Clinical and Laboratory Haematology via MedWorm.com

Race-specific WBC and neutrophil count reference intervals

Clinical and Laboratory Haematology — Thu, 04 Mar 2010 00:00:00 +0100

The objective is to establish race-specific reference intervals for WBC and ANC using US National Health and Nutrition Examination Survey (NHANES) of 2000[ndash]2003. A total of 14 184 civilian noninstitutionalized US citizens participated in NHANES 2000[ndash]2003 had complete blood count, red cell distribution width, platelet count and automated WBC differential determined on a Coulter MAXM. The exclusion criteria were used: ferritin 30, diastolic blood pressure >100 mm Hg, creatinine >2.5 mg/dl, glucose >126 mg/dl. Data were separated into six sex/race categories: female non-Hispanic white, non-Hispanic black (NHBF)], Mexican American; male non-Hispanic white, non-Hispanic black (NHBM), Mexican American and two age groupings (12[ndash]18 and >18 years). NHB 2.5[ndash]97.5 percentile WBC...

Performance evaluation of the body fluid mode on the platform Sysmex XE-5000 series automated hematology analyzer

Clinical and Laboratory Haematology — Wed, 03 Mar 2010 00:00:00 +0100

We evaluated the performance of the automated body fluid mode of the Sysmex XE-5000 series automated haematology analyzer and compared the performance of the automated method for obtaining white blood cell (WBC), red blood cell (RBC) counts and WBC differential counts with microscopic method. One hundred and seventy-four samples were analysed: 81 ascitic fluid, 32 cerebrospinal fluid (CSF), 26 pleural fluid (PF), 18 synovial fluid (SF), 13 peritoneal fluid (PeF) and 4 other types. The agreement between the automated method and the manual reference showed high correlation, with Pearson correlation coefficients greater than 0.9 for all types of body fluids. We also demonstrate that the automated body fluid analysis on the XE-5000 is an acceptable alternative to the microscopic reference meth...

Association between the neutrophil myeloperoxidase index and subsets of bacterial infections

Clinical and Laboratory Haematology — Fri, 26 Feb 2010 00:00:00 +0100

Conclusion] These results indicate that MPXI is correlated with some specific infectious states, i.e. MPXI is low in bacterial sepsis and high in nontuberculous nonseptic bacterial infections. MPXI appears to be an independent and useful biomarker for the diagnosis and follow-up of infectious diseases, especially when the MPXI values are obtained at regular intervals during the disease courses of the patients. (Source: Clinical and Laboratory Haematology)

Serum myeloperoxidase levels and platelet activation parameters as diagnostic and prognostic markers in the course of coronary disease

Clinical and Laboratory Haematology — Thu, 25 Feb 2010 00:00:00 +0100

Early prediction of coronary artery disease complications is vital for the prevention and effective treatment of patients with coronary cardiac disease. It has been reported that inflammatory markers play a key role in the progression of cardiovascular diseases. Platelet count and platelet morphological parameters were analyzed on a fully-automated hematological analyzer ADVIA 2120 (Siemens). Serum myeloperoxidase (MPO) level was determined with an enzyme immunoassay (BioCheck). The measuring range of this assay is between 0 and 40 ng/ml. We demonstrate that serum MPO concentration and platelet activation increase systematically with the advancement of coronary artery disease. Moreover, MPO level is significantly higher in patients with unstable coronary artery disease and myocardial infar...

Characterisation and relevance of CD138-negative plasma cells in plasma cell myeloma

Clinical and Laboratory Haematology — Thu, 25 Feb 2010 00:00:00 +0100

Conclusion: We have characterised the CD138[minus] PCs as more immature and with a significantly higher proliferative potential. The current trend to ignore this more immature and proliferative subpopulation of malignant PCs may have serious implications when determining gene expression, classifications and drug sensitivity of the malignancy. (Source: Clinical and Laboratory Haematology)

Nontransferrin-bound iron in transfused patients with sickle cell disease

Clinical and Laboratory Haematology — Thu, 25 Feb 2010 00:00:00 +0100

The value of nontransferrin-bound iron (NTBI) as an index of iron overload in patients with thalassemia has been evaluated; however, data in patients with sickle cell disease (SCD) is limited. NTBI levels were evaluated in a cross-sectional study of 43 transfused patients with SCD. Patient charts were reviewed for demographics, status of the spleen, and total number of lifetime transfusions. All patients were chelation naïve and none of the patients had evidence of hepatitis B or C infection. Blood samples were taken for assessment of NTBI and serum ferritin (SF); liver iron concentration (LIC) was determined by R2 magnetic resonance imaging. NTBI levels were generally low with a median of [minus]0.01 [mu]m (range [minus]2.56 to 6.37 [mu]m). Among study variables, NTBI levels were only si...

Prognostic value of serum CA125 levels in diffuse large B-cell lymphoma: potential role of a new sex- and age-adjusted reference value

Clinical and Laboratory Haematology — Thu, 25 Feb 2010 00:00:00 +0100

CA125, a tumor marker normally used to follow the clinical course of ovarian cancer, also may have a role in lymphoma. All available series were analyzed using the standard reference value 35 U/ml, but age and sex may influence serum CA125 (sCA125) levels. We aim to study the prognostic value of serum CA125 (sCA125) levels in diffuse large B-cell lymphoma (DLBCL), considering the influence of age and sex on sCA125 levels. We investigated the relationship between sCA125 and clinical outcome after treatment in 42 patients with DLBCL, comparing both the standard (35 U/ml) and a new age and sex adjusted (sex/age-adjusted) reference value proposed by our group. We found that patients with elevated sCA125 levels had significantly more adverse prognostic factors at diagnosis, lower CR rates, high...

Characteristic distribution of iron in the bone marrow after parenteral iron therapy

Clinical and Laboratory Haematology — Thu, 25 Feb 2010 00:00:00 +0100

(Source: Clinical and Laboratory Haematology)

The value of the Thomas-plot in the diagnostic work up of anemic patients referred by general practitioners

Clinical and Laboratory Haematology — Thu, 18 Feb 2010 00:00:00 +0100

In this study, we assessed the diagnostic value of the so-called Thomas'-plot [soluble transferrin receptor (sTfR)/log ferritin (sTfr/log Ferr) and the reticulocyte hemoglobin equivalent (Ret-HE)] in the anemia work up of patients referred by general practitioners. During July 2008[ndash]March 2009, 337 consecutive patients were included because of lowered Hb values. The laboratory results of the first 133 consecutive patients were used to determine the cut-off values for the diagnostic plot. The laboratory results of these patients were assessed and interpreted independently by two investigators, blinded from sTfR/log Ferr and Ret-HE values. The following 204 patients were used to test the plot in practice. In 32% of the first 133 patients, no indication of the cause of anemia could be fo...

Are 10 min of seating enough to guarantee stable haemoglobin and haematocrit readings for the athlete's biological passport?

Clinical and Laboratory Haematology — Tue, 09 Feb 2010 00:00:00 +0100

Haemoglobin (Hb) and haematocrit (Hct) are measured as indirect markers of doping in athletes. We studied the effect of posture on these parameters in a typical antidoping setting. Venous blood samples were obtained from nine endurance athletes (six males, three females) and nine control subjects (six males, three females) immediately and after 5, 10, 15, 20 and 30 min after having adopted a seated position from normal daily activity. Hb (CV 0.72%) and Hct (CV 0.87%) were determined using an automated cell counter, plasma volume changes were calculated. Differences between the time points, gender and groups were calculated using a mixed-model procedure. Significant changes were observed in the first 10 min after sitting down but no further changes were noted between 10 and 30 min. Mean dir...

Comparison of a point of care device against current laboratory methodology using citrated and EDTA samples for the determination of D-dimers in the exclusion of proximal deep vein thrombosis

Clinical and Laboratory Haematology — Tue, 09 Feb 2010 00:00:00 +0100

Conclusion: The Biosite Triage D-dimer assay performed on either citrate or EDTA samples is comparable with the Stago Liatest laboratory D-dimer assay when used in conjunction with clinical pretest probability scoring and CUS for the exclusion of DVT. (Source: Clinical and Laboratory Haematology)

Production of Interleukin-10 in serum and erythropoietin sensitivity in ESRD patients on hemodialysis

Clinical and Laboratory Haematology — Tue, 09 Feb 2010 00:00:00 +0100

One of the clinical consequences of aberrant cytokines production in patients with end stage renal disease (ESRD) may be impaired erythropoiesis. To determine the interleukin (IL)-10 levels in ESRD patients on regular hemodialysis (HD) with good and poor response to recombinant human erythropoietin (Epo). Two groups of ESRD-HD patients were evaluated; 48 high epo HD patients and 32 low epo HD patients were evaluated for some laboratory tests and Interleukin-10 by ELISA. The production of IL-10 is decreased in HD with low epo group than high epo group 32.4 ± 7.9 vs. 45 ± 6.9 pg/ml (P < 0.001). IL-10 level is well correlated with CRP, ESR, Ferritin, Epo dose, and EPO/Hb ratio in ESRD-HD patients. These findings suggest that IL-10 is playing a part in affecting the response to EPO, even in ...

A novel homozygous point mutation at codon 82 (HBB:c.247A > T)) in the beta-globin gene leads to thalassemia major

Clinical and Laboratory Haematology — Sat, 06 Feb 2010 00:00:00 +0100

(Source: Clinical and Laboratory Haematology)

Evaluation of mean sphered corpuscular volume for predicting hereditary spherocytosis

Clinical and Laboratory Haematology — Fri, 05 Feb 2010 00:00:00 +0100

Hereditary spherocytosis (HS) is a common red blood cell disorder. It has been shown that the mean sphered corpuscular volume (MSCV), an artificial volume, is always lower than the MCV in HS and also in some autoimmune haemolytic anaemia (AIHA). Our purpose was to assess the reliability of MSCV in routine practise, and its relevance in screening for HS. Comparison of MSCV and MCV was undertaken in a prospective study of 366 patients with anaemia. In addition, included were patients previously diagnosed to have HS (n = 33) or AIHA (n = 16). When MSCV was lower than MCV, a flow cytometric (FC) test for HS was performed. Delta (MCV[ndash]MSCV) values >9.6 fl were obtained for all HS patients. A wider spread of delta (MCV[ndash]MSCV) values was obtained for AIHA patients whose red cells gave F...

Evaluation of the CellaVision™ DM automated microscope in pediatrics

Clinical and Laboratory Haematology — Wed, 03 Feb 2010 00:00:00 +0100

The DM is an automated microscope, which performs WBC differential counts and monitors red cell morphology. The user either validates the cell recognition if the DM has correctly identified the WBCs or reclassifies the WBCs in the good category in case of a DM mis-assignment. Morphological anomalies of leukocytes, red blood cells or platelets are analyzed and registered. We studied 521 newborns and infants sorted by age and pathology. The results correlated well with those using conventional microscopy except for samples containing blasts, in which the percentage of malignant cells was underestimated. Newborns had the lowest rates of overall accuracy and postclassification agreement. For red cell analysis, 10% of the selected areas were considered unreadable. However, the DM diagnosed fait...

RET-Y and RBC-Y in the diagnosis of iron deficiency associated with anaemia of inflammation

Clinical and Laboratory Haematology — Wed, 27 Jan 2010 00:00:00 +0100

We evaluated the usefulness of RET-Y and RBC-Y in distinguishing functional iron deficiency from iron-deficiency anaemia (IDA) in patients with anaemia of inflammation (AI). Sixty healthy blood donors constituted the control group. We studied RET-Y and RBC-Y in 115 patients with hypochromic/microcytic anaemia. Of these 42 patients had uncomplicated IDA and 73 had AI. The AI patients were further subdivided into AI with IDA and AI with functional IDA based on soluble transferrin receptor (sTfR) levels. The mean RBC-Y and RET-Y values in iron-deficient patients were 122.4 and 119.8, respectively, which were significantly lower than the control (P < 0.001). The mean level of RET-Y in patients with AI associated with IDA was 149.3 and this level in AI patients with functional iron deficiency w...

Role of mean platelet volume as discriminating guide for bone marrow disease in patients with thrombocytopenia

Clinical and Laboratory Haematology — Tue, 12 Jan 2010 00:00:00 +0100

This study was conducted to analyze the role of mean platelet volume (MPV) as a guide or an indicator for bone marrow disease in thrombocytopenic patients. All the patients with thrombocytopenia for various causes followed by bone marrow examination were divided into two groups, one group with and another without bone marrow disease, depending on pathophysiology. The MPV was statistically analyzed in both the groups to assess its role as guide for bone marrow disease in these patients. Mean MPV (average score of all individual mean values in patients) in the group with bone marrow disease was 7.3 fl, while in the group without bone marrow disease, it was 8.62 fl. Although the difference in MPV in the two groups of with (including megaloblastic anemia) and without bone marrow involvement wa...

Under-filled blood collection tubes containing K2EDTA as anticoagulant are acceptable for automated complete blood counts, white blood cell differential, and reticulocyte count

Clinical and Laboratory Haematology — Thu, 24 Dec 2009 00:00:00 +0100

Current laboratory standards from Clinical Laboratory Standards Institute (CLSI) and manufacturer's (Becton Dickinson) data indicate that under-filling K2EDTA blood collection tubes can result in erroneous hematology values. To accommodate under-filled tubes and reduce collection volumes while optimizing our automation, we explored the acceptable limit of under-filled tubes for hematology values. We collected 8.0 ml of blood from 30 normal adult volunteers. Each donation was aliquoted in the following volumes: 4.0, 2.0, 1.0, 0.5 ml × 2. These samples were analyzed within 1 h of blood collection on Sysmex XE-2100 (Sysmex America Inc., Mundelein, IL, USA) for complete blood count, reticulocyte, and white blood cell differentials. Results of the under-filled tubes were compared to those of t...

