International journal of laboratory hematology最新文献

{"title":"Significance of Myelodysplasia-Related Mutations and the Genetic Landscape of Acute Leukemias of Ambiguous Lineage.","authors":"Timothy J Kirtek, Olga K Weinberg","doi":"10.1111/ijlh.14529","DOIUrl":"https://doi.org/10.1111/ijlh.14529","url":null,"abstract":"<p><p>The recent fifth edition WHO classification and ICC classification systems have moved further toward genetically defined classifications of acute leukemias. Both now recognize myelodysplasia-related (MR) mutations as defining of MDS-related AML (AML-MR). Acute leukemias of ambiguous lineage (ALAL) are a heterogenous group of acute leukemias characterized by leukemic blasts that either express markers of multiple lineages, mixed phenotype acute leukemia (MPAL), or too few to be assigned a definitive lineage, acute undifferentiated leukemia (AUL). However, the recent classifications are unclear on how ALALs should be categorized in the presence of MR mutations. In short, the current recommendations are to classify cases that are immunophenotypically consistent with ALAL but harbor MR cytogenetics or mutations as AML-MR. Due to their rarity, investigations into the genetic basis of ALAL are limited but show great heterogeneity in their mutational landscapes. Data on the frequencies and significance of MR mutations in ALAL is particularly scant. Our comprehensive review of the literature reporting on the genetic landscapes of MPAL and AUL shows that a significant proportion of MPAL and AUL cases, ~32% and ~59% on average respectively, may harbor one or more mutations in MR genes, with mutations in RUNX1 and ASXL1 among the most common. Additional research is needed into the clinical, immunophenotypic, and genetic characteristics of ALAL to aid in refining classification and to support therapeutic decision making.</p>","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602639","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":"Determination of Fibrinogen Ratio Cutoff Limits Using Indirect Reference Interval Methodology.","authors":"Abdulrahman Saadalla, Kelly Doyle, Karen Moser, Kristi Smock","doi":"10.1111/ijlh.14526","DOIUrl":"https://doi.org/10.1111/ijlh.14526","url":null,"abstract":"<p><strong>Introduction: </strong>Discordant fibrinogen antigen to activity ratios are utilized by clinicians as evidence of dysfibrinogenemia. Abnormal ratio cutoffs implemented by clinical laboratories are typically determined by validation studies that include limited numbers of samples. We here utilize large datasets of stored clinical results and apply indirect reference interval (RI) methodology to determine fibrinogen ratio cutoffs suggestive of dysfibrinogenemia.</p><p><strong>Methods: </strong>Panel results comprised of fibrinogen antigen and activity measurements and calculated ratios of antigen to activity were retrieved for analysis. Two datasets were analyzed: (1) 3693 unique patient results in which antigen concentrations were measured by radial immunodiffusion (RID) from January 2019 to April 2023, and (2) 2192 patient results with antigen concentrations measured using turbidimetry immunoassay between April 2024 and March 2025. Both datasets were analyzed using the RefineR algorithm to estimate the corresponding RI of fibrinogen activity and antigen, and ratio cutoffs.</p><p><strong>Results: </strong>Estimated fibrinogen antigen/activity ratio cutoffs were within close range (< 8% difference) to the validated cutoffs used by our laboratory: 1.17 versus 1.23 and 1.06 versus 1.01 using antigen RID and turbidimetry assays, respectively. Contrarily, estimated upper RI limits of antigen and activity were higher by 38.4%-57.2% than validated limits, and RI was wider by 41.8%-80%.</p><p><strong>Conclusion: </strong>The RefineR algorithm could be used to determine fibrinogen ratio cutoffs with the advantage of including significantly larger numbers of available clinical results. For antigen and activity, the algorithm could not separate out acute-phase elevated fibrinogen (activity and antigen) results and overestimated the upper RI limits relative to the clinically validated cutoffs.</p>","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593245","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":"Performance Evaluation of the Sysmex XN, XR, and DI-60 Body Fluid Applications for Leukocyte Differentiation.","authors":"Marth Briers, Nancy Boeckx, Lieselot Dedeene, Lien Gruwier, Christine Van Laer","doi":"10.1111/ijlh.14530","DOIUrl":"https://doi.org/10.1111/ijlh.14530","url":null,"abstract":"<p><strong>Introduction: </strong>In response to the growing demand for automation in body fluid (BF) analysis, we evaluated the research four-part white blood cell (WBC) differentiation provided by the Sysmex XN and XR hematology analyzers (BF mode), as well as the Sysmex digital cell imaging analyzer DI-60 (CellaVision) BF application for microscopic analysis.</p><p><strong>Methods: </strong>Cerebrospinal, pleural, peritoneal, and synovial fluid samples were analyzed. The four-part WBC differentiation (neutrophil, lymphocyte, monocyte, and eosinophil count (%)) provided by the XN- and XR-BF mode and the DI-60 BF application was compared to manual microscopic examination of May-Grünwald Giemsa stained cytocentrifuge slides. Additionally, the DI-60 BF application was assessed for its capability to detect malignancies.