 91% were females, and the median age of the study participants was 45 (IQR = 36, 55) years. Red blood cell, white blood cell, and lymphocyte counts, as well as hematocrit and hemoglobin values, were significantly reduced after the initiation of cancer treatment, while the platelet count and red cell distribution width were significantly increased. The prevalence of anemia was 21.7% (95% CI: 16.6, 26.8), 22.7% (95% CI: 17.6, 27.8), and 26.4% (95% CI: 21.3, 31.5) before, during, and after the initiation of cancer treatment, respectively. The prevalence of leukopenia before, during, and after treatment was 9.7%, 18.8%, and 15.1%, respectively. Finally the prevalence of thrombocytopenia was 6.3%, 3.4%, and 8% at before, during, and after treatment, respectively.

Conclusion

This study concluded that many hematological parameters were significantly affected by the breast cancer treatment. Therefore, proper patient follow-up and provide appropriate interventions related to their hematological abnormalities is crucial. It is also important to conduct further prospective studies to confirm the findings of this study.