Laboratory hematology : official publication of the International Society for Laboratory Hematology最新文献

{"title":"Prevalence of heparin in samples submitted for lupus anticoagulant testing.","authors":"Nikhil A Sangle,&nbsp;George M Rodgers,&nbsp;Kristi J Smock","doi":"10.1532/LH96.10024","DOIUrl":"https://doi.org/10.1532/LH96.10024","url":null,"abstract":"<p><strong>Introduction: </strong>Lupus anticoagulant (LA) testing can be affected by the presence of anticoagulant medications such as heparin, and current guidelines recommend caution when performing and interpreting LA testing for patients who are receiving anticoagulation treatment. We searched our reference laboratory database to determine the prevalence of heparin in samples submitted for LA testing.</p><p><strong>Methods: </strong>We reviewed 18,676 LA reflexive testing panels. Heparin was identified by partial thromboplastin time (before and after heparin neutralization), thrombin time, and reptilase time results. Samples containing heparin were subclassified (not significant, significant) according to the degree of thrombin time prolongation.</p><p><strong>Results: </strong>Of the panels, 1909 panels (10%) were LA positive. We found that 2011 samples (11%) contained some heparin and that 616 samples contained a significant amount of heparin (3% of all samples and 31% of samples containing heparin). LA-positive results were obtained for 80 (13%) of these samples, which represented 4% of the samples containing heparin and 0.4% of all samples.</p><p><strong>Conclusion: </strong>LA-testing guidelines recommend that samples not contain anticoagulant medications. Despite these recommendations, our data show that a significant proportion (11%) of these samples contain heparin. We conclude that LA-testing algorithms should use methods to identify and neutralize heparin and that laboratories should provide education regarding appropriate sample collection for LA testing.</p>","PeriodicalId":85078,"journal":{"name":"Laboratory hematology : official publication of the International Society for Laboratory Hematology","volume":"17 1","pages":"6-11"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29756616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leukocyte differential for acute abdominal pain in adults.","authors":"Joelle Deibener-Kaminsky,&nbsp;Jean-François Lesesve,&nbsp;Pierre Kaminsky","doi":"10.1532/LH96.10023","DOIUrl":"https://doi.org/10.1532/LH96.10023","url":null,"abstract":"<p><strong>Background: </strong>Abdominal pain is a common symptom underlying a variety of disorders with different prognoses. Neutrophilia or lymphopenia have been used as prognostic markers in several stress- or infection-mediated disorders. We studied the clinical relevance of the leukocyte differential in the initial workup of adult patients presenting with abdominal pain.</p><p><strong>Methods: </strong>We reviewed all leukocyte differentials and medical records of 441 consecutive patients admitted for abdominal pain in an emergency department. Patients were matched by age and sex with controls and were assigned to 4 groups: functional disorders (group FUN), infectious medical disorders (group INF) and noninfectious medical disorders (group MED), and surgical disorders (group SUR). Patients of groups INF and SUR were pooled into group INF+SUR to predict severe illness, and this group was compared with others with nonsevere illness.</p><p><strong>Results: </strong>All patients exhibited neutrophilia, along with a neutrophil count that increased with illness severity. Lymphopenia, eosinopenia, and basopenia characterized patients of group INF+SUR. Neutrophilia, eosinopenia, and lymphopenia were independent predictors of the most severely affected patients. The association of a neutrophil count >9.0 × 10⁹/L with lymphopenia (<1.4 × 10⁹L) and eosinopenia (<0.04 × 10⁹/L) had a specificity of 94.9% (95% confidence interval, 91.2%-97.1%) for inclusion in group INF+SUR, although with a low sensitivity (27.5%).</p><p><strong>Conclusion: </strong>Lymphocyte, eosinophil, and neutrophil counts should be considered in medical admissions of adults with abdominal pain. Lymphopenia associated with eosinopenia and significant neutrophilia is highly suggestive of a more severe illness.</p>","PeriodicalId":85078,"journal":{"name":"Laboratory hematology : official publication of the International Society for Laboratory Hematology","volume":"17 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29756180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the role of JAK2(V617F) mutation in leukemic transformation of myeloproliferative neoplasms?","authors":"Rodrigo Lopes da Silva,&nbsp;Patricia Ribeiro,&nbsp;Alexandra Lourenço,&nbsp;Susana Costa Santos,&nbsp;Margarida Santos,&nbsp;Isabel Costa,&nbsp;Aida Botelho de Sousa","doi":"10.1532/LH96.10018","DOIUrl":"https://doi.org/10.1532/LH96.10018","url":null,"abstract":"<p><strong>Background and objectives: </strong>The role of the Janus kinase 2 V617F (JAK2(V617F)) mutation in the pathogenesis of the various BCR-ABL1-negative myeloproliferative neoplasms (MPNs) remains unclear. Its significance in leukemic transformation is a matter of even greater controversy. The aim of this study was to evaluate both the JAK2(V617F) mutational status of the rare cases in which blast crisis occurred in our institution and the response after intensive treatment.