Myelodysplastic syndrome in elderly patients: correlation of CBC with cytogenetic and FISH analysis

Clinical and Laboratory Haematology — Wed, 23 Dec 2009 00:00:00 +0100

Unexplained anemia in the elderly could represent myelodysplastic syndrome (MDS). We assessed the utility of using a fluorescence in situ hybridization (FISH) panel for common chromosomal abnormalities seen in MDS. A total of 101 elderly outpatients with anemia of unknown etiology were evaluated. Complete blood count, bone marrow biopsy, conventional cytogenetic analysis (CC), and FISH panel were reviewed. A total of 21 (21%) of the 101 patients had MDS. A combination of CC and FISH identified chromosomal abnormalities in 17 (81%) of the patients with MDS. The remaining 4 (19%) were diagnosed with MDS based solely on morphologic criteria. Except in two cases, FISH did not reveal abnormalities not already detected by CC. Furthermore, MDS patients infrequently had isolated anemia (14%) as op...

Immunophenotype of myeloid granulocytes: a pilot study for distinguishing myelodysplastic syndrome and aplastic anemia by flow cytometry

Clinical and Laboratory Haematology — Mon, 30 Nov 2009 00:00:00 +0100

It is often difficult to distinguish myelodysplastic syndrome (MDS) from aplastic anemia (AA) because of the considerable clinical, cytologic histologic similarities between these two disorders; however, distinguishing between AA and MDS is of great importance because there is a higher risk of progression to acute leukemia in patients with MDS compared with AA. Up to now, CD34+ cells in MDS and AA patients have been studied extensively; however, little information is available on myeloid granulocytes. The aim of this study was to determine whether immunophenotype of myeloid granulocytes in AA patients was different from that of MDS. Flow cytometry was used to assess the immunophenotype of myeloid granulocytes in 22 patients with MDS, 12 with AA, and 10 normal subjects. Our data showed that...

Peripheral blood vs. bone marrow for molecular monitoring of BCR-ABL1 levels in chronic myelogenous leukemia, a retrospective analysis in allogeneic bone marrow recipients

Clinical and Laboratory Haematology — Mon, 30 Nov 2009 00:00:00 +0100

This study shows that BCR-ABL1 RQ-PCR monitoring of CML patients after ASCT with PB is concordant with BM in 95.3% of cases, and thus may be used to monitor the disease. This may be relevant when discussing both quality of life issues and the need for post-transplant monitoring with the patient. (Source: Clinical and Laboratory Haematology)

Pro-hepcidin and iron metabolism parameters in multi-time blood donors

Clinical and Laboratory Haematology — Mon, 30 Nov 2009 00:00:00 +0100

A high number of blood donations may cause iron depletion. The pathophysiology behind this process may involve hepcidin, a recently discovered peptide that acts by inhibiting iron absorption and promoting iron retention in reticuloendothelial macrophages. The aim of this study was to determine serum pro-hepcidin levels and iron metabolism parameters in multi-time blood donors. The study group consisted of 132 multi-time male blood donors and 25 healthy male volunteers (nondonors). Complete blood cell count and iron status including serum iron, ferritin, soluble transferrin receptor (sTfR), total iron binding capacity (TIBC), unsaturated iron binding capacity (UIBC), erythropoietin and pro-hepcidin (ELISA) were assessed. In blood donors, ferritin level drops markedly in relation to donation...

Frequent STAT3 activation is associated with Mcl-1 expression in nasal NK-cell lymphoma

Clinical and Laboratory Haematology — Tue, 24 Nov 2009 00:00:00 +0100

Nasal natural killer (NK)-cell lymphoma was resistant to various antitumor agents. Although high expression of p-glycoprotein has been reported, other molecular mechanism of the chemo-resistance is largely unknown. Activation of STAT3 and expression of major apoptosis-related proteins Bcl-2, Bcl-x, and Mcl-1 were analyzed by immunohistochemistry. Effects of STAT3 inhibitor AG490 on NK-YS cell line were analyzed by Western blotting and flow cytometric apoptosis assay. STAT3 was activated in six of the nine nasal NK-cell lymphomas (67%). In contrast, STAT3 activation was detected in 35% of diffuse large B-cell lymphoma (DLBCL) and in 10% of follicular lymphoma (FL). Frequent activation of STAT3 was significantly correlated with Mcl-1 expression in nasal NK-cell lymphoma, i.e., Mcl-1 was posi...

Using neutrophil and lymphocyte VCS indices in ambulatory pediatric patients presenting with fever

Clinical and Laboratory Haematology — Mon, 23 Nov 2009 00:00:00 +0100

(Source: Clinical and Laboratory Haematology)

How much does international normalized ratio monitoring cost during oral anticoagulation with a vitamin K antagonist? A systematic review

Clinical and Laboratory Haematology — Mon, 23 Nov 2009 00:00:00 +0100

In conclusion, the cost of INR monitoring varied substantially between studies depending on the monitoring modality and setting, and the cost categories included. When selecting a published estimate, healthcare decision makers should ensure that the chosen estimate reflects local service provision as closely as possible. (Source: Clinical and Laboratory Haematology)

Development of a biochip-based assay integrated in a global strategy for identification of fusion transcripts in acute myeloid leukemia: a work flow for acute myeloid leukemia diagnosis

Clinical and Laboratory Haematology — Mon, 23 Nov 2009 00:00:00 +0100

In this study, we propose a biochip-based assay integrated in a global strategy for identification of rare FT in AML, after fluorescence in situ hybridization detection, as described by the World Health Organization classification. Using cell lines, we developed and validated a biochip-based assay called the AMLFusionChip that identifies every FT of AML1-ETO, CBF[beta]-MYH11 as well as MLL-AF9, MLL-ENL, MLL-AF6, and MLL-AF10. The original design of our AMLFusionChip.v01 enables the identification of these FT wherever the breakpoint on the partner gene may be. In case of biochip negative result, our 3'RACE amplification strategy enables to clone and then sequence the new translocation partner. This AMLFusionChip strategy fits into the concept of personalized medicine for the largest number ...

Mean cell volume of neutrophils and monocytes compared with C-reactive protein, interleukin-6 and white blood cell count for prediction of sepsis and nonsystemic bacterial infections

Clinical and Laboratory Haematology — Tue, 17 Nov 2009 00:00:00 +0100

Clinicians are in need of better diagnostic markers for rapid diagnosis of severe infections. Therefore, we studied the diagnostic significance of mean cell volume of neutrophils (MNV) and monocytes (MMV) compared with Interleukin-6 (IL-6), C-reactive protein (CRP) and white blood cell count for predicting systemic clinical infection (sepsis). MNV and MMV were obtained by volume conductivity scatter (VCS) technique of the Coulter LH 750 hematology analyzer during automated differential counts, and blood samples from patients with sepsis (n = 37), nonsystemic bacterial infections (n = 39) and controls (n = 48) were studied. We observed a significant increase in MNV and MMV in the sepsis group compared with limited infections and controls. However, at a designated cut-off point of 250 pg/ml,...

Application of an expanded multiplex genotyping assay for the simultaneous detection of Hemoglobin Constant Spring and common deletional α-thalassemia mutations

Clinical and Laboratory Haematology — Mon, 16 Nov 2009 00:00:00 +0100

Hemoglobin Constant Spring (HbCS) is the most common nondeletional [alpha]-thalassemia variant causing HbH disease, making its detection crucial in populations at risk. Universal newborn screening for HbH is carried out in California. Identification of [alpha]-thalassemia genotypes responsible for HbH and HbH-CS requires rapid, accurate and cost-effective genotyping methods suitable for population screening. We incorporated the HbCS mutation into our existing seven-plex genotyping assay for common [alpha]-thalassemia deletions. To assess the feasibility and diagnostic utility of this expanded multiplex gap-PCR assay, we determined genotypic frequencies of HbCS in samples referred for [alpha]-thalassemia testing between 1 January 2006 and 31 December 2008. During the 3-year study period, 14...

The utility of the Sysmex XE-2100 analyzer's NEUT-X and NEUT-Y parameters for detecting neutrophil dysplasia in myelodysplastic syndromes

Clinical and Laboratory Haematology — Tue, 10 Nov 2009 00:00:00 +0100

The diagnosis of myelodysplastic syndromes (MDS) is based on morphological changes in the blood and bone marrow. The parameters NEUT-X and NEUT-Y of the Sysmex XE-2100 analyzer could help detect neutrophil dysplasia. A control group of 50 patients, along with 50 postpartum patients, 50 anemias, 50 leukopenias, 50 patients with microscopically visible hypergranulated neutrophils and 50 MDS patients were assessed. The NEUT-X and NEUT-Y values (mean ± SD) for the control group were 1346 ± 28.2 and 420 ± 19.3, respectively, with the anemia and leukopenia groups giving similar values. The postpartum and hypergranulated neutrophils groups presented higher values (P < 0.05), whereas the values in the MDS group were 1286 ± 72.8 and 385 ± 50.9 (P < 0.05), respectively. There were no difference...

Audit on the use of coagulation screen in the acute admission unit in a tertiary centre

Clinical and Laboratory Haematology — Mon, 02 Nov 2009 00:00:00 +0100

(Source: Clinical and Laboratory Haematology)

Plasma thrombopoietin level and platelet indices in hemodialysis patients receiving recombinant human erythropoietin

Clinical and Laboratory Haematology — Wed, 28 Oct 2009 00:00:00 +0100

This study included 25 HD patients undergoing treatment with rHuEPO at 9000 IU/week. These patients were divided into two groups by reference PLT of 130 × 109/l [eight patients with low PLT (L-PLT group) and 17 patients with normal PLT (N-PLT group)], and TPO level and platelet indices in each group were compared with those in nine HD patients not receiving rHuEPO. In HD patients, the mean value of MPV was slightly higher and the mean values of PLT, PCT, and MPC were significantly lower than those in healthy controls. TPO levels were significantly higher in patients receiving rHuEPO than in patients not receiving rHuEPO. However, no significant difference was found between TPO levels in patients in the L-PLT group and patients in the N-PLT group. TPO levels were not correlated with PLT in...

Direct international normalized ratio determination using multicalibrators is more responsive than the conventional method for measuring prothrombin time

Clinical and Laboratory Haematology — Wed, 28 Oct 2009 00:00:00 +0100

Direct international normalized ratio (INR) determination using certified INR plasmas was shown to improve precision and accuracy. We evaluated the utility of a multicalibrator in determining INR. INR values were measured in 493 blood samples from patients subjected to anticoagulation therapy (320) and control subjects (173). Study was performed using CA-7000 coagulation analyzer (Sysmex, Japan) with Thromborel S (Dade Behring, Germany). Direct INR values were obtained using PT-Multi Calibrator (Dade Behring) composed of five lyophilized calibrant plasmas. Conventional INR values were calculated from mean normal prothrombin time and instrument/reagent-specific international sensitivity index (ISI). We compared the difference between the INR results obtained with the two methods. The mean I...

Could rapid particle gel immunoassay (ID-PaGIA) replace standard ELISA for laboratory detection of heparin/pf4 antibodies?

Clinical and Laboratory Haematology — Wed, 28 Oct 2009 00:00:00 +0100

(Source: Clinical and Laboratory Haematology)

Hirudin-induced pseudothrombocytopenia in a patient with EDTA-dependent platelet aggregation: report of a new laboratory artefact

Clinical and Laboratory Haematology — Wed, 28 Oct 2009 00:00:00 +0100

(Source: Clinical and Laboratory Haematology)

Expression patterns of specific promyelocytic/retinoic acid receptor-α transcripts in patients with acute promyelocytic leukemia

Clinical and Laboratory Haematology — Mon, 26 Oct 2009 00:00:00 +0100

Several additional promyelocytic/retinoic acid receptor-[alpha] (PML/RAR[alpha]) transcripts besides bcr1, bcr2, and bcr3 have been identified in patients with acute promyelocytic leukemia (APL). However, the expression levels of these specific isoforms and their clinical relevance have not been studied to date. The real-time quantitative polymerase chain reaction was established to detect each specific isoform of PML/RAR[alpha] transcripts (bcr1/2, P46R3, P4R3, bcr3, and P2R3) in 46 APL patients. Whereas P46R3 and P4R3 isoforms were concurrently expressed in both bcr1- and bcr2-positive patients, P2R3 isoform was expressed only in bcr3-positive patients. A total of 13 patients had lower expression of bcr1/2 (median 11.60%, 0.86[ndash]108.51%) than that of P46R3 (median 14.26%, 6.03[ndash]...

International Council for Standardization in Haematology technical report 1-2009: new reference material for haemiglobincyanide for use in standardization of blood haemoglobin measurements

Clinical and Laboratory Haematology — Mon, 26 Oct 2009 00:00:00 +0100

The International Council for Standardization in Haematology (ICSH) in conjunction with Eurotrol, B.V. has released a new lot of the haemiglobincyanide or haemoglobin standard. This technical report describes the purpose, methodology in manufacturing, summary of value assignment data and availability of this standard material used for the standardization and calibration of whole blood haemoglobin measurements on most haemoglobinometers and automated blood cell counters throughout the world. (Source: Clinical and Laboratory Haematology)

Utility of hematologic and volume, conductivity, and scatter parameters from umbilical cord blood in predicting chorioamnionitis

Clinical and Laboratory Haematology — Sun, 27 Sep 2009 23:00:00 +0100

We evaluated the utility of routine hematologic parameters and volume, conductivity, and scatter (VCS) parameters from umbilical cord blood in predicting pathologically confirmed chorioamnionitis. Chorioamnionitis is strongly associated with early neonatal sepsis and is the major in utero source of infectious exposure. We prospectively identified mothers who had placenta submitted for pathology and subsequently identified corresponding neonate cord blood sent for routine blood typing (n = 99). Cord blood was then sent for routine complete blood count with differential (CBCD). Among the same neonates, we retrospectively identified those who had peripheral blood sent for CBCD. We collected VCS parameter data, which are used in determining an automated leukocyte differential, from our hematol...

