International journal of laboratory hematology最新文献

{"title":"Laboratory Identification of Lupus Anticoagulant (LA) Using Different Activated Partial Thromboplastin Time (APTT) Assays.","authors":"Bárbara G Barion, Bianca Stefanello, Maria Luiza S A de Paula, Thaís S Saraiva, Paula R Villaça, Vanderson Rocha, Fernanda A Orsi, Tania R F da Rocha","doi":"10.1111/ijlh.14549","DOIUrl":"https://doi.org/10.1111/ijlh.14549","url":null,"abstract":"<p><strong>Introduction: </strong>The International Society of Thrombosis and Hemostasis (ISTH) guidelines suggest a three-step evaluation for the detection of lupus anticoagulant (LA), including screening, mixing, and confirmation. According to the guidelines, the LA assay based on activated partial thromboplastin time (APTT) should include an initial screening step followed by a confirmatory step that uses a higher concentration of phospholipids in either bilayer or hexagonal form. For the activator, the guidelines recommend using silica, though ellagic acid is also an option. In this context, HemosIL Silica Clotting Time (SCT, Instrumentation Laboratory) is the only assay that fully complies with the guidelines. However, there are other assays available using different reagents, such as Dade Actin FSL/FS (Siemens Healthcare Diagnostics) and PTT-LA/Staclot LA (Diagnostica Stago), and the relevance of these differences in LA detection is not known.</p><p><strong>Methods: </strong>This study compared the performance of the three platforms.</p><p><strong>Results: </strong>Out of 136 samples, the majority were from females (82%) with a median age of 41 years (IQR 32-50); 44 (32%) had a history of thrombosis, and 28 (21%) were on anticoagulants. PTT-LA/Staclot LA had the highest sensitivity (100%) and specificity (100%). There was an almost perfect agreement between PTT-LA/Staclot LA and Dade Actin FSL/FS (kappa 0.812). HemosIL SCT sensitivity was 100% and the specificity was 74%, which was increased to 99% by increasing the phospholipid concentration of the screening step.</p><p><strong>Conclusion: </strong>We observed a good agreement between PTT-LA/Staclot LA and Dade Actin FSL/FS, and fair to moderate agreement with HemosIL SCT, whose performance improved with increasing phospholipid concentration. These results demonstrate that all three assays are comparable for APTT-LA detection.</p>","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983632","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":"Can Flow Cytometry Immunophenotyping Predict Cytogenetic Abnormalities in Acute Myeloid Leukemia? A Focus on Myelodysplasia-Related Cytogenetic Abnormalities.","authors":"Orathai Promsuwicha, Weerapat Owattanapanich, Supattra Kankhaw, Theera Ruchutrakool, Smith Kungwankiattichai","doi":"10.1111/ijlh.14546","DOIUrl":"https://doi.org/10.1111/ijlh.14546","url":null,"abstract":"<p><strong>Introduction: </strong>The European LeukemiaNet (ELN) 2022 classification introduced significant modifications to acute myeloid leukemia (AML) categorization, including refined criteria for AML with myelodysplasia-related cytogenetic abnormalities (AML-MRC). While cytogenetic analysis is essential for a definitive diagnosis, the question remains whether flow cytometry can aid in the initial identification of this AML subgroup. This study aimed to characterize the immunophenotypic profiles of AML-MRC and validate previously reported immunophenotypic patterns of AML with t(8;21) and inv(16) using flow cytometry.</p><p><strong>Methods: </strong>This retrospective study analyzed 911 non-acute promyelocytic leukemia (APL) AML cases. Flow cytometric immunophenotyping was performed using a comprehensive panel of 23 markers. Statistical analysis included univariate and multivariate logistic regression to identify discriminatory markers.</p><p><strong>Results: </strong>Among 911 patients, 241 (26.5%) were classified as AML-MRC. AML-MRC patients were significantly older (mean age: 55.9 vs. 47.9 years, p < 0.001) and presented with lower WBC counts (median: 8.9 vs. 24.2 × 10^9/L, p < 0.001) compared to non-MRC cases. AML-MRC demonstrated higher expression of CD34 (75.9% vs. 57.6%, p < 0.001), CD41a (10.8% vs. 4.5%, p = 0.002) and CD235a (5.8% vs. 1.2%, p < 0.001), with CD235a showing the highest discriminatory power (OR 4.458, 95% CI 1.720-11.552). For core-binding factor AML, AML with t(8;21) exhibited characteristic expression of CD19 (46.3% vs. 9.4%, p < 0.001) and CD56 (72.5% vs. 34.5%, p < 0.001), while AML with inv(16) showed distinctive CD34 (88.9% vs. 61.7%, p = 0.004) and CD14 (59.3% vs. 18.1%, p < 0.001) expression patterns.</p><p><strong>Conclusion: </strong>This study identifies markers that distinguish AML-MRC, including CD235a, CD41a, and CD34. This suggests that acute erythroid leukemia and acute megakaryocytic leukemia are subsets within the AML-MRC category. Additionally, the study validates previously reported immunophenotypic characteristics of AML with t(8;21) and inv(16).