</p><p><strong>Materials and methods: </strong>Between 1999 and 2009, 778 patients received diagnoses of BCR-ABL1-negative MPNs in our center (395 polycythemia vera, 329 essential thrombocythemia, and 45 primary myelofibrosis cases, as well as 9 MPN cases not otherwise classifiable). Of these patients, 7 developed leukemic transformation. The genotyping of the JAK2(V617F) mutation was performed by the amplification-refractory mutation system.</p><p><strong>Results: </strong>Six of the 7 patients were tested for JAK2(V617F) in the chronic phase of their disease, and 3 of these patients were positive for JAK2(V617F). These patients, 2 with polycythemia vera and 1 with essential thrombocythemia, also harbored JAK2(V617F) in the heterozygous state during blast crisis and even after intensive treatment in one of these patients. The other cases that evolved to blast crisis did not harbor the JAK2(V617F) mutation before and after transformation. All 7 patients died despite conventional or supportive treatment.</p><p><strong>Conclusions: </strong>The transformation of MPNs into acute leukemia is by itself a very rare phenomenon, and so is the persistence of the JAK2(V617F) mutation after blast crisis. In our series, all JAK2(V617F)-positive patients remained positive for this mutation after leukemic transformation, although in the heterozygous state, suggesting that JAK2(V617F) is not essential for transformation in these cases. The fact that all JAK2(V617F)-negative cases remained negative after blast crisis reinforces the theory that other molecular event(s) may play a role in the clonal heterogeneity of MPNs. Owing to the poor outcome of acute myeloid leukemia secondary to MPN, patients should be included in clinical trials of the novel JAK2 inhibitors.</p>","PeriodicalId":85078,"journal":{"name":"Laboratory hematology : official publication of the International Society for Laboratory Hematology","volume":"17 1","pages":"12-6"},"PeriodicalIF":0.0,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29756617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of peroxidase activity by alpha-naphthol/pyronine staining compared with benzidine staining in 101 acute leukemia cases.","authors":"Véronique Latger-Cannard,&nbsp;Valérie Bardet,&nbsp;Michèle Malet,&nbsp;Monique Lagrange,&nbsp;Fabienne Empereur,&nbsp;Odile Fenneteau","doi":"10.1532/LH96.10007","DOIUrl":"https://doi.org/10.1532/LH96.10007","url":null,"abstract":"Cytochemical detection of myeloperoxidase (MPO) activity, a strong marker for myeloid differentiation, is usually performed by benzidine dihydrochloride staining, with the threshold at 3%. Several reports have demonstrated the potential toxicity of benzidine, and bans have been issued, under French law, prohibiting female technicians from being exposed to the aromatic hydrocarbon group, including benzidine. The aim of this study was to test an alpha-naphthol and pyronine-based substitute using a standardized kit (MYELOPEROXIDASE KIT, RAL [Réactifs RAL, Martillac, France]) to measure MPO activity in blast cells. This prospective, multicenter study made it possible to analyze 101 acute leukemia (AL) cases; it has also demonstrated both the 96% specificity and the 99% sensitivity of the method, with a threshold for positive staining of 3%, as well as good correlation (r = 0.95) between the staining method tested and the benzidine staining method. When using the alpha-naphthol/pyronine-based staining for MPO, the mean number of positive blast cells is statistically lower than that obtained using benzidine, but without incidence on AL classification. These results allow us to conclude that this method makes it possible to classify acute blood diseases by measuring MPO activity using reagents permitted by law, according to a standardized and reproducible protocol.","PeriodicalId":85078,"journal":{"name":"Laboratory hematology : official publication of the International Society for Laboratory Hematology","volume":"16 4","pages":"76-82"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29486232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A practical approach to the flow cytometric detection and diagnosis of T-cell lymphoproliferative disorders.","authors":"Howard J Meyerson","doi":"10.1532/LH96.10001","DOIUrl":"https://doi.org/10.1532/LH96.10001","url":null,"abstract":"<p><p>The flow cytometric analysis of T-cell malignancies is difficult due to the heterogeneity of T-cells and the lack of convenient methods to detect T-cell clonality. Neoplastic T-cells are most often detected by their altered level of surface antigen expression, and detection requires an extensive knowledge of the phenotype of normal T-lymphocytes. This review focuses on the methods to distinguish malignant T-cells from their normal counterparts and the phenotypic features of the T-cell lymphoproliferative disorders.