{"title":"Reproducible Data Analysis With R in Laboratory Hematology","authors":"Amrom E. Obstfeld","doi":"10.1111/ijlh.70147","DOIUrl":"10.1111/ijlh.70147","url":null,"abstract":"<p>Laboratory hematology generates large, complex datasets that increasingly exceed the capabilities of traditional spreadsheet-based analytical workflows. Despite their familiarity, spreadsheets obscure analytical logic, encourage manual data manipulation, and lack durable records of analytical steps, limiting transparency, auditability, and reproducibility. These limitations present specific challenges in clinical laboratory settings subject to regulatory oversight. Script-based data analysis offers a practical alternative by encoding analytical workflows as explicit, ordered, and reusable operations. This review outlines the structural limitations of spreadsheet-centered analysis, illustrates how these constraints contribute to analytical error, and introduces script-based analysis using R as a reproducible framework suited to laboratory hematology. Practical applications are highlighted across method comparison, reference interval estimation, quality control, flow cytometry, and operational monitoring. The discussion also includes the importance of complementary technologies like integrated development environments, version control, and large language models. Adoption of reproducible, script-based analytical tools such as R represents a foundational step toward improving data integrity, analytical rigor, and readiness for advanced analytical techniques in laboratory hematology.</p>","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 4","pages":"757-764"},"PeriodicalIF":2.2,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijlh.70147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"AML, Myelodysplasia-Related With B/Myeloid MPAL Immunophenotype, Normal Karyotype, and SRSF2/ASXL1/FLT3 Co-Mutations","authors":"Zhaodong Xu, Monika Hudoba","doi":"10.1111/ijlh.70092","DOIUrl":"10.1111/ijlh.70092","url":null,"abstract":"","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 4","pages":"708-709"},"PeriodicalIF":2.2,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"An Update on the Activities of the International Society for Laboratory Hematology, 2025","authors":"John L. Frater, Tracy I. George","doi":"10.1111/ijlh.14446","DOIUrl":"10.1111/ijlh.14446","url":null,"abstract":"","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 4","pages":"694-695"},"PeriodicalIF":2.2,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Investigator-Led Research to Improve the Diagnostic Assessment of Platelet Function Disorders: Reflections on the Challenges and Rewards","authors":"Catherine P. M. Hayward","doi":"10.1111/ijlh.70110","DOIUrl":"10.1111/ijlh.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Investigator-led research and quality improvement initiatives have led to important improvements in the diagnostic assessment of platelet function disorders (PFD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Personal reflections were used to summarize our contributions to knowledge on PFD diagnostic assessment, pathogenesis, and bleeding risks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Light transmittance platelet aggregometry (LTA) and whole mount electron microscopy assessment for platelet dense granule deficiency (DGD) both detect abnormalities that are highly predictive of a bleeding disorder. Observations on LTA findings that are predictive of a bleeding disorder (including those specific to certain conditions) have been incorporated into guidelines to reduce LTA interpretation errors. Efforts to improve LTA assessment of PFD with thrombocytopenia (e.g., Bernard Soulier syndrome) have led to validated, trustworthy diagnostic procedures. Commonly encountered PFD that manifest with abnormal aggregation responses to multiple agonists and/or DGD are now established to have significantly increased bleeding risks, emphasizing the need for diagnosis and treatment. Unraveling of the molecular pathogenesis of some specific PFD has provided important insights and simplified diagnosis. In the case of Quebec platelet disorder (QPD), the pathogenesis is a unique gain-of-function defect in fibrinolysis from a mutation that repositions a megakaryocyte-specific enhancer that normally upregulates <i>VCL</i> expression during megakaryopoiesis and “rewires” <i>PLAU</i>, increasing its expression > 100-fold in megakaryocytes only. Presently, the molecular causes of many “commonly encountered” PFD await elucidation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Research has meaningfully improved diagnostic laboratory testing for PFD. Unraveling the causes of “commonly encountered” PFD will be important to understanding their pathogenesis and increasing the yield of diagnosis by genetic investigations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 4","pages":"721-731"},"PeriodicalIF":2.2,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijlh.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Developments in the International Journal of Laboratory Hematology","authors":"Ian Mackie, Giuseppe d'Onofrio","doi":"10.1111/ijlh.14493","DOIUrl":"10.1111/ijlh.14493","url":null,"abstract":"","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elena Chatzikalil, Polyxeni Delaporta, Konstantinos Bistas, Antonis Kattamis