DNA Index in childhood acute lymphoblastic leukaemia: a karyotypic method to validate the flow cytometric measurement

Clinical and Laboratory Haematology — Sun, 27 Sep 2009 23:00:00 +0100

The DNA index (DI) is a prognostic factor in childhood acute lymphoblastic leukemia (ALL). The accuracy of DI measurement is important for treatment stratification: hyperdiploidy with DI [ge] 1.16 is predictive of favorable prognosis whereas hypodiploidy is associated with poor prognosis. The aim of this study was to validate the accuracy of the DI measured by flow cytometry (FCM) by comparison with the karyotype. From samples of 112 childhood ALL, we created a formula to calculate a theoretical DNA index (tDI) based on the blast cell karyotype, taking into account the additional or missing chromosome material of the major clone. FCM DI correlated with tDI calculated from karyotype (R = 0.987) and with modal chromosome number (DI = 0.0202 × Modal NB + 0.0675 and R = 0.984). In three cases...

An evaluation of the SPIFE® 3000 semi-automated gel electrophoresis system for the identification of hemoglobin variants and comparison of relative electrophoretic mobilities with manual gel electrophoresis methods

Clinical and Laboratory Haematology — Wed, 16 Sep 2009 23:00:00 +0100

Laboratory identification of hemoglobin (Hb) variants can involve multiple techniques. The use of semi-automated instruments that perform gel electrophoresis and staining, such as the SPIFE® 3000 electrophoresis system, can greatly reduce the labor required for these commonly used techniques. We performed a comparison of the method involved in SPIFE® 3000 system with those of manual gel electrophoresis. A total of 22 540 samples were analyzed using the SPIFE® 3000, and compared with mobilities on cellulose acetate and citrate agar gels using standard manual methods. The results were compared using relative electrophoretic mobilities (REM). Of the 191 Hb variants identified, only 13 had REM that differed from manual electrophoresis when analyzed using the SPIFE® 3000 system. One variant...

Sideroblastic changes of the bone marrow can be predicted by the erythrogram of peripheral blood

Clinical and Laboratory Haematology — Tue, 25 Aug 2009 23:00:00 +0100

In this study, we analyzed the value of a specific erythrogram pattern from peripheral blood, produced by the ADVIA®120 cell counter, to predict sideroblastic changes in the bone marrow. In a two step-design study, we first showed that 32/38 consecutive patients reporting [ge]15% RS had such a pattern in the erythrogram. In the second step, we prospectively identified over a period of 32 months 21 patients with this typical erythrogram; 20/21 had [ge]15% RS in the bone marrow. Hence, by this validation, we confirm that the erythrogram is highly predictive of RS in the bone marrow. The interpretation of the erythrogram should become daily practice in hematology to improve the efficacy to detect sideroblastic changes. (Source: Clinical and Laboratory Haematology)

Relationships of serum free thyroxine and erythrocyte measures in euthyroid HFE C282Y homozygotes and control subjects: the HEIRS Study

Clinical and Laboratory Haematology — Mon, 24 Aug 2009 23:00:00 +0100

Hemoglobin (Hb) levels and mean corpuscular volume (MCV) are abnormal in some persons with hemochromatosis or thyroid disorders. We sought to determine whether serum free thyroxine (T4) affects erythrocyte measures in euthyroid adults with or without C282Y homozygosity. We evaluated 488 white HFE C282Y homozygotes and controls (no HFE C282Y or H63D; normal serum iron measures) identified in screening; we excluded those with thyroid disorders, anemia, erythrocytosis, or serum ferritin (SF) (Source: Clinical and Laboratory Haematology)

Detection of circulating antierythropoietin antibodies in patients with end stage renal disease on regular hemodialysis

Clinical and Laboratory Haematology — Sun, 23 Aug 2009 23:00:00 +0100

Recombinant human erythropoietin (rHuEPO) has been successfully and safely used to treat anemia in patients with end stage renal disease (ESRD). The safety profile of rHuEPO had been considered to be excellent with possible exception of hypertension and increased risk of dialysis access thrombosis. Recently, antibody-mediated pure red cell aplasia associated with administration of rHuEPO has been identified as a cause of major concern; we aimed to detect and evaluate the presence of anti-EPO antibodies in patients with ESRD on regular dialysis who are using rHuEPO. Serum anti-EPO antibodies were detected by enzyme-linked immunosorbant assay technique in a total of 90 patients who are currently on regular hemodialysis and using rHuEPO alpha subcutaneously for more than 6 months. All patient...

Immature platelet fraction measurement in patients with chronic liver disease: a convenient marker for evaluating cirrhotic change

Clinical and Laboratory Haematology — Wed, 19 Aug 2009 23:00:00 +0100

We examined whether the measurement of the immature platelet fraction (IPF) in thrombocytopenic patients with liver dysfunction is useful as a rapid and noninvasive method for the differential diagnosis of chronic liver diseases. We examined 20 liver cirrhosis patients, 56 patients with chronic hepatitis, 9 patients with fatty liver, and 86 patients without liver disease. The percentage value of IPF (IPF%) was measured using an XE-2100 multiparameter automatic hematology analyzer. Using a receiver operating characteristic curve, we found diagnostic significance of the absolute platelet count and the absolute number of the IPF between cirrhotic patients and noncirrhotic patients, and developed a powerful multivariate discriminant analysis (MDA) function based on the platelet count and the I...

Letter to the Editor

Clinical and Laboratory Haematology — Tue, 18 Aug 2009 23:00:00 +0100

(Source: Clinical and Laboratory Haematology)

Cotransplantation of HLA-identical mesenchymal stem cells and hematopoietic stem cells in Chinese patients with hematologic diseases

Clinical and Laboratory Haematology — Mon, 27 Jul 2009 23:00:00 +0100

Mesenchymal stem cells (MSCs) may be employed to support hematopoietic reconstitution and mitigate graft-vs.-host disease (GVHD) in transplantation of hematopoietic stem cells (HSCs). The aim of this study was to explore the feasibility and safety of cotransplantation culture-expanded MSCs and HSCs from the same human leukocyte antigen (HLA)-identical sibling donor in Chinese patients with hematologic diseases. Bone marrow mononuclear cells from healthy donors were cultured and expanded ex vivo. Immunophenotype, adipogenic and osteogenic differentiation potential, and karyotype of the harvested MSCs were detected on those who had been cotransplanted with HSCs and MSCs from the same donor. Hematopoietic reconstitutions, complications, and clinical outcomes were observed after cotransplantat...

Establishment of a reference interval for natural killer cell activity through flow cytometry and its clinical application in the diagnosis of hemophagocytic lymphohistiocytosis

Clinical and Laboratory Haematology — Tue, 14 Jul 2009 23:00:00 +0100

Recently, the Histiocyte Society revised the diagnostic criteria for hemophagocytic lymphohistiocytosis (HLH) to include low or absent natural killer (NK) cell activity, according to local laboratory reference. The aim of this study was to establish reference interval for functional NK-cell activity in 63 healthy Korean individuals using a flow-cytometric assay. We used peripheral blood mononuclear cells (PBMCs) as effector cells and Fluorescein isothiocyanate-labeled K562 cells as target cells. NK-cell activity was calculated using the following equation: NK-cell activity (%) = (test lysis [minus] spontaneous lysis) × 100/(maximum lysis [minus] spontaneous lysis). NK-cell activity was analyzed in 13 known HLH patients and 16 suspected non-HLH patients using a flow-cytometric assay. The m...

Telomerase activity and telomere length in acute leukemia: correlations with disease progression, subtypes and overall survival

Clinical and Laboratory Haematology — Tue, 14 Jul 2009 23:00:00 +0100

The progressive shortening of telomeres and the activation of telomerase are considered to be one of the important mechanisms in cellular immortalization and disease progression. Bone marrow samples were collected from 148 patients with acute leukemia (AL). Based on the stage of the disease, patients were divided into the newly diagnosed group, the relapsed group and the complete remission (CR) group. telomerase activity (TA) was examined by PCR-ELISA, and telomere length (TL) was examined by Southern blot analyses. TA and TL were analyzed in relation to AL stage and subtype. Five-year survival was analyzed using Kaplan[ndash]Meier survival curve. TA in AL patients was higher than healthy individuals. TA level was the highest in the relapsed group, followed by the newly diagnosed group, an...

An automated anti-IIa assay to measure UFH levels in plasma – a method without exogenous antithrombin

Clinical and Laboratory Haematology — Mon, 13 Jul 2009 23:00:00 +0100

(Source: Clinical and Laboratory Haematology)

Usefulness of measuring reticulocyte hemoglobin equivalent in the management of haemodialysis patients with iron deficiency

Clinical and Laboratory Haematology — Mon, 13 Jul 2009 23:00:00 +0100

In this study, to clarify the accuracy of RET-He in diagnosing iron deficiency in dialysis patients, we initially compared RET-He with such iron parameters as serum ferritin levels, transferrin saturation and content of reticulocyte hemoglobin (CHr) which has been established as indicators of functional iron deficiency. Secondly, we investigated the changes in RET-He during iron supplementation for iron-deficient patients to determine whether this marker is a prospective and reliable indicator of iron sufficiency. The participants in this study were 217 haemodialysis patients. Iron deficiency was defined as havsing a transferrin saturation (TSAT) < 20% or serum ferritin < 100 ng/ml. Conventional parameters of red blood cells and RET-He were measured by on a XE-2100 automated blood cell cou...

Anti-polymorphonuclear neutrophil antibodies in patients with leukopenia or neutropenia

Clinical and Laboratory Haematology — Sun, 05 Jul 2009 23:00:00 +0100

Conclusion: Our results suggest that diagnosis of immune Np in the laboratory may be improved by focusing on patient's PMN together with the assessment of cellular markers. (Source: Clinical and Laboratory Haematology)

Myeloablative hematopoietic stem cell transplantation for myelodysplastic syndrome in patients younger than 55 years: impact of comorbidity and disease burden on the long-term outcome

Clinical and Laboratory Haematology — Sat, 04 Jul 2009 23:00:00 +0100

We retrospectively investigated 31 myelodysplastic syndrome (MDS) patients receiving myeloablative hematopoietic stem cell transplantation (HCT) and focused on prognostic factors affecting the long-term outcome. Patients were classified according to the French-American-British classification and the HCT-comorbidity index was determined. Cytosine arabinoside or thiotepa combined with cyclophosphamide and total body irradiation was used as myeloablative conditioning in eight and 23 patients respectively. After a follow-up period of 0.8[ndash]14.2 years from transplantation (median: 6.4 years), 23 patients were alive in complete remission, and the 5-year overall survival (OS) and disease-free survival (DFS) rates were 79% and 72% respectively. The cumulative nonrelapse mortality (NRM) rate wa...

RBC-Y/MCV as a discriminant function for differentiating carriers of thalassaemia and HbE from iron deficiency

Clinical and Laboratory Haematology — Sun, 28 Jun 2009 23:00:00 +0100

Individuals with [alpha]-thalassaemia (ATT), [beta]-thalassaemia (BTT) and HbE trait (HET) are often initially identified based on haematological parameters. However, the values of these parameters usually overlap with iron deficiency anaemia (IDA) and anaemia of chronic disease (ACD). We evaluated the use of RBC-Y in 156 normal individuals and 332 patients; ATT (n = 37), BTT (n = 61), HET (n = 25), HbH disease (n = 5), ACD (n = 67), IDA (n = 83) and ACD with IDA (n = 54). Diagnostic efficiency was analysed by receiver operating characteristics (ROC). MCH was better compared with RBC-Y in discriminating normal from abnormal with sensitivity and specificity of 94% at a cut-off of 26 pg. The Green and King (G&K) index performed the best in discriminating carriers from IDA and ACD with area u...

Myelodysplastic syndromes: the role of flow cytometry in diagnosis and prognosis

Clinical and Laboratory Haematology — Thu, 25 Jun 2009 23:00:00 +0100

Flow cytometric immunophenotypic analysis is a well-recognized and widely accepted adjuvant test to increase the sensitivity and specificity of diagnosis in potential myelodysplastic syndrome (MDS) cases. In addition, flow cytometric analysis provides prognostic information in MDS that is not available from other sources. The flow cytometric findings indicative of MDS and its value is a diagnostic adjunct are discussed. (Source: Clinical and Laboratory Haematology)

Evaluating glutathione S-Transferase (GST) null genotypes (GSTT1 and GSTM1) as a potential biomarker of predisposition for developing leukopenia

Clinical and Laboratory Haematology — Wed, 24 Jun 2009 23:00:00 +0100

Glutathione S-transferase (GST) enzymes protect cells against xenobiotics and oxidative stress products through an electrophilic conjugation process. We investigated the theta (GSTT1) and mu (GSTM1) null genotypes in a group of leukopenic subjects and normal subjects from Northeast Brazil, evaluating their use as biomarkers of susceptibility for developing leukopenia. In a sample-based case[ndash]control study, we analysed white blood cell (WBC) counts and GSTT1 and GSTM1 genotypes. A total of 278 subjects were analysed: 91 with leukopenia and 187 controls. GSTT1 null genotype conferred a 5.92-fold risk for occurrence of leukopenia [odds ratios (OR) = 5.92, CIMLE: 1.64[ndash]26.72, PMLE = 0.002] and a 3.90-fold risk of neutropenia (OR = 3.90; CIMLE: 1.05[ndash]13.66; PMLE = 0.02), while GS...

BAALC and ERG expression in acute myeloid leukemia with normal karyotype: impact on prognosis

Clinical and Laboratory Haematology — Mon, 22 Jun 2009 23:00:00 +0100

Cytogenetic aberrations are important prognostic factors in acute myeloid leukemia (AML). About 45% of de novo AML lack cytogenetic abnormalities, so identification of predictive molecular markers might improve therapy. We studied the prognostic impact of brain and acute leukemia, cytoplasmic (BAALC) and ETS-related gene (ERG) expression in AML with normal karyotype. Pretreatment bone marrow samples from 30 cytogenetically normal AML patients were analysed for BAALC and ERG expression using real time RT-PCR. The patients were dichotomized at BAALC and ERG mean expression into low and high expression. BAALC showed high expression in 70% of patients and its expression did not correlate with the clinical parameters of patients. ERG was high in 33.3% of patients and its expression was associat...