</p>","PeriodicalId":85078,"journal":{"name":"Laboratory hematology : official publication of the International Society for Laboratory Hematology","volume":"16 3","pages":"32-52"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40084001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do we need time adjusted mean platelet volume measurements?","authors":"Marcus D Lancé,&nbsp;Rene van Oerle,&nbsp;Yvonne M C Henskens,&nbsp;Marco A E Marcus","doi":"10.1532/LH96.10011","DOIUrl":"https://doi.org/10.1532/LH96.10011","url":null,"abstract":"<p><p>Mean platelet volume (MPV) is associated with various diseases. Several authors reported anticoagulant and time dependency. Therefore, standardized laboratory methods are essential. The aim of this study was to standardize the MPV measurement. Blood was collected in potassium-ethylenediaminetetra-acid (EDTA) and sodium-citrate tubes. First, MPV and platelet count were determined every half hour for 4 hours in 20 healthy volunteers. The same parameters were acquired from a second group of 100 healthy donors. We measured at the point of highest stability determined in the first step and aimed to determine a reference range. Citrate samples revealed significantly smaller MPV (7.0 fL ± 0.69 standard deviation [SD]) than EDTA (8.0 fL ± 0.8 SD). Platelets swell until 120 minutes in EDTA and until 60 minutes in citrate. Mean platelet count changed significantly in citrate. In the second group, no inverse correlation between MPV and platelet count was seen. A reference range was calculated (EDTA, 7.2-10.8 fL; citrate, 6.1-9.5 fL). Platelets stored in citrate are significantly smaller compared to those stored in EDTA. Timing is important when measuring platelet volume. Optimal measuring time should be 120 minutes after venipuncture. For this we depicted a reference range. Platelet count is most stable in EDTA. There was no inverse relation between MPV and platelet count.</p>","PeriodicalId":85078,"journal":{"name":"Laboratory hematology : official publication of the International Society for Laboratory Hematology","volume":"16 3","pages":"28-31"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40084000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review: Stem cells and gene therapy.","authors":"Faris Q Alenzi,&nbsp;Mahmoud Lotfy,&nbsp;Waleed G Tamimi,&nbsp;Richard K H Wyse","doi":"10.1532/LH96.10010","DOIUrl":"https://doi.org/10.1532/LH96.10010","url":null,"abstract":"<p><p>Both stem cell and gene therapy research are currently the focus of intense research in institutions and companies around the world. Both approaches hold great promise by offering radical new and successful ways of treating debilitating and incurable diseases effectively. Gene therapy is an approach to treat, cure, or ultimately prevent disease by changing the pattern of gene expression. It is mostly experimental, but a number of clinical human trials have already been conducted. Gene therapy can be targeted to somatic or germ cells; the most common vectors are viruses. Scientists manipulate the viral genome and thus introduce therapeutic genes to the target organ. Viruses, in this context, can cause adverse events such as toxicity, immune and inflammatory responses, as well as gene control and targeting issues. Alternative modalities being considered are complexes of DNA with lipids and proteins. Stem cells are primitive cells that have the capacity to self renew as well as to differentiate into 1 or more mature cell types. Pluripotent embryonic stem cells derived from the inner cell mass can develop into more than 200 different cells and differentiate into cells of the 3 germ cell layers. Because of their capacity of unlimited expansion and pluripotency, they are useful in regenerative medicine. Tissue or adult stem cells produce cells specific to the tissue in which they are found. They are relatively unspecialized and predetermined to give rise to specific cell types when they differentiate. The current review provides a summary of our current knowledge of stem cells and gene therapy as well as their clinical implications and related therapeutic options.