{"title":"Iron Overload: Pathophysiology, Diagnosis and Monitoring","authors":"Elena Chatzikalil, Polyxeni Delaporta, Konstantinos Bistas, Antonis Kattamis","doi":"10.1111/ijlh.70132","DOIUrl":"10.1111/ijlh.70132","url":null,"abstract":"<p>Iron overload is associated with significant health risks, underscoring the importance of understanding its pathophysiology as well as establishing accurate diagnostic and monitoring methods. Chronic iron overload is associated with either genetic disorders characterized by excessive iron accumulation (hereditary hemochromatosis), or is secondary to diseases of ineffective erythropoiesis and/or requiring regular blood transfusions (like thalassemia, sickle cell disease, myelodysplastic syndromes). Diagnosis is based on clinical suspicion, corroborated by laboratory findings such as elevated serum ferritin and transferrin saturation, along with imaging techniques (magnetic resonance imaging) which facilitate non-invasive assessment of iron levels in parenchymal organs. Elevated ferritin and transferrin saturation and exclusion of secondary causes should prompt genetic evaluation for hereditary disorders predisposing iron overload. Chronic systemic iron overload causes progressive tissue iron accumulation, leading to severe clinical implications, including myocardial dysfunction, liver cirrhosis, and increased risk of hepatocellular carcinoma. Monitoring includes evaluating iron overload indices (serum ferritin, transferrin saturation, liver and heart iron concentration) along with serum and urine indices of parenchymal organ damage at different timepoints regarding the type of disease, patient's age, severity and response to treatment, and aims in improving disease progression and preventing complications. This article provides a comprehensive overview of the pathophysiologic mechanisms and the diagnostic and monitoring techniques of iron overload, in order to revise current knowledge and to raise clinical awareness for effective management.</p>","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 4","pages":"747-756"},"PeriodicalIF":2.2,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijlh.70132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Developments in the International Journal of Laboratory Hematology","authors":"Ian Mackie, Giuseppe d'Onofrio","doi":"10.1111/ijlh.70104","DOIUrl":"10.1111/ijlh.70104","url":null,"abstract":"","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"An Update on the Activities of the International Society for Laboratory Hematology, 2026","authors":"John L. Frater, Tracy I. George","doi":"10.1111/ijlh.70118","DOIUrl":"10.1111/ijlh.70118","url":null,"abstract":"","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 4","pages":"699-701"},"PeriodicalIF":2.2,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Navigating Quality in Lean Times: Sustaining Laboratory Standards Amidst Budget Constraints","authors":"Gordon Sinclair","doi":"10.1111/ijlh.70117","DOIUrl":"10.1111/ijlh.70117","url":null,"abstract":"<p>Healthcare systems in wealthy countries are facing rising costs due to ageing populations and the prevalence of chronic illnesses, leading to constrained budgets. Pathology services, essential for accurate diagnosis and treatment, have merged to cope with these financial pressures. However, maintaining laboratory quality standards during economic downturns remains critical, as it directly affects patient outcomes, safety and satisfaction. This review explores evidence-based approaches to maintaining quality standards amid financial difficulties. Major challenges include hiring freezes, heavier workloads and an increased risk of burnout, which is associated with higher error rates and staff turnover. The Conservation of Resources theory helps explain burnout by highlighting the importance of organisational support. Strategies to mitigate burnout include policies for digital disconnection, the promotion of transformational leadership among junior managers and the fostering of supportive leadership at higher levels. Additional measures involve sustaining competencies through Entrustable Professional Activities, structured feedback, cross-training and Lean task prioritisation. Initiatives focused on staff well-being, centred on autonomy, psychological empowerment and happiness, are crucial for preserving morale and performance. Overall, these strategies demonstrate that quality can be maintained through structured, evidence-based interventions even during challenging times, thereby ensuring patient-focused care and organisational resilience.</p>","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 4","pages":"732-736"},"PeriodicalIF":2.2,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijlh.70117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Review of the Current Issues Surrounding Monitoring of the Direct Thrombin Inhibitor Argatroban in the Laboratory","authors":"Susan Guy, Kieron Hickey, Rhona Maclean","doi":"10.1111/ijlh.70103","DOIUrl":"10.1111/ijlh.70103","url":null,"abstract":"<p>The direct thrombin inhibitor argatroban is licensed for use in Heparin-induced thrombocytopenia. Original trial data gave the recommendation of monitoring argatroban by Activated Partial Thromboplastin Time (APTT) stating a therapeutic target range of 1.5–3.0 times baseline APTT and not exceeding 100 s. APTT has limitations due to prolongation arising in factor deficiencies, lupus anticoagulants, liver disease, and high FVIII levels leading to potential overestimation of argatroban. Argatroban has demonstrated a plateau effect on APTT at higher concentrations; additionally, APTT reagents have different sensitivity to argatroban, potentially underestimating or overestimating the argatroban. Anti-IIa methods have been recommended as a suitable alternative to accurately quantify argatroban levels. However, there is a lack of consensus on what the target therapeutic range should be. This review will demonstrate how argatroban monitoring by APTT may not be the most suitable method to successfully dose argatroban based on the current state of knowledge and recent published guidelines and highlight the benefits of the anti-IIa methods.</p>","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 4","pages":"737-746"},"PeriodicalIF":2.2,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijlh.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}