Photochemical decomposition of dipyridamole in aqueous solution and the utilization of citrate–theophylline–adenosine–dipyridamole anticoagulant for monitoring of heparin

Clinical and Laboratory Haematology — Sun, 21 Jun 2009 23:00:00 +0100

(Source: Clinical and Laboratory Haematology)

Quantitation of whole blood Epstein-Barr virus DNA is useful for assessing treatment response in patients with non-Hodgkin's lymphoma

Clinical and Laboratory Haematology — Tue, 16 Jun 2009 04:00:00 +0100

Conclusion. These results suggest that whole blood EBV-DNA quantitation might be of value as a convenient biomarker for therapeutic responsiveness of NHL. (Source: Clinical and Laboratory Haematology)

International Normalized Ratio (INR), coagulation factor activities and calibrated automated thrombin generation – influence of 24 h storage at ambient temperature

Clinical and Laboratory Haematology — Wed, 27 May 2009 01:39:19 +0100

International Normalized Ratio (INR) measurements are used to monitor oral anticoagulation therapy with coumarins. Single coagulation factor activities and calibrated automated thrombin (CAT) generation are considered as more advanced methods for evaluating overall haemostatic capacity. The aims were to assess the variability of INR, coagulation factor activities, and CAT, during 24 h of storage of blood samples at ambient temperature. A total of 24 patients on stable coumarin treatment were followed prospectively for 6 weeks. INR was analyzed at 0, 6 and 24 h after blood sampling and 1-stage clotting activity of coagulation factors II, VII, IX, and X as well as CAT generation was recorded after 0 and 24 h respectively. Statistical analyses included Bland[ndash]Altman plot, 95% limits of a...

Genomic analysis of acute leukemia

Clinical and Laboratory Haematology — Tue, 19 May 2009 04:00:00 +0100

Acute leukemia is the commonest childhood cancer and a major cause of morbidity from hematologic malignancies in adults. Acute lymphoblastic leukemia (ALL) is commonest in children, and acute myeloid leukemia (AML) is more frequent in adults. Apart from childhood ALL, the prognosis of acute leukemia is suboptimal, with many patients experiencing relapse, which carries a poor prognosis, or toxicities from nonspecific therapies. Recent years have witnessed great interest in the application of high-resolution, genome wide approaches to the study of acute leukemia. These studies have identified multiple novel genetic alterations targeting critical cellular pathways that contribute to leukemogenesis, including alterations of genes regulting lymphoid development, tumor suppressors, apoptosis reg...

Real-time PCR quantification of haematopoietic chimerism after transplantation: a comparison between TaqMan and hybridization probes technologies

Clinical and Laboratory Haematology — Fri, 15 May 2009 04:00:00 +0100

This study aimed to compare the sensitivity and accuracy of two methods of quantitative real-time polymerase chain reaction (qrt-PCR), in order to determine haematopoietic chimerism (CH): single nucleotide polymorphisms using TaqMan (TM) probes and insertion/deletion polymorphisms using Hybridization (Hyb) probes. A total of 106 samples from 20 patients who underwent allogenic stem cell transplantation (n = 14) or live-donor liver transplantation (n = 6) were studied. The mean level of chimerism was 8.37% for the TM method and 7.73% in the Hyb method, which was not significantly different (P = 0.69). The Pearson correlation coefficient between the two methods was r = 0.91 (P < 0.001). The estimation of the regression line, using the Passing and Balbock method was Intercept A [minus]0.0381 ...

Investigation of the distribution of lymphocyte subsets and zinc levels in multitransfused β-thalassemia major patients

Clinical and Laboratory Haematology — Fri, 24 Apr 2009 04:00:00 +0100

This study was designed to utilize flow cytometric immunophenotyping to characterize effects of regular blood transfusion, and high serum ferritin levels because of irregular use of iron chelation therapy on T lymphocytes (CD2, CD3, CD4 and CD8), B lymphocytes (CD19) and natural killer cells (CD56) and zinc levels in the blood of patients with thalassemia major (n = 49) and healthy normal controls (n = 60) in Kuwait. None of the patients had active infections. T-cell markers' percentage levels were comparable between patients and controls (P > 0.05), while B cell marker (CD19) was significantly higher in patients (P = 0.007). Patients had lower percentage levels of CD56 cells (P = 0.007) and normal serum zinc. All patients had high serum ferritin levels with no significant correlation to C...

A novel hemoglobin variant beta135(H13) Ala > Asp identified in an asymptomatic Korean family by direct sequencing: suggesting a new insight into Hb Beckman mutation

Clinical and Laboratory Haematology — Wed, 22 Apr 2009 04:00:00 +0100

This article describes the clinical observation of a novel hemoglobin (Hb) variant found during the course of routine blood testing on a 61-year-old subject. The Hb variant was observed during HbA1c testing by ion-exchange high-performance liquid chromatography. Alkaline electrophoresis and DNA sequencing confirmed the presence of a new Hb variant, HBB:c.407C > A (p.Ala136Asp). This mutation has been reported to induce Hb Beckman variant in the Globin Gene Server. However, it was different from the only experimental report for Hb Beckman by Rahbar, Lee & Asmeron (p.Ala136Glu; Hb Beckman alpha2 beta2 135(H13) ala-to-glu: a new unstable variant and reduced oxygen affinity. Blood 78, 204a). And our case was asymptomatic with normal lab findings, while Rahbar et al.'s case showed the clinical ...

Multiple myeloma presenting with an acute bacterial infection

Clinical and Laboratory Haematology — Mon, 20 Apr 2009 04:00:00 +0100

Increased susceptibility to bacterial infections is a common manifestation of multiple myeloma (MM), arising mainly from a defect in humoral immunity and is associated with major morbidity and mortality. The propensity to infection is increased in the first months after the initial diagnosis and in patients with renal dysfunction. Gram-positive infections, mainly pneumonia from Streptococcus pneumoniae, occur more frequently in patients with untreated disease while Gram-negative infections, mainly of the urinary tract, are more common after chemotherapy. However, an acute bacterial infection is rarely reported as the first manifestation of underlying MM. In this review, we analysed data from 17 such cases reported between 1978 and 2008. Median age was 65.5 years and most patients were fema...

Evaluating five dedicated automatic devices for haemoglobinopathy diagnostics in multi-ethnic populations

Clinical and Laboratory Haematology — Mon, 20 Apr 2009 04:00:00 +0100

We have tested five haemoglobin (Hb) separation apparatuses, dedicated to haemoglobinopathy diagnostics. These are the four high performance liquid chromatography devices: VARIANT II[trade], HA 8160, G7, Ultra2 and the Capillary Electrophoresis apparatus from Sebia. In the first place, we focussed on the capacity of all apparatuses to detect the most common structural variants relevant for public health, these being HbS, HbC, HbE, HbD-Punjab and HbO-Arab. We then compared how the high HbA2[beta]-thalassaemia carriers were identified. All apparatuses were able to identify carriers of these traits with the expected sensitivity and specificity. With the primary goal of a high degree of conformity in basic diagnostics of haemoglobinopathies, we present the interpretation and the significance o...

Berend Houwen Memorial Lecture: ISLH Las Vegas May 2009

Clinical and Laboratory Haematology — Mon, 20 Apr 2009 04:00:00 +0100

Thrombotic microangiopathies are a relatively rare group of congenital and inherited disorders caused by defects in processing the ultra large forms of von Willibrand factor which pathologically give rise to platelet rich microthrombi in the micro arterial circulation leading to end organ damage particularly in the brain, heart and kidneys. Identification of the ADAMTS 13 gene has led to the definition of congenital deficiency of its activity or failure of activity due to the development of an inhibitory IgG antibody. The idiopathic autoimmune form of the disease is the most common. There are various subgroups of acquired TTP associated with HIV infection, pregnancy, pancreatitis, associated with bone marrow transplantation, various disseminated malignancies and certain drugs, particularly...

Quality counts: new parameters in blood cell counting

Clinical and Laboratory Haematology — Fri, 17 Apr 2009 04:00:00 +0100

Recently several parameters have been introduced to the complete blood count such as nucleated red blood cells, immature granulocytes; immature reticulocyte fraction, immature platelet fraction and red cell fragments as well as new parameters for detection of functional iron deficiency. Leucocyte positional parameters, which may diagnose specific diseases (e.g. differentiate between abnormal lymphocytes in leukaemia and viral conditions and may also detect malarial infection) are now available. At this time they are only used for research; however, generally such parameters later become reportable. One manufacturer's routine analyser allows measurement of cells by flow cytometry using monoclonal antibodies. Currently, there are no accredited external quality assessment schemes (EQAS) for t...

Clinical and haematological features in a compound heterozygote (HBB:c.92 + 5G > C/HBB:c.93-2A > C) case of thalassaemia major

Clinical and Laboratory Haematology — Mon, 13 Apr 2009 04:00:00 +0100

This report confirms the presence of HBB:c.93-2A > C in the Indian subcontinent and has important implications for screening and prenatal diagnosis of beta thalassaemia. This report also supports inclusion of this mutation in the beta globin gene mutation database. (Source: Clinical and Laboratory Haematology)

Clinicovirologic analysis of hepatitis C infection in transfusion-dependent β-thalassemia major children

Clinical and Laboratory Haematology — Tue, 07 Apr 2009 04:00:00 +0100

Regular blood transfusion puts [beta]-thalassemia major patients at a higher risk of developing hepatic iron overload and hepatitis C virus (HCV) infection. The association between several transfusion-related factors and an increased risk of developing HCV viremia has been reported. The effect of HCV infection on liver damage in transfusion-dependent thalassemia patients has been poorly described. A sample of 100 Egyptian transfusion-dependent [beta]-thalassemia major children were studied. Individual patients underwent full history taking, clinical examination and a panel of laboratory tests including HCV ribonucleic acid polymerase chain reaction (HCV-PCR) in blood samples. Liver biopsy was performed for 24 patients. HCV-PCR was positive in 64% of patients. A statistically significant co...

British Society for Haematology, slide session, annual scientific meeting, Glasgow, 2008

Clinical and Laboratory Haematology — Thu, 02 Apr 2009 04:00:00 +0100

A morphology session is held each year at the Annual Scientific Meeting of the British Society of Haematology. Prior to the meeting this year, eight morphology cases were made available to BSH members as glass slides and also digitally as 'virtual slides'. A panel of invited commentators who had no prior knowledge of the diagnosis discussed the eight cases. An initial limited history and blood count are given with representative images from the case material; this is followed by the discussants' comments and suggested diagnosis. The actual clinical diagnosis is then given with other relevant information. (Source: Clinical and Laboratory Haematology)

Can Thromboelastography performed on kaolin-activated citrated samples from critically ill patients provide stable and consistent parameters?

Clinical and Laboratory Haematology — Fri, 20 Mar 2009 04:00:00 +0100

Thromboelastography (TEG®) is a potentially useful tool but analysis within 4-6 min of collection imposes limitations on its use and access. The use of citrate blood tubes potentially increases the time frame for processing specimens. There is, however, limited research on the stability of citrate specimens, timing of processing and the accuracy of TEG® results. The purpose of this study was to examine the effects of early and delayed processing on TEG® parameters using kaolin-activated citrated blood samples in the intensive care population. TEG® analysis was performed on 61 patients. Blood was collected into two 3.2% sodium citrate (0.105 m) tubes. Kaolin-activated samples were analysed at 15, 30 and 120 min postcollection. TEG® parameters analysed included reaction time (R), clot f...

Expression profile of Notch-related genes in multidrug resistant K562/A02 cells compared with parental K562 cells

Clinical and Laboratory Haematology — Tue, 17 Mar 2009 04:00:00 +0100

Drug resistance is the major setback of acute myeloid leukemia (AML) therapy. Notch proteins have demonstrated functional regulation in cell proliferation, differentiation, and apoptosis and thus may affect drug resistance. Our study aimed to identify the Notch-related gene profile in drug-resistant AML cells and provide potential strategies for resistant AML therapy. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was conducted to detect the cytotoxicity of adriamycin toward K562 and drug-resistant K562/A02. Intracellular mean fluorescence intensity was monitored to reflect the intake of adriamycin by confocal microscopy. cDNA microarray was used to test the expression of 113 Notch signaling pathway-related genes in K562/A02 and K562. Real-time reverse transcriptase pol...

Apoptosis inducing and differentiation enhancement effect of oridonin on the all-trans-retinoic acid-sensitive and -resistant acute promyelocytic leukemia cells

Clinical and Laboratory Haematology — Sat, 14 Mar 2009 04:00:00 +0100

We investigated the effects of oridonin (Ori), a diterpenoid isolated from Rabdosia rubescens, on apoptosis and differentiation of all-trans-retinoic acid (ATRA)-sensitive (NB4) and ATRA-resistant (NB4-R1) cells. The results showed that reactive oxygen species initiates Ori-induced apoptosis. In addition, we found that neither Ori nor ATRA (10 nm) alone induced marked cell differentiation, while co-treatment of these two compounds can induce differentiation of NB4 and NB4-R1 cells which was accompanied by increased RAR[alpha], C/EBP[epsilon] or C/EBP[beta]. This is the first report to show that RAR[alpha] could be accumulated by Ori which may be useful as a probe to investigate the mechanism of RAR[alpha] catabolism. These results suggest that Ori is a potential candidate for acute promyel...

Fresh-frozen, optimal cutting temperature (OCT) compound-embedded bone marrow aspirates: a reliable resource for morphological, immunohistochemical and molecular examinations

Clinical and Laboratory Haematology — Mon, 09 Mar 2009 04:00:00 +0100

The usefulness of fresh-frozen, optimal cutting temperature (OCT) compound-embedded (FFOE) bone marrow (BM) aspirates was evaluated as a reliable resource for morphological, immunohistochemical and molecular examinations. One hundred BM aspirates were collected in polypropylene tubes and immediately frozen for 2 h in a deep freezer. Frozen BM was transferred to a cryomold filled with OCT compound and the prepared samples were stored in a deep freezer. Histological examination and immunohistochemical staining, polymerase chain reaction (PCR), sequencing and reverse transcription (RT)-PCR were performed to evaluate the quality of the FFOE BM sections in 10% of randomly selected samples. FFOE BM sections revealed better morphologies than paraffin-embedded clot sections in haematoxylin and eos...