</p>","PeriodicalId":85078,"journal":{"name":"Laboratory hematology : official publication of the International Society for Laboratory Hematology","volume":"16 3","pages":"53-73"},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40084208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blast flagging with the UniCel DxH 800 Coulter Cellular Analysis System.","authors":"P W Barnes,&nbsp;C S Eby,&nbsp;G Shimer","doi":"10.1532/LH96.09015","DOIUrl":"https://doi.org/10.1532/LH96.09015","url":null,"abstract":"<p><p>We recently conducted a series of evaluations of the new UniCel DxH 800 Coulter Cellular Analysis System at Barnes-Jewish Hospital in St. Louis, Missouri. This report addresses issues relating to the flagging performance of the DxH 800, especially as it relates to the detection of blast cells. The DxH 800 was designed with major performance and hardware enhancements over the previous LH series analyzer. Capturing 29 individual measurements per cell analyzed, the system provides improved sensitivity and specificity, which means more reliable assessment of abnormal cell populations. We undertook these particular studies to assess these enhancements and to evaluate the analytical performance of the DxH 800's automated white blood cell differential and flagging of abnormal blood samples. Our studies placed specific emphases on the detection of blast cells. The Initial evaluation of the ability of the DxH 800 to flag blast cells was remarkable. We ran 95 samples containing > or =1% blasts on both the Beckman Coulter LH 750 and DxH 800 instruments. Whereas the LH 750 had a 6.4% false-negative rate, the DxH 800 had a 0.0% false-negative rate. We then conducted an extensive study of 435 blast-positive samples on the LH 750, 302 of which were analyzed on the DxH 800 and 94 of which were analyzed on Siemens' ADVIA 2120 Hematology System. With a 0.3% false-negative rate, the DxH 800 outperformed the LH 750, which had a 9.6% false-negative rate. In a previous study of 311 random patient samples, the overall success rate of the DxH 800 in detecting abnormal samples in a mixed population of samples resulted in fewer false negatives (3 versus 6) and significantly fewer false positives (60 versus 152) than the LH 750. The lower rate of false positives for the DxH 800 dramatically reduced the number of unnecessary smear reviews that otherwise would have to be run on the LH 750. The DxH 800 has demonstrated that it is capable of reducing the number of unnecessary differentials performed, while performing better at detecting samples with abnormalities, particularly when blast cells are present.</p>","PeriodicalId":85078,"journal":{"name":"Laboratory hematology : official publication of the International Society for Laboratory Hematology","volume":"16 2","pages":"23-5"},"PeriodicalIF":0.0,"publicationDate":"2010-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29043041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of a compound heterozygote hemoglobin S/hemoglobin Fannin-Lubbock-I individual. Is it a sickling disorder?","authors":"Nadja K Burns,&nbsp;Semyon A Risin","doi":"10.1532/LH96.10004","DOIUrl":"https://doi.org/10.1532/LH96.10004","url":null,"abstract":"","PeriodicalId":85078,"journal":{"name":"Laboratory hematology : official publication of the International Society for Laboratory Hematology","volume":"16 2","pages":"26-7"},"PeriodicalIF":0.0,"publicationDate":"2010-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29043042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reticulocyte count and reticulocyte maturation profile in human umbilical cord blood from healthy newborns.","authors":"Mariacaterina Maconi,&nbsp;Debora Formisano,&nbsp;Leandra Cavalca,&nbsp;Alessandro Rolfo,&nbsp;Simona Cardaropoli,&nbsp;Paolo Danise","doi":"10.1532/LH96.09012","DOIUrl":"https://doi.org/10.1532/LH96.09012","url":null,"abstract":"<p><p>Most fetal hematologic parameters show a significant relationship with gestational age: a linear increase is evident throughout gestation for several hematologic parameters. A few reports have described reference values for umbilical cord blood reticulocyte counts performed with automated hematology analyzers. Our aim was to use automated hematology analyzers (ADVIA 120; Siemens Healthcare Diagnostics) to establish reference intervals for reticulocyte parameters in cord blood from healthy newborns of 34 to 42 weeks of gestation. We also investigated whether differences in reticulocyte parameters exist between the sexes and between different weeks of gestation. We enrolled 98 healthy, appropriate for gestational age newborns. In term infants, the reticulocyte percentage, the absolute reticulocyte count, and the reticulocyte hemoglobin content decreased significantly as the gestational age increased, but the maturation subpopulations did not change significantly. We found no significant differences between the sexes. In conclusion, our results contribute to the establishment of reference intervals for cord blood from full-term newborns that are measured with an automated hematology analyzer.</p>","PeriodicalId":85078,"journal":{"name":"Laboratory hematology : official publication of the International Society for Laboratory Hematology","volume":"16 1","pages":"3-7"},"PeriodicalIF":0.0,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28771882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}