</p>","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983512","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":"Fulminant Pneumococcal Bacteriemia Revealed by a Peripheral Blood Smear.","authors":"P L García-Villarroel, C Fernández Maqueda, R Forés Cachón","doi":"10.1111/ijlh.14548","DOIUrl":"https://doi.org/10.1111/ijlh.14548","url":null,"abstract":"","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983618","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 5B9 as a Calibrator or Expression of Results in Absorbance Values for the Diagnosis of Hit With a PF4/Heparin Specific Elisa.","authors":"Claire Pouplard, Noémie Charuel, Estelle Archer, Caroline Vayne, Anne Bauters, Simon Jaouen, Philippe Savard, Laure Maucorps, Eve-Anne Guery, Yves Gruel, Jérôme Rollin","doi":"10.1111/ijlh.14547","DOIUrl":"https://doi.org/10.1111/ijlh.14547","url":null,"abstract":"<p><strong>Background: </strong>Immunoassays detecting anti-PF4/H antibodies must be sensitive to exclude heparin-induced thrombocytopenia (HIT), and optical density (OD) values are useful for confirming HIT, but no calibration is currently available.</p><p><strong>Objectives: </strong>To study the impact of OD values on the performance of the Asserachrom HPIA IgG in a cohort of patients with suspected HIT, and the value of a calibration performed with 5B9, a HIT monoclonal antibody.</p><p><strong>Methods: </strong>The HPIA IgG was performed in 170 patients with a high or intermediate probability of HIT. Results were expressed in OD₄₅₀ or '5B9 equivalent' units, using a calibration done with 5B9. HIT was confirmed when HPIA and SRA/PF4 tests were positive.</p><p><strong>Results: </strong>HIT was excluded in 97 cases because HPIA and SRA/PF4 were negative. The HPIA was positive in 73 cases and HIT confirmed in 43 cases (SRA/PF4+). Applying an OD threshold of 1.05, the NPV and PPV of the test were 98% and 83%, respectively. Calibration of HPIA with 5B9 did not improve its performance, since similar AUC values (ROC curves) were obtained whether results were expressed in OD values or in equivalent units of 5B9. Bayesian analysis showed that in patients with an intermediate pre-test probability of HIT, the post-test probability equalled 1% when OD was less than 1, and 100% when OD was over 2.</p><p><strong>Conclusion: </strong>5B9 as a calibrator failed to improve the performance of HPIA, but this assay can reliably exclude (when negative) or confirm HIT (when OD > 2), without requiring a functional assay.</p>","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983532","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":"Compound Heterozygous Hb Milledgeville With -α^4.2 Thalassemia-A Rare and First Reported Cause of Primary Erythrocytosis in an Indian Family.","authors":"Richa Chauhan, Vandana Puri, Shreyam Acharya, Jasmita Dass, Ravi Ranjan, Prashant Sharma, Ganesh Kumar Viswanathan, Mukul Aggarwal, Pradeep Kumar, Rishi Dhawan, Tulika Seth, Manoranjan Mahapatra","doi":"10.1111/ijlh.14544","DOIUrl":"https://doi.org/10.1111/ijlh.14544","url":null,"abstract":"<p><p>Recent review collated 22 rare and novel alpha globin gene variants amongst the Indian population published in the literature in the last 52 years. We report another rare high-oxygen affinity alpha-globin variant hemoglobinopathy in a compound heterozygous state with α⁺ thalassemia. The patient, a 42-year-old male, came for evaluation of JAK2 p.V617F negative erythrocytosis requiring multiple phlebotomies in the last 4-5 years. On laboratory investigations for high-oxygen affinity hemoglobinopathy, he was found to have an unknown peak eluting as a left shoulder hump of the Adult hemoglobin (HbA0) in Cation exchange High-Performance Liquid Chromatography (CE-Hb-HPLC). His family study revealed the variant hemoglobinopathy coexisting with a single alpha-globin deletion in the mother, sibling, and two children. Next-generation sequencing (NGS), Gap Polymerase chain reaction (GAP-PCR), and multiplex ligation probe amplification (MLPA) on the extracted DNA of the index case showed compound heterozygous state for Hb Milledgeville and -α^4.2 thalassemia. This is the first report of a rare high-oxygen-affinity alpha hemoglobin variant Hb Milledgeville from India.</p>","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983499","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 Interference at the Onset of Acute Myeloid Leukemia.","authors":"María Del Mar Gutiérrez-Hernández, Guillermo Ramil, Nuria González-Álvarez, Paula San-José","doi":"10.1111/ijlh.14545","DOIUrl":"https://doi.org/10.1111/ijlh.14545","url":null,"abstract":"","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983808","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":"Aggressive T-Cell Large Granular Lymphocyte Leukemia With the Unusual Double-Negative CD4-/CD8-/TCRαβ+ Phenotype; Report of Two Cases and Review of the Literature.","authors":"Angeliki Kotsiafti, Nikolaos J Tsagarakis, Chrissa M Vadikolia, Dimitrios Maltezas, Christina Karela, Georgios Oudatzis, Panagiotis Repousis, Paraskevi Vasileiou, Georgios Paterakis","doi":"10.1111/ijlh.14540","DOIUrl":"10.1111/ijlh.14540","url":null,"abstract":"","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884669","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":"An