Enhanced expression of CD71, transferrin receptor, on immature reticulocytes in patients with paroxysmal nocturnal hemoglobinuria

Clinical and Laboratory Haematology — Fri, 06 Mar 2009 05:00:00 +0100

Erythroid cells in the marrow express CD71, transferrin receptor, and reticulocytes released from the marrow lose their expression during maturation. The immature reticulocyte fraction, the proportion of reticulocytes with the highest content of RNA, has been determined by hematology analysis. In the present study, we examined CD71 expression on immature reticulocytes by flow cytometry (FCM) in paroxysmal nocturnal hemoglobinuria (PNH) patients with reticulocytosis. We modified 'reticulocyte-gated FCM' to multi-color FCM, i.e. RNA/CD71, RNA-CD59 or CD59/CD71/CD45. In PNH, in addition to the increased number of immature reticulocytes (%CD71-positive), a more immature phenotype in regard to both CD71 intensity and RNA content levels was demonstrated. In seven PNH patients studied, %CD71-posi...

Detecting methylation patterns of p16, MGMT, DAPK and E-cadherin genes in multiple myeloma patients

Clinical and Laboratory Haematology — Wed, 04 Mar 2009 05:00:00 +0100

In this study, the methylation status of four genes; p16, O6-methyl guanine DNA methyl transferase (MGMT), death-associated protein kinase (DAPK) and E-cadherin (ECAD); at the time of diagnosis was investigated using methylation-specific polymerase chain reaction (MS-PCR). In the 20 cases studied; methylation of the promoter regions of p16, MGMT, DAPK and ECAD genes was detected in 10%, 40%, 10% and 45% of the cases, respectively. In 65% (13/20) of cases, at least one of the genes studied had promoter methylation; while 35% of cases (7/20) had methylated promoters of more than one gene. There was a significant correlation between promoter hypermethylation of MGMT and the presence of extramedullary involvement; but for the other genes no correlation was found regarding disease properties li...

Clinical and hematological study for Parvovirus b19 infection in children with acute leukemia

Clinical and Laboratory Haematology — Sat, 28 Feb 2009 05:00:00 +0100

This study aimed to detect parvovirus B19 DNA together with its antibodies in the sera of children with recent acute leukemia and those with acute leukemia receiving chemotherapy to clarify the contribution of this infection to changes observed in hematological and clinical presentations in these populations. Two groups were included: Group I comprised 45 children with acute leukemia receiving chemotherapy and Group II comprised 40 children with recently diagnosed acute leukemia. Serum parvovirus B19 IgG and IgM were investigated by enzyme-linked immunosorbant assay and the virus DNA was sought by polymerase chain reaction assay. Viral DNA was found in 22.2% of Group I patients and in 45% of Group II patients. Hemoglobin levels were significantly reduced in patients with recent infection, ...

International Council for Standardization in Haematology – the first 40 years

Clinical and Laboratory Haematology — Thu, 26 Feb 2009 05:00:00 +0100

This brief history of the origin and development of ICSH must, inevitably, be selective as it has been extracted from the many pages of the records of the meetings of the ICSH board and its secretariat, the annual assembly and the reports of the various expert panels and working groups. It is hoped that it will give a picture of the way in which ICSH functioned and the many experts around the world who have contributed to its activities [ndash] but with an apology and appreciation, to other colleagues who have not been named in this annotation, but who made significant contributions to the activities that are described. (Source: Clinical and Laboratory Haematology)

Letter to the Editor

Clinical and Laboratory Haematology — Thu, 26 Feb 2009 05:00:00 +0100

(Source: Clinical and Laboratory Haematology)

Plasma levels of JAK2 mRNA in patients with chronic myeloproliferative diseases with and without V617F mutation: implications for prognosis and disease biology

Clinical and Laboratory Haematology — Wed, 25 Feb 2009 05:00:00 +0100

In conclusion, we studied JAK2 total and V6217F mutant mRNA levels in plasma. We show high levels of JAK2 expression in MPD patients and these levels correlate with survival. (Source: Clinical and Laboratory Haematology)

The effects of proteasome inhibitor bortezomib on a P-gp positive leukemia cell line K562/A02

Clinical and Laboratory Haematology — Wed, 25 Feb 2009 05:00:00 +0100

The aim of this study is to clarify the efficacy of proteasome inhibitor bortezomib to multidrug resistant (MDR) acute leukemia cells. We observed the effects of bortezomib on a P-glycoprotein (P-gp) positive leukemia line K562/A02. The results showed that bortezomib has significant effects on P-gp positive K562/A02 cells including cytotoxicity (48 h IC50: 171.36 nm), induction of apoptosis (31.71 ± 1.07% apoptotic cells after 24 h treatment at 100 nm), and inhibition of proteasome chymotrypsin-like activity (relative activity to untreated controls: 20.07 ± 0.66% at 24 h with 10 nm bortezomib). These effects were lower than those observed in K562 cells (IC50, percentage of apoptotic cells, relative chymotrypsin-like activity to untreated controls were 56.28 nm, 77.95 ± 0.35%, 5.35 ± 2....

Ferritin assays on the Beckman Access using EDTA-plasma samples

Clinical and Laboratory Haematology — Wed, 25 Feb 2009 00:00:00 +0100

(Source: Clinical and Laboratory Haematology)

Comparison between two functional assays to detect factor V Leiden

Clinical and Laboratory Haematology — Wed, 18 Feb 2009 05:00:00 +0100

(Source: Clinical and Laboratory Haematology)

Prognostic relevance of 9q34 deletion and the suppressor of cytokine signalling-1 in CML patients

Clinical and Laboratory Haematology — Tue, 17 Feb 2009 05:00:00 +0100

This study aims to determine the incidence and prognostic value of the 9q34 deletion using fluorescence in situ hybridization and SOCS-1 mRNA aberrant expression by PCR in 43 CML patients at different phases of the disease and in 10 normal controls and correlate the data to interferon response. All patients were Philadelphia-positive, deletions of 9q34 were observed in 20.9% of all patients (13.3% chronic phase, 10% accelerated phase and 33.3% in blast crisis). SOCS expressions were positive in 53.4% of all patients (40% chronic phase, 50% AP and 66.67% in blast crisis). Analysing outcome based on 9q34 deletion and SOCS expression status showed a statistically significant difference in overall survival and progression-free survival between those with deletions and those without (P < 0.001)...

Performance of automated slidemakers and stainers in a working laboratory environment – routine operation and quality control

Clinical and Laboratory Haematology — Wed, 11 Feb 2009 05:00:00 +0100

The automated slidemaker/stainers of the four Beckman Coulter LH755 hematology systems in our laboratory are operated as analyzers, with similar requirements for setup, maintenance and quality control. A study was performed to confirm that these slide maker/stainers in routine use produce peripheral blood films that are completely satisfactory for microscopy and without cells, particularly abnormal cells, being pulled to the edges or sides of the film outside the usual working area. One hundred and thirty-nine automated blood films that had been produced during routine operation were compared with well-prepared manual films from the same patients. None of the films was unacceptable for microscopy. The distributions of normal white cell types within the counting areas of automated films com...

Right or wrong sample received for coagulation testing? Tentative algorithms for detection of an incorrect type of sample

Clinical and Laboratory Haematology — Tue, 10 Feb 2009 05:00:00 +0100

This study aimed to identify a simple, quick and inexpensive process to help laboratories distinguish the type of sample, should there be suspicion of inappropriate collection. Samples from 15 patients [selected on the basis that four different primary tubes were available: serum, citrated plasma, ethylene diamine tetraacetic acid (EDTA) plasma, lithium-heparin plasma], were tested for common electrolytes that might substantially differ according to the type of sample. In citrated plasma, potassium, chloride, calcium and magnesium were significantly decreased compared with serum and lithium-heparin plasma, while sodium was markedly increased. In EDTA plasma, sodium and chloride were significantly decreased compared with both serum and lithium-heparin plasma, potassium was always >14 mmol/l...

The new mature red cell parameter, low haemoglobin density of the Beckman-Coulter LH750: clinical utility in the diagnosis of iron deficiency

Clinical and Laboratory Haematology — Mon, 09 Feb 2009 05:00:00 +0100

This study aimed to establish LHD% values in the normal population and in different types of anaemia, to investigate its clinical usefulness in the study of iron status and its correlation with %Hypo. Samples from 449 patients [120 healthy individuals, 86 iron deficiency anaemia (IDA), 102 chronic kidney disease, 58 anaemia of chronic disease and 83 [beta]-thalassaemia carriers] were run sequentially on the LH 750 (Beckman-Coulter) and Advia 2120 (Siemens) analysers. The reliability of LHD% as a marker of iron deficiency was evaluated on a group of 152 consecutive patients with IDA. Good correlation was observed between %Hypo and LHD%, r2 = 0.869. Receiver operating characteristic curve analysis for LHD% and the diagnosis of iron deficiency was: cut-off point 4.0%; area under the curve 0.9...

Arsenic-trioxide-induced apoptosis of chronic lymphocytic leukemia cells

Clinical and Laboratory Haematology — Thu, 05 Feb 2009 05:00:00 +0100

Chronic lymphocytic leukemia (CLL) cells are characterized by defective apoptosis which leads to their extended survival. Arsenic trioxide (As2O3) was reported to induce cell death in many malignant cells, but the specific pathway of As2O3-induced apoptosis/necrosis remains controversial. Our aim was to determine if As2O3 kills CLL cells through apoptosis and whether this is accompanied by reduction in Bcl-2 levels. Cells from nine patients with CLL were incubated with increasing concentrations of As2O3 (0.5[ndash]2 [mu]m) for 2, 7, or 14 days. Cells viability was measured using Alamar Blue assay and apoptosis using human Annexin V-FITC and propidium iodine (PI) kit (BMS306FI; Bender MedSystems, Vienna, Austria). Intracellular Bcl-2, Bax, and caspase-3 levels were measured by flow cytometr...

Evaluation of Ves-Matic Cube 200 – an automated system for the measurement of the erythrocyte sedimentation rate

Clinical and Laboratory Haematology — Tue, 20 Jan 2009 03:50:24 +0100

Ves-Matic Cube 200 is fully automated analyzer that performs erythrocyte sedimentation rate (ESR) measurement using the standard ethylenediaminetetraacetic acid blood sample tube, thus markedly reducing the analytical time and avoiding the need for an extra blood sample. The aim of this study was to assess the automatic Ves-Matic Cube 200 system for the measurement of ESR in comparison with the original International Council for Standardization in Hematology reference method (Westergren). The evaluation comprised accuracy which was established using a 95% confidence interval (CI) for the mean difference between Ves-Matic Cube 200 and Westergren method (mean of difference: 0.47 ± 6.84 mm/h; 95% CI: [minus]0.376 to 1.325 mm/h), within-run imprecision for samples with ESR values of 9, 42 and...

In vitro studies with 'acatalasemic-like' erythrocytes and hydrogen peroxide: attention to the formation of lysis resistant erythrocytes

Clinical and Laboratory Haematology — Mon, 19 Jan 2009 03:47:46 +0100

Hemolysis assays, using hydrogen peroxide as an oxidant injury agent and sodium azide as a catalase inhibitor, were performed to evaluate how assay conditions affect the development of lysis resistant erythrocytes. The concentration of hydrogen peroxide should be carefully selected for use in hemolysis assays, as it was found to affect the number of water resistant erythrocytes. (Source: Clinical and Laboratory Haematology)

Role of RFLP using TspRI for carrier detection in Glanzmann's thrombasthenia: a report on two families

Clinical and Laboratory Haematology — Sun, 18 Jan 2009 05:00:00 +0100

Glanzmann's thrombasthenia (GT) was diagnosed in two patients who presented with bleeding manifestations accompanied by absent platelet aggregation, secondary to adenosine-5'-diphosphate, adrenaline, arachidonic acid and collagen. Flow cytometry analysis for GPIIb/IIIa expression was done using CD61 and CD41 markers in these patients and their family members including siblings. The patients were sub typed as Type I as he had absent glycoproteins (GP) IIb/IIIa. Family studies by flow cytometry showed reduced GPII/IIIa expression in both the parents and one sibling. However, western blot showed abnormal GPIIb protein in all the family members including siblings. It is possible that abnormal GPIIb protein by western blot in family members may reflect their carrier status. Patients' DNA was an...

The utility of immature reticulocyte fraction as an indicator of erythropoietic response to altitude training in elite cyclists

Clinical and Laboratory Haematology — Sun, 18 Jan 2009 05:00:00 +0100

Altitude training is sometimes employed by elite endurance athletes to improve their sea level performance. This improvement results from the increased red cell mass consequent upon the boost in erythropoietin (EPO) level that occurs as a response to the relatively hypoxic environment at high altitudes. We measured serum EPO levels together with various red cell and reticulocyte parameters including immature reticulocyte fraction (IRF) in eight national track-endurance cyclists, resident at sea-level, prior to and upon return from an altitude of approximately 1905 m. Reticulocytes and soluble transferrin receptor (sTfR) were significantly increased with reduction in ferritin levels immediately on return from high altitude indicating increased erythropoietic activity. IRF in particular show...

A biparametric flow cytometry analysis for the study of reticulocyte patterns of maturation

Clinical and Laboratory Haematology — Fri, 16 Jan 2009 05:00:00 +0100

Automated haematological analysers still represent the gold standard for the study of reticulocyte maturation even if this technique is based on structural properties and staining affinity rather than on functional aspects. On the contrary, flow cytometry allows the simultaneous analysis of multiple cellular characteristics including functional features. Aim was to investigate whether simultaneous analysis of different reticulocyte parameters using flow cytometry may add functional information when considering their pattern of maturation. Thirty-nine healthy donors (H) and 31 haemodialysed patients on treatment with rHuEpo (HDT) were analysed. Reticulocyte counts and their stages of maturation were studied both with ADVIA 2120 and by flow cytometry. TO/CD71 scattergraph reticulocyte analys...

