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De Ramón Ortiz C, Justo Sanz R, Beauverd Y, Humala K, López de la Guia A, De Paz R, Gasior M, Gómez Prieto P, Fabra Urdiola M, Canales Albendea M, Butta N, Jiménez Yuste V. Low Plasma Levels of Hyaluronic Acid Might Rule Out Sinusoidal Obstruction Syndrome after Hematopoietic Stem Cell Transplantation. Dis Markers 2023; 2023:7589017. [PMID: 37101837 PMCID: PMC10125768 DOI: 10.1155/2023/7589017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 10/26/2022] [Accepted: 02/27/2023] [Indexed: 04/28/2023]
Abstract
Background Sinusoidal obstructive syndrome (SOS) is a potentially fatal complication secondary to hematopoietic stem cell transplant (HSCT) conditioning. Endothelial damage plasma biomarkers such as plasminogen activator inhibitor-1 (PAI-1), hyaluronic acid (HA), and vascular adhesion molecule-1 (VCAM1) represent potential diagnostic tools for SOS. Methods We prospectively collected serial citrated blood samples (baseline, day 0, day 7, and day 14) in all adult patients undergoing HSCT at La Paz Hospital, Madrid. Samples were later analyzed by ELISA (enzyme-linked immunosorbent assay) for HA, VCAM1, and PAI-1 concentrations. Results During sixteen months, we prospectively recruited 47 patients. Seven patients (14%) were diagnosed with SOS according to the EBMT criteria for SOS/VOD diagnosis and received treatment with defibrotide. Our study showed a statistically significant elevation of HA on day 7 in SOS patients, preceding clinical SOS diagnosis, with a sensitivity of 100%. Furthermore, we observed a significant increase of HA and VCAM1 levels on day 14. Regarding risk factors, we observed a statistically significant association between SOS diagnosis and the fact that patients received 3 or more previous lines of treatment before HSCT. Conclusions The early significant increase in HA levels observed opens the door to a noninvasive peripheral blood test which could have the potential to improve diagnosis and facilitate prophylactic and therapeutic management of SOS before clinical/histological damage is established.
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Affiliation(s)
| | - Raul Justo Sanz
- Hematology, Hospital La Paz Institute for Health Research, Madrid, Spain
| | - Yan Beauverd
- Hematology, University Hospital of Geneva, Switzerland
| | - Karem Humala
- Hematology, La Paz University Hospital, Madrid, Spain
| | | | - Raquel De Paz
- Hematology, La Paz University Hospital, Madrid, Spain
| | | | | | | | | | - Nora Butta
- Hematology, Hospital La Paz Institute for Health Research, Madrid, Spain
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Bourquard A, Pablo-Trinidad A, Butterworth I, Sánchez-Ferro Á, Cerrato C, Humala K, Fabra Urdiola M, Del Rio C, Valles B, Tucker-Schwartz JM, Lee ES, Vakoc BJ, Padera TP, Ledesma-Carbayo MJ, Chen YB, Hochberg EP, Gray ML, Castro-González C. Non-invasive detection of severe neutropenia in chemotherapy patients by optical imaging of nailfold microcirculation. Sci Rep 2018; 8:5301. [PMID: 29593221 PMCID: PMC5871877 DOI: 10.1038/s41598-018-23591-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 03/15/2018] [Indexed: 01/06/2023] Open
Abstract
White-blood-cell (WBC) assessment is employed for innumerable clinical procedures as one indicator of immune status. Currently, WBC determinations are obtained by clinical laboratory analysis of whole blood samples. Both the extraction of blood and its analysis limit the accessibility and frequency of the measurement. In this study, we demonstrate the feasibility of a non-invasive device to perform point-of-care WBC analysis without the need for blood draws, focusing on a chemotherapy setting where patients’ neutrophils—the most common type of WBC—become very low. In particular, we built a portable optical prototype, and used it to collect 22 microcirculatory-video datasets from 11 chemotherapy patients. Based on these videos, we identified moving optical absorption gaps in the flow of red cells, using them as proxies to WBC movement through nailfold capillaries. We then showed that counting these gaps allows discriminating cases of severe neutropenia (<500 neutrophils per µL), associated with increased risks of life-threatening infections, from non-neutropenic cases (>1,500 neutrophils per µL). This result suggests that the integration of optical imaging, consumer electronics, and data analysis can make non-invasive screening for severe neutropenia accessible to patients. More generally, this work provides a first step towards a long-term objective of non-invasive WBC counting.
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Affiliation(s)
- Aurélien Bourquard
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA. .,Biomedical Image Technologies, Universidad Politécnica de Madrid and CIBER-BBN, Madrid, Spain.
| | - Alberto Pablo-Trinidad
- Biomedical Image Technologies, Universidad Politécnica de Madrid and CIBER-BBN, Madrid, Spain
| | - Ian Butterworth
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Álvaro Sánchez-Ferro
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA.,Centro Integral en Neurociencias HM CINAC, HM Hospitales, Móstoles, Madrid, Spain
| | - Carolina Cerrato
- Departamento de Hematología, Hospital Universitario La Paz, Madrid, Spain
| | - Karem Humala
- Departamento de Hematología, Hospital Universitario La Paz, Madrid, Spain
| | | | - Candice Del Rio
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Betsy Valles
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Jason M Tucker-Schwartz
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Elizabeth S Lee
- Institute of Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Benjamin J Vakoc
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA
| | - Timothy P Padera
- Edwin L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - María J Ledesma-Carbayo
- Biomedical Image Technologies, Universidad Politécnica de Madrid and CIBER-BBN, Madrid, Spain
| | - Yi-Bin Chen
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Ephraim P Hochberg
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Martha L Gray
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA.,Institute of Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Carlos Castro-González
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA. .,Biomedical Image Technologies, Universidad Politécnica de Madrid and CIBER-BBN, Madrid, Spain.
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