Atypical Case of Burkitt Lymphoma With MYC Gain and Cryptic IGH::MYC Rearrangement Detected by Rapid Nanopore Sequencing.","authors":"Ka Ngai Lau, Tsz Fung Wong, Lawrence Lap Chi Tsui, Ka Wai Wong, Yuen Ting Sin, Coty Hing Yau Cheung, Eleanor Koon Chun Hui, Joyce Sin Cheung, Alice Ching Ching Wong, Sze Fai Yip","doi":"10.1111/ijlh.14542","DOIUrl":"https://doi.org/10.1111/ijlh.14542","url":null,"abstract":"","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983454","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":"Exploring Cell Population Data for the Diagnosis and Assessment of Severity in Sepsis: A Preliminary Report.","authors":"Priyanka Mishra, Pratik Thosani, Mrinal Patra, Preeti Tripathi, Mallikarjun Dube, Brajesh Singh","doi":"10.1111/ijlh.14539","DOIUrl":"10.1111/ijlh.14539","url":null,"abstract":"<p><strong>Background: </strong>Cell Population Data (CPD), derived from next-generation hematology analyzers, is emerging as a promising tool for diagnosis of early sepsis. This preliminary case-control study assessed the diagnostic utility of CPD and its association with sequential organ failure assessment (SOFA) scores and procalcitonin levels in sepsis patients.</p><p><strong>Methods: </strong>Seventy-two sepsis patients and 72 age- and sex-matched non-septic controls were enrolled. CPD parameters were measured using a Sysmex XN-1000 analyzer. Univariate and multivariate analyses, including PCA, PLS-DA, and OPLS-DA, were used to distinguish between groups. ROC analysis evaluated diagnostic performance. Spearman's rank correlation assessed associations between CPD, SOFA scores, and procalcitonin.</p><p><strong>Results: </strong>Several CPD parameters-LY-X, LY-Z, MO-X, MO-Y, NE-WX, NE-WY, NE-WZ, LY-WX, LY-WY, and LY-WZ-were significantly elevated in sepsis. Multivariate analysis identified MO-X, MO-WY, LY-X, and LY-Z as strong discriminators (VIP > 1.15). ROC analysis showed MO-X (> 119.6) had 95.83% sensitivity, 73.61% specificity (AUC 0.876), and IG% (> 0.6) had 83.33% sensitivity, 80.56% specificity (AUC 0.880). IG count (> 40/μL) showed 81.94% sensitivity, 81.32% specificity (AUC 0.859); LY-X (> 79.3) had 93.06% sensitivity, 48.61% specificity (AUC 0.685); and MO-WY (> 752) had 84.72% sensitivity, 45.83% specificity (AUC 0.597). SOFA score correlated with MO-X (r = 0.40, p = 0.007), LY-X (r = 0.40, p = 0.008) and LY-Z (r = 0.39, p = 0.009), while procalcitonin correlated with MO-X (r = 0.30, p = 0.03) and HFLC (r = 0.40, p = 0.005).</p><p><strong>Conclusion: </strong>CPD is a promising, cost-effective biomarker for diagnosis and severity assessment of sepsis, but inter-equipment variability and current \"research use only\" status warrant further clinical validation.</p>","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877616","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":"Distinguishing Reactive Lymphocytes From Blasts Using Fractal Chromatin Patterns.","authors":"Abigail Gordhamer, Henry Tullis, Ryan Cordner","doi":"10.1111/ijlh.14541","DOIUrl":"https://doi.org/10.1111/ijlh.14541","url":null,"abstract":"<p><strong>Introduction: </strong>Of all the cells identified in peripheral blood smears, reactive lymphocytes (RLs) and blasts are considered especially difficult to differentiate. Blasts and RLs are present in distinct diseases that carry unique prognoses and treatments; however, there are currently no definitive methods to distinguish these cells morphologically.</p><p><strong>Methods: </strong>We developed a method to distinguish between blasts and RLs based on the quantification of fractal chromatin patterns. Nuclei from white blood cell images were isolated, and the fractal patterns were quantified using The Workflow of Matrix Biology Informatics (TWOMBLI) software. Quantified fractals were compared using the t-test. The data was further split into training and testing sets. Models (random forest and k-nearest neighbors) were selected through cross-validation on the training sets. Performance metrics, including area under the curve (AUC), accuracy, precision, specificity, and sensitivity, were determined for the selected models on the testing sets. Principal component analysis (PCA) was also performed.</p><p><strong>Results: </strong>Our most general model was able to identify RLs and blast subtypes with an average 84.2% accuracy and an AUC of 0.844. Testing on the holdout set gave every model an area under the curve greater than 0.815. PCA revealed two components that account for 50% of the data's variance.</p><p><strong>Conclusion: </strong>Our results suggest that a classification algorithm can effectively distinguish between blasts and RLs based solely on fractal chromatin patterns. It is possible that a similar algorithm could be utilized in the clinical hematology laboratory to assist in distinguishing RLs and blasts in peripheral blood smears.</p>","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860025","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}