Sodium valproate in combination with ganciclovir induces lysis of EBV-infected lymphoma cells without impairing EBV-specific T-cell immunity

Clinical and Laboratory Haematology — Mon, 12 Jan 2009 05:00:00 +0100

We present a case of a patient with multiple relapsed EBV-positive Diffuse Large B-cell Lymphoma that was chemo-refractory to anthracylcines, alkylating agents and rituximab. Treatment was commenced with the HDACi sodium valproate (VPA) in combination with the anti-viral nucleoside analogue ganciclovir (GCV). Therapy resulted in detectable cell-free unencapsulated circulating EBV-DNA providing supportive evidence for the first-time that lysis of virus infected lymphoma cells is induced using this therapeutic combination. EBV-specific CD8+ effector T-cell immunity was not impaired by VPA/GCV. Although GCV/VPA was insufficient to induce clinical remission, our data furthers the rationale that more potent HDAC inhibitors such as butyrate or gemcitabine together with GCV, perhaps in combinatio...

Methylation of DAPK1 promoter: frequent but not an adverse prognostic factor in myelodysplastic syndrome

Clinical and Laboratory Haematology — Mon, 12 Jan 2009 05:00:00 +0100

In this study, the methylation status of death-associated protein kinase 1 (DAPK1) gene promoter was analyzed by using methylation-specific polymerase chain reaction in bone marrow (BM) samples from 59 patients with different stages of MDS. The abnormal methylation of the DAPK1 gene was found in 37 of 59 (62.7%) MDS cases. The correlation was significant between the sex and the methylation status of DAPK1 promoter in MDS patients (R = 0.332, P = 0.010). Furthermore, methylation status of DAPK1 promoter was associated with the percentage of BM blasts (R = 0.346, P = 0.010) and International Prognosis Scoring System (IPSS) groups (R = 0.278, P = 0.034). The estimated 50% survival time of the methylated DAPK1 group and unmethylated group was 20 and 33 months, respectively. There was no signif...

Acute variation of leucocytes counts following a half-marathon run

Clinical and Laboratory Haematology — Mon, 12 Jan 2009 05:00:00 +0100

There is growing interest on haematological changes following elite and recreation sports. However, no information is available on leucocyte variations after an intermediate-distance run. Complete blood cell count was assessed on 17 trained, middle-aged males before a 21-km half-marathon, at the end and 3, 6, 24 h thereafter. Statistically significant variations by one-way analysis of variance were observed for all the parameters tested. Haematocrit, haemoglobin and red blood cells and platelet count increased significantly by the end of the run and returned to pre-run values 3 h thereafter. White blood cells, neutrophils, monocytes and basophils counts increased after the run, reached the peak at 3 h and returned to the baseline after 24 h. Conversely, the eosinophils count significantly ...

The additional role of bone marrow particle sections ('clot sections') in confirming marrow involvement by multiple myeloma: a single centre study

Clinical and Laboratory Haematology — Mon, 12 Jan 2009 05:00:00 +0100

(Source: Clinical and Laboratory Haematology)

Immunohistochemistry is a more sensitive marker for the detection of myeloperoxidase in acute myeloid leukemia compared with flow cytometry and cytochemistry

Clinical and Laboratory Haematology — Thu, 11 Dec 2008 03:52:23 +0100

Myeloperoxidase (MPO) is an unequivocal marker of myeloid differentiation which is routinely detected using cytochemistry (CC), flow cytometry (FC) and immunohistochemistry (IH). Several studies have compared the use of two of these methods, but to our knowledge none has compared all three techniques. We compared the performance of these three modalities in the detection of MPO in 158 cases of acute myeloid leukaemia (AML). Discrepancies were noted in a total of 28 cases. Of 110 cases in which all three modalities were performed, 23 cases showed discrepancies. CC was the least sensitive marker, being negative in 11 of 23 cases in the presence of positive IH and/or FC. IH was the most sensitive marker with only one case being negative in the presence of a positive result by FC and/or CC. Th...

Frequency and distribution of Epstein–Barr virus infection and its association with P53 expression in a series of primary nodal non-Hodgkin lymphoma patients from South India

Clinical and Laboratory Haematology — Sun, 07 Dec 2008 03:57:53 +0100

This study investigated the prevalence of Epstein[ndash]Barr virus (EBV) infection and its association with P53 expression in a panel of 87 previously untreated nodal non-Hodgkin lymphomas (NHLs) from India. Polymerase chain reaction specific for Epstein Barr nuclear antigen 1 (EBNA1) and EBNA-3C was performed on the lymphnode tissue DNA, while P53 expression was analyzed by immunohistochemistry. EBV, predominantly type A strain, was detected in 27/87 (31%) nodal lymphoid malignancies, 11/46 diffuse large B-cell lymphomas, 6/17 follicular lymphoma, 4/6 anaplastic large cell lymphomas (ALCL), 5/11 peripheral T-cell lymphomas (PTCL) and 1/7 lymphoblastic lymphomas. EBV infection was more frequently observed in a specific subset of nodal NHL, suggesting a causative role of EBV infection in th...

Oxidative stress may modify zinc protoporphyrin/heme ratio in hematofluorometry

Clinical and Laboratory Haematology — Thu, 04 Dec 2008 05:00:00 +0100

Washed red blood cells (RBCs), supplemented or non-supplemented with sodium azide (to inhibit catalase activity), were exposed to different concentrations of hydrogen peroxide as well as ascorbic acid. Strikingly, catalase within RBCs protected the cells against exogenic hydrogen peroxide even at millimolar concentrations. However, the activity of the erythrocytic catalase failed to protect the RBCs when they were exposed to an oxidative burst of stimulated polymorphonuclear cells (PMNCs) in the presence of several reactive species in addition to peroxide. Oxyhemoglobin, with an excess of hydrogen peroxide, formed oxidized hemoglobin species and caused protein denaturation as well as the rise of heme degradation products which was suspected to falsify zinc protoporphyrin/heme (ZPP/heme) ra...

United Kingdom myeloma forum position statement on the use of lenalidomide in multiple myeloma

Clinical and Laboratory Haematology — Fri, 28 Nov 2008 05:00:00 +0100

Lenalidomide is an immunomodulatory drug, which has anti-myeloma activity in vitro. Phase II clinical trials have demonstrated lenalidomide in combination with dexamethasone is effective for the treatment of both relapsed refractory myeloma and newly diagnosed patients. Two large phase III studies comparing lenalidomide and dexamethasone to dexamethasone alone in relapsed patients showed superiority in response, progression free and overall survival. It is administered orally for 21 days in a 28 day cycle. Side effects are manageable and include neutropenia and venous thrombotic events. It is currently approved, in combination with dexamethasone, for the treatment of multiple myeloma patients who have received at least one prior therapy. Studies in front line patients and with other drug c...

Oral cobalamin (vitamin B12) treatment. An update

Clinical and Laboratory Haematology — Sun, 23 Nov 2008 04:20:42 +0100

The objective of this review was to evaluate oral cobalamin (vitamin B12) therapy in adult and elderly patients, from the perspective of a hematologist. PubMed was systematically searched for English and French articles published from January 1990 to January 2007. Data from our working group, the 'Groupe d'étude des carences en vitamine B12des Hôpitaux Universitaires de Strasbourg', have also been included. Several prospective studies in well-determined population (n = 4), prospective randomized studies (n = 3) and a systematic review by the Cochrane group (n = 1) provide evidence that oral cobalamin therapy may adequately treat cobalamin deficiency, particularly hematological abnormalities or manifestations. These studies suggest that at least 1000 [mu]g/day of oral cyanocobalmin are ne...

Definition of ringed sideroblasts

Clinical and Laboratory Haematology — Fri, 21 Nov 2008 05:00:00 +0100

(Source: Clinical and Laboratory Haematology)

Definition of ringed sideroblast

Clinical and Laboratory Haematology — Fri, 21 Nov 2008 05:00:00 +0100

(Source: Clinical and Laboratory Haematology)

Modified ELISPOT assay may predict T-cell hyporesponsiveness to non-inherited maternal antigens

Clinical and Laboratory Haematology — Fri, 21 Nov 2008 05:00:00 +0100

Clinical reports have suggested the existence of immunological tolerance to noninherited maternal antigens (NIMA) in human leukocyte antigen (HLA) mismatched allogeneic stem cell transplantation (allo-SCT). We studied the T-cell reactivity using IFN-[gamma] enzyme-linked immunospot (ELISPOT) assay in three HLA fully matched allo-SCT cases and one healthy volunteer family case. In HLA fully matched allo-SCT cases, ELISPOT assay could detect the hyporesponsiveness of T cells from donors to the B cells from recipients. Moreover, ELISPOT assay showed that the T cells from an individual responded to B cell from his mother significantly weakly than those from an unrelated HLA-haploidentical individual. These observations suggest that our IFN-[gamma] ELISPOT assay-based method may predict the pre...

The reliability of point-of-care prothrombin time testing. A comparison of CoaguChek S® and XS® INR measurements with hospital laboratory monitoring

Clinical and Laboratory Haematology — Fri, 21 Nov 2008 05:00:00 +0100

This study adds to the growing evidence that POC testing is a reliable and safe alternative to hospital laboratory monitoring but highlights the importance of external quality control when these devices are used for monitoring oral anticoagulation. (Source: Clinical and Laboratory Haematology)

Rapid real-time PCR assay for detection of MPL W515L mutation in patients with chronic myeloproliferative disorders

Clinical and Laboratory Haematology — Wed, 12 Nov 2008 05:00:00 +0100

We report here a highly specific real-time assay based on the TaqMan® technology to detect the MPL W515L mutation with high sensitivity from the patient's blood. This assay can be easily performed together with the JAK2 V617F mutation assay on the same real-time PCR reaction plate. (Source: Clinical and Laboratory Haematology)

Comparison of laboratory detection methods of aspirin resistance in coronary artery disease patients

Clinical and Laboratory Haematology — Mon, 10 Nov 2008 05:00:00 +0100

Aspirin reduces the prevalence of nonfatal myocardial infarction, stroke, and death by 25.0% in high risk group of patients with cardiovascular disease. Previous studies have estimated that about 5.5[ndash]56.8% of the population are aspirin resistant. The mechanisms of aspirin resistance (AR) have not been fully understood. We compared the detection methods for AR using traditional platelet aggregometry and VerifyNow system. One hundred and seventy-two coronary artery disease patients who had taken aspirin only or combinations with aspirin and clopidogrel for over 7 days were included. Of the 55 patients with aspirin only, aggregometer detected six AR (10.9%) and VerifyNow identified 10 AR (18.2%) cases. Among 117 patients with combined therapy, none (0.0%) and 10 (8.5%) of AR were detect...

Position statement on the use of lenalidomide in multiple myeloma

Clinical and Laboratory Haematology — Tue, 04 Nov 2008 05:00:00 +0100

Pseudohyperkalaemia is a common finding in myeloproliferative disorders that may lead to inappropriate management of patients

Clinical and Laboratory Haematology — Mon, 03 Nov 2008 05:00:00 +0100

Pseudohyperkalaemia in conditions with increased platelet counts is caused by an in vitro rise of the serum potassium concentration during whole blood coagulation and the lysis of the platelets and other cellular components, in the presence of normal renal function and normal plasma potassium levels. The association between pseudohyperkalaemia and aetiology of thrombocytosis was studied in a 6-year retrospective audit on 90 patients with thrombocytosis referred to the Haematology Department in Ulster Hospital Dundonald, a large district general hospital. Over two-thirds of this study population had myeloproliferative disorders, and the most common diagnosis was primary thrombocythaemia (41%, n = 37). Reactive thrombocytosis was observed in approximately one-third of the cases (32%, n = 29)...

A retrospective study of the utility of desmopressin (1-deamino-8-D-arginine vasopressin) trials in the management of patients with von Willebrand disorder

Clinical and Laboratory Haematology — Thu, 30 Oct 2008 04:00:00 +0100

(Source: Clinical and Laboratory Haematology)

Frequency of Mediterranean mutation among a group of Saudi G6PD patients in Western region-Jeddah

Clinical and Laboratory Haematology — Thu, 16 Oct 2008 04:00:00 +0100

Glucose-6-phosphate dehydrogenase deficiency (G6PD), a common human enzymatic defects characterized by extreme molecular and biochemical heterogeneity is found to have a variable frequency in different regions. The molecular basis of polymorphic variants in Saudi Arabia have yet to be fully addressed to. Accordingly, a study was designed to determine the frequency of G6PD gene mutations in G6PD deficient cases. From forty-seven unrelated G6PD-deficient subjects, DNA was extracted individually from peripheral blood samples and exons 6 and 7 of the G6PD gene were amplified by PCR. Mutation analysis was carried out by using conformation sensitive gel electrophoresis (CSGE), followed by direct DNA sequencing. The results showed definite altered CSGE patterns. Two mutations were resolved in exo...

Discrepancies between APTT results determined with different evaluation modes on automated coagulation analyzers

Clinical and Laboratory Haematology — Thu, 16 Oct 2008 04:00:00 +0100

The objectives of this study were to determine the possible impact of an evaluation mode on activated partial thromboplastin time (APTT) results and to investigate potential benefits from visual inspection of obtained reaction curves. APTT was determined by using actin FS as reagent on two coagulometers (Siemens Medical Solutions) in 174 plasma samples with three different evaluation modes: fixed absorbance (FA), drifting baseline (DB), and point of inflexion (POI) on Behring coagulation timer (BCT), and with DB mode on Behring coagulation system (BCS). Statistically significant difference of APTT results applying the Friedman's test (P < 0.0001) followed by Dunn's multiple comparison test (P < 0.05) was obtained in all tested samples between POI mode and all other evaluation modes, indepe...

Flow cytometric detection of circulating endothelial cells and endothelial progenitor cells in healthy subjects

Clinical and Laboratory Haematology — Thu, 16 Oct 2008 04:00:00 +0100

This study aimed to develop a flow cytometric (FCM) method for the immunophenotipic detection and enumeration of these cells in a healthy population. Peripheral blood samples from 32 subjects were analysed. Multiparameter FCM analysis was used to quantify resting and activated CEC and CEP. The mean values of the percentage and of the absolute number were: 0.005 ± 0.004% and 306 ± 243 cells/ml for CEC; 0.002 ± 0.001% and 130 ± 110 cells/ml for rCEC; 0.003 ± 0.002% and 176 ± 150 cells/ml for aCEC; 0.0001 ± 0.00005% and 6 ± 2 for CEP. We confirmed that FCM is an accurate and sensitive method for the quantitative analysis of CEC and CEP. The determination of normal ranges of CEC and CEP is helpful in defining their role as surrogate biomarkers of antiangiogenic treatment efficacy durin...

Evaluation of mean platelet volume in the differential diagnosis of thrombocytopenia

Clinical and Laboratory Haematology — Thu, 16 Oct 2008 04:00:00 +0100

(Source: Clinical and Laboratory Haematology)

Immunophenotypic analysis of cerebrospinal fluid cell populations with the Cell-Dyn Sapphire haematology analyser: method feasibility and preliminary observations

Clinical and Laboratory Haematology — Wed, 15 Oct 2008 04:00:00 +0100

Cerebrospinal fluid (CSF) samples (n = 50) from patients with neurological disease (bacterial infection, viral infection, neuroborreliosis and multiple sclerosis) were analysed to characterize cell populations by fluorescent immunocytometry with the CD-Sapphire haematology analyser. Reagent combinations applied to all CSF samples comprised CD3/CD19/HLA-DR and CD4/CD8, with some being further analysed using CD3/CD4, CD3/CD16 and CD3/CD25 protocols. Of the 50 samples, 11 were excluded because of high proportions of nonviable cells (n = 2) or insufficient cell numbers (n = 9). Apart from bacterial infection with granulocytosis, all diagnostic groups showed high proportions (51.4[ndash]77.0%) of CD3+ T cells. There was a modest association between T-cell and B-cell counts, but absolute B-cell ...

Differences in detecting blasts between ADVIA 2120 and Beckman-Coulter LH750 hematology analyzers

Clinical and Laboratory Haematology — Tue, 14 Oct 2008 04:00:00 +0100

The complete blood count is often used as a screening tool to detect hematologic abnormalities in the peripheral blood. In patients with suspected or known leukemia, blast cells serve as an indicator of disease pathology. We compared the analytical performance of the Siemens ADVIA 2120 to the Beckman-Coulter LH750 in the detection of blasts. In the study, 390 blood samples were analyzed from a general hospital population, which included oncology patients. The presence of blasts, as indicated by the analyzers' flags, was compared with the results of a manual differential (regarded as the reference method). The ADVIA 2120 demonstrated 100% sensitivity at detecting blasts compared with 62% using the LH750. This improved sensitivity came at the expense of a lower specificity (49%vs. 86%). The ...

Multiplex fluorescence in situ hybridization in identifying chromosome involvement of complex karyotypes in de novo myelodysplastic syndromes and acute myeloid leukemia

Clinical and Laboratory Haematology — Mon, 13 Oct 2008 04:00:00 +0100

In this study, M-FISH was used in 16 patients with de novo MDS and 22 with AML with CCA detected by R-banding CC, and revealed 206 aberrations involved all 24 chromosomes, including 73 numerical chromosomal abnormalities and 133 structural abnormalities. The chromosomes most often involved were, by decreasing incidence, 5, 17, 8, 11, 7 and 21 in 57.9%, 55.3%, 44.7%, 36.8%, 34.2% and 34.2% of the cases, respectively. There were 98 unbalanced translocations, which were the most frequently observed aberrations in our study. Derivative chromosome 5 and 8 were implicated most often. The other derivatives were der(11), der(12), der(7), der(14), der(15) and der(17). Fourteen balanced translocations were detected in our series, and the most frequent reciprocal translocations was t(8;21). Fifty-fiv...

Age-related plasma reference ranges for two heparin-binding proteins – vitronectin and platelet factor 4

Clinical and Laboratory Haematology — Mon, 13 Oct 2008 04:00:00 +0100

This study was conducted to establish age-related reference ranges for two heparin-binding proteins [ndash] vitronectin and platelet factor 4 (PF4) [ndash] and to determine if the quantitative values of these proteins may contribute to the reported age-dependent effect of unfractionated heparin (UFH). Plasma samples were obtained from healthy children aged between 1 month and 16 years and from healthy adult volunteers. Two commercial kits were used to measure plasma vitronectin and PF4 levels. Results were reported as mean and boundaries including 95% of the population. Plasma vitronectin levels for children aged 1[ndash]5 years were significantly higher compared with adults. Plasma PF4 levels for infants (Source: Clinical and Laboratory Haematology)

Laboratory findings in CD4(+) large granular lymphocytoses

Clinical and Laboratory Haematology — Thu, 09 Oct 2008 04:00:00 +0100

We report the clinicopathologic features of eight patients with aberrant CD4(+), cytotoxic T-cell lymphocytoses. Median follow-up was 29 months (range 8[ndash]100), during which all were alive without requirement for therapy. Four of eight patients had an additional malignancy; none had a history of rheumatoid arthritis, lymphadenopathy or hepatosplenomegaly. Morphologic expansions of granulated lymphocytes were evident in 6/8. All had immunophenotypically aberrant populations of CD4(+) T cells with uniform, moderate or bright CD56. Seven of eight expressed CD57, and four were CD8(partial dim +). Abnormal levels of expression of two or more T-cell antigens were seen in all cases. All tested cases were T[gamma] PCR positive. Our results support that CD4(+) T-LGL lymphocytosis is a clonal di...

M/H ratio for the differential diagnosis of microcytic anemia

Clinical and Laboratory Haematology — Wed, 08 Oct 2008 04:00:00 +0100

(Source: Clinical and Laboratory Haematology)

M/H ratio for the differential diagnosis of microcytic anemia: reply

Clinical and Laboratory Haematology — Wed, 08 Oct 2008 04:00:00 +0100

(Source: Clinical and Laboratory Haematology)

The classification and diagnosis of erythrocytosis

Clinical and Laboratory Haematology — Thu, 25 Sep 2008 04:00:00 +0100

An absolute erythrocytosis is present when the red cell mass is raised and the haematocrit is elevated above prescribed limits. Causes of an absolute erythrocytosis can be primary where there is an intrinsic problem in the bone marrow and secondary where there an event outside the bone marrow driving erythropoiesis. This can further be divided into congenital and acquired causes. There remain an unexplained group idiopathic erythrocytosis. Investigation commencing with thorough history taking and examination and then investigation depending on initial features is required. Clear simple criteria for polycythaemia vera are now defined. Those who do not fulfil these criteria require further investigation depending on the clinical scenario and initial results. The erythropoietin level provides...

Evaluation of eosin-5-maleimide flow cytometric test in diagnosis of hereditary spherocytosis

Clinical and Laboratory Haematology — Wed, 10 Sep 2008 04:00:00 +0100

A flow cytometry-based test using eosin-5-maleimide (EMA) dye was used for diagnosis of hereditary spherocytosis (HS). The mean fluorescence intensiy (MFI) of EMA tagged erythrocytes is lower in HS than that in other hemolytic and nonhemolytic anemias. We enrolled 114 subjects comprising 20 confirmed HS, 20 suspected HS/hemolytic anemia (HA), 20 normal controls, 20 other hemolytic anemias [13 autoimmune hemolytic anemia, three congenital dyserythropoietic anemia (CDA), one pyruvate kinase deficiency, two microangiopathic hemolytic anemia], 18 microcytic anemia and 16 macrocytic anemia cases. All samples were subjected to flow cytometry as per standard protocol. The mean MFI of normal control subjects was 11 861.5 (SD 883.5) and of confirmed HS was 7949.3 (SD 1304.1). Using this test, of 20...

Clinical utility of the new beckman-coulter parameter red blood cell size factor in the study of erithropoiesis

Clinical and Laboratory Haematology — Thu, 04 Sep 2008 04:00:00 +0100

This study shows a very good level of agreement between RSf and CHr. Both are suitable parameters for the study of erythropoiesis. (Source: Clinical and Laboratory Haematology)

Kinetics of factor VIII:C inhibitors and treatment response in severe hemophilia A patients

Clinical and Laboratory Haematology — Tue, 02 Sep 2008 04:00:00 +0100

Severe hemophilia A (HA) patients develop inhibitory alloantibodies to factor VIII:C and therefore require bypass agents that are scarce, expensive and may provoke secondary effects. Twenty-three severe HA patients who were high-responders to FVIII inhibitors were studied. FVIII:C activity in plasma was measured by one-stage activated partial thromboplastin time method, and the quantification of FVIII:C inhibitors was carried out by the Nijmegen[ndash]Bethesda method. Inhibition kinetics was assessed through serial plasma dilutions. FVIII:C activity was (Source: Clinical and Laboratory Haematology)

Point-of-care method for total white cell count: an evaluation of the HemoCue WBC device

Clinical and Laboratory Haematology — Fri, 29 Aug 2008 04:00:00 +0100

This report describes an assessment of its utility. The WBC of 500 routine blood samples from the hospital were tested in parallel by the HemoCue WBC and by a reference analyser to assess accuracy and utility of the former. The tests included precision, linearity, type of blood sample and anticoagulant and potential interfering substances in blood specimens. In the tests for accuracy, 192 of the 200 showed percentage difference from the NEQAS reference of (Source: Clinical and Laboratory Haematology)

Erroneous automated optical platelet counts in 1-hour post-transfusion blood samples

Clinical and Laboratory Haematology — Wed, 27 Aug 2008 04:00:00 +0100

This study demonstrates that the automated hematology analyzer Sysmex XE-2100 reports erroneously high optical platelet counts when the blood sample contains particles in the size range of platelets or smaller. Thrombocytopenic or low-normal whole blood samples were spiked with 1 [mu]m latex beads (n = 14) to mimic contaminants under controlled conditions. Optical and impedance measurements of spiked and control samples with the Sysmex XE-2100 were compared with the Advia 120 and the manual counts. The added beads unexpectedly increased the automated optical platelet counts in the Sysmex XE-2100 and, to a lesser extent, the Advia 120 (Wilcoxon signed ranks test, P < 0.05), while the beads were not included in the impedance or the manual microscopic platelet counts. Differential interferenc...

Evaluation of a capillary blood collection system for screening for hemoglobinopathies in remote areas

Clinical and Laboratory Haematology — Mon, 25 Aug 2008 04:00:00 +0100

Accurate estimation of hemoglobin (Hbs) A, Hb A2, Hb F and abnormal Hb is required for diagnosis of hemoglobinopathies and genetic counseling. High pressure liquid chromatography (HPLC) is the most suitable approach available. But for 70% of the rural Indian population, HPLC analysis facilities are not available and screening would require transportation of samples to laboratories in bigger cities. We thus evaluated the feasibility of using a kit designed for measuring Hb A1c using capillary blood for collection and preservation of samples over a period of 15 days at different temperatures for screening for hemoglobinopathies. Capillary blood (5 [mu]l) of 90 individuals was collected in the capillary collection system and run on the Variant Hemoglobin Testing System on days 1, 3, 5, 8, 12 ...

Hematological features and molecular lesions of hemoglobin gene disorders in Taiwanese patients

Clinical and Laboratory Haematology — Sun, 17 Aug 2008 04:00:00 +0100

In conclusion, the results of our study provide data of the complex interaction of thalassemias and Hb variants which might be useful for other researchers in this field. (Source: Clinical and Laboratory Haematology)

Review of the UK NEQAS (H) digital morphology pilot scheme for continuing professional development accessed via the internet

Clinical and Laboratory Haematology — Sun, 10 Aug 2008 04:00:00 +0100

UK NEQAS (H) developed and instigated a pilot scheme for digital morphology, which was accessed by participants over the internet in order to assess the viability of using high quality images as an educational tool for continuing professional development. The pilot scheme was trialled over a 2-year period with eight releases totalling 16 morphology cases. Digital images allowed participating individuals to examine and comment on exactly the same cells and compare their findings with those of other participants, consensus data from traditional glass slide surveys and expert opinion. Feedback from participants on their experience was then relayed back to the development team by UK NEQAS (H) in order to drive the educational format and to ensure that any new scheme would meet the requirements...

Clinical significance of Th1/Th2 ratio in patients with myelodysplastic syndrome

Clinical and Laboratory Haematology — Sat, 09 Aug 2008 04:00:00 +0100

In this study, we attempted to evaluate the clinical significance of T helper 1 (Th1)/T helper 2 (Th2) ratio in patients with myelodysplastic syndrome (MDS), five refractory anaemia (RA), four refractory anaemia with ringed sideroblasts (RARS), 31 refractory cytopenia with multilineage dysplasia (RCMD), nine refractory anaemia with excess blast-1 (RAEB-1) and seven refractory anaemia with excess blast-2 (RAEB-2). Intracellular interleukin-4 (Th2 cytokine) and interferon-[gamma] (Th1 cytokine) production was assessed in CD4+ T lymphocytes activated by phorbol 12-myristate 13-acetate and ionomycin using flow cytometry. Mean Th1/Th2 ratios in each MDS group were as follows: RA/RARS, 8.8 (95% CI, 5.8[ndash]11.8), RCMD, 14.7 (95% CI, 9.5[ndash]19.9), RAEB-1, 10.6 (95% CI, 4.6[ndash]16.6), RAEB-...

Rule based processing of the CD4000, CD3200 and CD Sapphire analyser output using the Cerner Discern Expert Module

Clinical and Laboratory Haematology — Thu, 07 Aug 2008 23:00:00 +0100

The latest version of our Laboratory Information System haematology laboratory expert system that handles the output of Abbott Cell-Dyn Sapphires, CD4000s and a CD3200 full blood count analyser in three high-volume haematology laboratories is described. The three hospital laboratories use Cerner Millennium Version 2007.02 software and the expert system uses Cerner Millennium Discern Expert rules and some small Cerner Command Language in-house programs. The entire expert system is totally integrated with the area-wide database and has been built and maintained by haematology staff members, as has the haematology database. Using patient demographic data, analyser numeric results, analyser error and morphology flags and previous results for the patient, this expert system decides whether to v...

Effect of HbS in the determination of HbA2 with the Menarini HA-8160 analyzer and comparison with other instruments

Clinical and Laboratory Haematology — Thu, 07 Aug 2008 04:00:00 +0100

It is known that the presence of hemoglobin S (HbS) affects the determination of hemoglobin A2 (HbA2) levels in clinical samples. We quantitated this effect using the Menarini HA-8160 analyzer and compared with other instruments (HELENA beta-thal quik column, TOSOH HLC-723G7 and BIORAD Variant II) using the HELENA SAS-MX alkaline gel electrophoresis kit as the reference method. The %HbA2 values from the HA-8160 analyzer and the alkaline gel electrophoresis show a good linear correlation in the absence of HbS. A strong positive bias in the %HbA2 values from the HA-8160 is apparent in the presence of HbS in the samples, when compared with the alkaline electrophoresis. The analytical imprecision and bias of the three HPLC instruments are comparable both in the presence and absence of HbS. The...

The feature of clonal expansion of TCR Vβ repertoire, thymic recent output function and TCRζ chain expression in patients with immune thrombocytopenic purpura

Clinical and Laboratory Haematology — Thu, 07 Aug 2008 04:00:00 +0100

In order to identify the feature of T cells immune status in idiopathic/immune thrombocytopenic purpura (ITP) patients, TCR V[beta] repertoire, T-cell receptor (TCR) excision DNA circles (TRECs) and TCR[zeta] chain gene expression were examined. Reverse-transcriptase polymerase chain reaction, genescan and real-time PCR techniques were used to analyze. DNA and cDNA from peripheral blood mononuclear cells (PBMCs) of 18 ITP patients were investigated and 25 normal individuals served as control. The results showed that only 4[ndash]11 V[beta] subfamilies could be detected in each ITP case. The most frequently expressed V[beta] subfamilies were V[beta]2 and V[beta]3, while 11 V[beta] subfamilies were absent. Clonal expansion of V[beta] T cells were found in all patients. The most frequent clon...

The effect of tissue factor concentration on calibrated automated thrombography in the presence of inhibitor bypass agents

Clinical and Laboratory Haematology — Thu, 07 Aug 2008 04:00:00 +0100

Thrombin generation has been suggested as a method to monitor treatment with factor eight inhibitor bypassing activity (FEIBA®) or recombinant FVIIa (rFVIIa). The sensitivity of the assay for individual coagulation factors is dependent on the tissue factor (TF) concentration. An inverse relation between the rFVIIa concentration needed to shorten the clotting time and TF concentration has been shown but the data on thrombin generation are inconsistent. Information on TF concentration in measurements with FEIBA® is limited. We studied the influence of TF concentration (1 and 5 pm) on thrombin generation through spiking experiments with rFVIIa and/or FEIBA® in the plasma of severe haemophilia A patients and after four and three treatment episodes, respectively, using the calibrated automat...

Comments to the article 'Incorporation of erythrocytic and reticulocytic parameters in a common formula: will it provide a more accurate differentiation between iron deficiency anemia and â-thalassemic trait?'

Clinical and Laboratory Haematology — Fri, 01 Aug 2008 04:00:00 +0100

(Source: Clinical and Laboratory Haematology)

Sensitivity and specificity of Anti-HBc screening assays – which assay is best for blood donor screening?

Clinical and Laboratory Haematology — Thu, 31 Jul 2008 04:00:00 +0100

Compared to HIV and hepatitis C virus, the residual infectious risk of hepatitis B virus (HBV) posed by blood products is about 10 times higher. In addition to HBsAg testing, screening for anti-HBc was recommended by the German Advisory Committee Blood in March 2005. Prevalence of anti-HBc in German blood donors was investigated at five test sites located in different geographic regions. In total, 12 000 blood donors were screened for anti-HBc by PRISM® HBcore, and a statistically representative number of these were tested with Abbott Murex® anti-HBc total, bioMérieux Hepanostika® anti-HBc uniform, Bio-Rad Monolisa® anti-HBc PLUS and Dade Behring Enzygnost® anti-HBc. Anti-HBc repeat reactive samples were tested for anti-HBs, anti-HBe and HBV DNA by individual donation NAT. The mean p...

The changing face of homozygous sickle cell disease: 102 patients over 60 years

Clinical and Laboratory Haematology — Fri, 18 Jul 2008 04:00:00 +0100

The objective of this study was to examine the features of elderly cases and assess factors determining survival and the behaviour of this disease with advancing age. A retrospective review of all cases and prospective assessment in survivors was conducted at The Sickle Cell Clinic at the University of the West Indies, Kingston, Jamaica previously operated by the MRC Laboratories. All patients with SS disease born prior to December 31, 1943 who would, by January 2004, have passed their 60th birthday were traced and their current status ascertained. The molecular and clinical features were assessed and observations on the clinical behaviour of the disease and of haematology and biochemistry are presented. Of the 102 patients, 58 had died, four had emigrated and 40 were alive, resident in Ja...

Characterization of the bone marrow immunofluorescence test in childhood autoimmune neutropenia

Clinical and Laboratory Haematology — Wed, 16 Jul 2008 04:00:00 +0100

The bone marrow immunofluorescenece test (BMIFT) demonstrates autoantibodies to granulocytes and their precursors on fresh-frozen bone marrow slides. It may be used to differentiate childhood autoimmune neutropenia (AIN) from other causes of childhood neutropenia, even when circulating neutrophil counts are low. We sought to characterize the diagnostic utility of the BMIFT in childhood AIN. All BMIFT requests for investigation of children with neutropenia between January 1998 and May 2007 were reviewed. Patients were classified as AIN or nonautoimmune causes. Baseline demographic data, results of BMIFT, granulocyte immunofluorescence testing and bone marrow findings were collected from clinical records and the institutional laboratory database. Seventy-six children had BMIFT performed for ...

Comparative analysis of G-CSFR and GM-CSFR expressions on CD34+ cells in patients with aplastic anemia and myelodysplastic syndrome

Clinical and Laboratory Haematology — Mon, 14 Jul 2008 04:00:00 +0100

The aim of this article was to explore the pathogenetic differences, as well as to provide a new way for the differential diagnosis of these two diseases by comparative analysis of CD34+ cells numbers and their surface expression of granulocyte colony-stimulating factor receptor (G-CSFR) and granulocyte-macrophage colony-stimulating factor receptor (GM-CSFR) in patients with aplastic anemia (AA) and myelodysplastic syndrome (MDS). Twenty-seven patients with AA, 45 patients with MDS, and 20 normal controls were enrolled in this study. The ratio of CD34+ cells and their surface expression of G-CSFR and GM-CSFR were detected by flow cytometry (FCM). The ratio of CD34+ cells in BMMNC of AA, MDS patients and controls were 0.2438 ± 0.1129%, 2.1677 ± 1.1345% and 1.0792 ± 0.3221%, respectively....

Performance evaluation of the Sysmex XS-1000i automated haematology analyser

Clinical and Laboratory Haematology — Sun, 13 Jul 2008 04:00:00 +0100

The Sysmex® XS-1000i is a compact new, fully automated haematology analyser, designed to generate complete blood counts with five-part leucocyte differential. In our study, a Sysmex XS-1000i instrument was evaluated according to Clinical Laboratory Standards Institute (CLSI) and International Council for Standardization in Haematology (ICSH) guidelines. Precision, carry-over and linearity were determined. Using a total of 700 patient samples, results from the Sysmex XS-1000i were compared with those from a Sysmex XE-2100, an Abbott Cell Dyn 4000 and the manual reference leucocyte differential. Using quality control material, total and within-run imprecision was less than 3% except for platelets. The system demonstrated good linearity over the entire reporting range and no carry-over ( (So...

Haematological values from a Gambian cohort – possible reference range for a West African population

Clinical and Laboratory Haematology — Thu, 10 Jul 2008 04:00:00 +0100

The objective of this study was to establish haematological reference ranges for the West African subregion using a Gambian cohort. We analysed full blood counts from 1279 subjects aged [ge]1 year. Anthropometric and body composition measurements were performed. Haematological mean values, medians and 90% reference values were calculated and related to malnutrition in children and thinness and/or obesity in adults. Haemoglobin (Hb) and mean corpuscular volume (MCV) significantly increased with age (P < 0.00001). There were gender-related changes in Hb from 15 years of age (P = 0.001) and for MCV only in adults (P = 0.0002). Hb was significantly reduced in underweight and stunted children (P = 0.0001 and 0.0002, respectively) but was unaffected by thinness or obesity in adults. White blood ...

The red blood cell distribution width is associated with serum levels of thyroid stimulating hormone in the general population

Clinical and Laboratory Haematology — Wed, 09 Jul 2008 04:00:00 +0100

(Source: Clinical and Laboratory Haematology)

An electronic thesaurus of Evidence Based Laboratory Medicine hematological and biochemical diagnostic tests

Clinical and Laboratory Haematology — Wed, 09 Jul 2008 04:00:00 +0100

The adoption of Evidence Based Laboratory Medicine (EBLM) has been hampered until today by the lack of effective tools. The SIMeL EBLM e-Thesaurus (on-line Repertoire of the diagnostic effectiveness of the laboratory, radiology and cardiology test) provides a useful support to clinical laboratory professionals and to clinicians for the interpretation of the diagnostic tests. The e-Thesaurus is an application developed using Microsoft® Active Server Pages technology and carried out with Web Server Microsoft® Internet Information Server and is available at the SIMeL website using a browser running JavaScript® scripts (Internet Explorer® is recommended). It contains a database (in Italian, English and Spanish) of the sensitivity and specificity (including the 95% confidence interval), the...

Expression level of lipoprotein lipase in Chinese patients with chronic lymphocytic leukemia and its correlation with other prognostic factors

Clinical and Laboratory Haematology — Tue, 08 Jul 2008 04:00:00 +0100

Chronic lymphocytic leukemia (CLL) is the most common adult form of leukemia in the Western world, however, infrequent in the Eastern. It shows a remarkable heterogeneity, with some patients having an almost normal lifespan, others surviving only several years after diagnosis despite intensive therapy. To investigate lipoprotein lipase (LPL) expression level in Chinese patients with CLL and its correlation with other prognostic factors, including immunoglobulin heavy-chain variable region (IgVH) mutation status, Binet stages, ZAP-70 protein and CD38 expression level, semiquantitative RT-PCR was used to detect LPL expression in peripheral blood samples of 58 Chinese patients with CLL. LPL expression level was significantly correlated with IgVH mutational status (r = 0.348, P = 0.010), Binet...

Comparability of the results of PT–INR with local MNPT and APTTR with MNAPTT on different coagulation analyzers in China

Clinical and Laboratory Haematology — Thu, 29 May 2008 18:13:57 +0100

International Journal of Laboratory Hematology, Volume 0, Issue 0, Page ???, OnlineEarly Articles. SummaryThe prothrombin time (PT), International normalized ratio (INR) and activated partial thromboplastin time (APTT) are the most used coagulation tests in China, where more than one type of automated coagulation analyzer is often used in the clinical ... (Source: Clinical and Laboratory Haematology)

Red blood cell microcytosis and hypochromia in the differential diagnosis of iron deficiency and β-thalassaemia trait

Clinical and Laboratory Haematology — Thu, 29 May 2008 03:20:50 +0100

International Journal of Laboratory Hematology, Volume 0, Issue 0, Page ???, OnlineEarly Articles. SummaryIron deficiency anaemia (IDA) and β-thalassaemia are the most common causes of microcytic anaemia. Some indices have been defined to quickly discriminate this diseases based on red cell parameters obtained from automated blood cell analyzers, and ... (Source: Clinical and Laboratory Haematology)

Analytical comparison of AxSYM, HemosIL DD HS and Innovance D-dimer immunoassays with the Vidas D-dimer

Clinical and Laboratory Haematology — Tue, 27 May 2008 23:23:55 +0100

International Journal of Laboratory Hematology, Volume 0, Issue 0, Page ???, OnlineEarly Articles. (Source: Clinical and Laboratory Haematology)

Red blood cell microcytosis and hypochromia in the differential diagnosis of iron deficiency and β-thalassaemia trait

Clinical and Laboratory Haematology — Tue, 27 May 2008 23:00:00 +0100

Iron deficiency anaemia (IDA) and [beta]-thalassaemia are the most common causes of microcytic anaemia. Some indices have been defined to quickly discriminate this diseases based on red cell parameters obtained from automated blood cell analyzers, and can be effective for use as a preliminary screening tool to allow the reflex HbA2 analysis, when a proper cut-off is chosen. Advia 2120 (Siemens Medical Solutions Diagnostics) directly measures volume and haemoglobin concentration of individual red cells, and quantifies the percentage of microcytic, normocytic, macrocytic, hypochromic, normochromic and hyperchromic red cells. Because of the inverse behaviour of the % microcytic and % hypochromic red cells in [beta]-thalassaemia trait and in IDA the ratio between these two values was computed ...

Incorporation of erythrocytic and reticulocytic parameters in a common formula: will it provide a more accurate differentiation between iron deficiency anemia and β-thalassemic trait?

Clinical and Laboratory Haematology — Fri, 23 May 2008 10:14:19 +0100

International Journal of Laboratory Hematology, Volume 0, Issue 0, Page ???, OnlineEarly Articles. (Source: Clinical and Laboratory Haematology)