</p><p><strong>Results: </strong>A total of 205 BF samples were included in the evaluation of the four-part WBC differentiation of the XN- and XR-BF mode. A very strong correlation coefficient (r_s) between the XN/XR analyzer and manual microscopic examination was observed for neutrophils (%): 0.851 (XN); 0.862 (XR) and lymphocytes (%): 0.833 (XN); 0.842 (XR). The XN and XR analyzers reported lower monocyte counts compared to manual microscopic examination (bias = -3.21% (XN); -1.16% (XR)). The eosinophil count (%) showed suboptimal correlation between the automated analyzers and manual microscopy (r_s = 0.428 (XN); 0.555 (XR)), probably due to low levels and outliers. Out of 161 cytospin slides, 39 could not be processed by the DI-60, resulting in 122 remaining samples. All WBC types showed strong correlation between the manual count and the DI-60 count (r_s values of 0.735-0.974).</p><p><strong>Conclusions: </strong>The four-part WBC differentiation provided by the Sysmex XN- and XR-BF mode and the Sysmex DI-60 BF application are valuable tools for automating and standardizing BF analysis.</p>","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585972","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":"Research Parameters in RBC Indices Shows Vital Importance in Screening α-Thalassemia.","authors":"Liang Fu, Li Peng, Aiqun Li, Zhuowen Hu, Jingxian Liang, Shaoling Liu, Yimei Liu, Xiluan Yuan, Sijie He, Nan Yu","doi":"10.1111/ijlh.14523","DOIUrl":"https://doi.org/10.1111/ijlh.14523","url":null,"abstract":"<p><strong>Background: </strong>The percentage of microcytic cells (%MICRO) and the percentage of hypochromic cells (%HYPO) were very useful in differentiating microcytic anemia, and hematological parameters had significant potential as predictive markers of the degree of α-gene deletions. This study aims to evaluate the value of these research parameters in screening for α-thalassemia compared to classical indices.</p><p><strong>Methods: </strong>We analyzed the data of 402 subjects with α-thalassemia deletions and 553 normal subjects and evaluated the performance of each parameter with receiver operating characteristic (ROC) curves, sensitivity, and specificity. The correlation between red blood cell (RBC) indices and the number of α-genes deleted was also assessed.</p><p><strong>Results: </strong>A close correlation was observed between the degree of α-gene deletions and cellular hemoglobin content (CH) (r = -0.835, p < 0.001), mean corpuscular hemoglobin (MCH) (r = -0.825, p < 0.001), and %MICRO+%HYPO (M + H) (r = 0.811, p < 0.001). The area under the curve (AUC) of CH consistently exceeded that of MCH (0.8988 vs. 0.8812, 0.987 vs. 0.984, 0.988 vs. 0.980, respectively). M + H exhibited better diagnostic performance than MCH in predicting two and three α-gene deletions (AUC 0.987 vs. 0.984, and 0.991 vs. 0.980, respectively). A CH < 23.35 pg. strongly suggests the presence of two α-gene deletions; when M + H > 89.40% or CH < 19.35 pg, a precise preliminary diagnosis of Hb H disease could be made.</p><p><strong>Conclusions: </strong>The research parameters in RBC indices have vital importance in screening for α-thalassemia and can serve as an effective preliminary screening tool to predict the number of α-gene deletions.</p>","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585973","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":"Bone Marrow Basophil Evaluation in Myeloproliferative Neoplasms Using Flow Cytometry.","authors":"Yuan Meng, Hongyan Liao, Yongmei Jin, Nenggang Jiang","doi":"10.1111/ijlh.14520","DOIUrl":"https://doi.org/10.1111/ijlh.14520","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the characteristics of bone marrow (BM) basophils in myeloproliferative neoplasm (MPN) using flow cytometry (FCM). Basophils have been known to be elevated in chronic myeloid leukemia (CML) through blood analyzers or microscopes, but these methods are not reliable for identifying BM basophils, and the changes in BM basophils in non-CML MPN were unclear.</p><p><strong>Methods: </strong>BM basophils of 101 MPN were evaluated by FCM, assessing indices related to basophil levels and CD63/CD203c expression. PB basophils were counted by blood analyzer. The basophil characteristics of MPN were compared to that of 95 individuals without hematopoietic disorders and 30 newly diagnosed myelodysplastic neoplasms (MDS).</p><p><strong>Results: </strong>MPN patients showed increased levels of BM basophils and basophils with CD203c expression compared to normal or reactive group. Although weak correlation was observed, BM basophil levels were statistically different from those in PB. Comparing basophil characteristics between non-CML MPN and normal or reactive group, BM basophil indices demonstrated higher elevated counts than PB basophil indices in MPN. BM baso/lym ratio and basophil percentage were most effective in distinguishing non-CML MPN from non-hematopoietic disorders, while PB basophil indices demonstrated limited discriminative value. Most of the basophil indices of CML were different from those of normal group, reactive basophilia, non-CML MPN and MDS. CML could be discriminated from non-hematopoietic disorders by all basophil indices, with BM baso/lym ratio, PB basophil count and PB baso/lym ratio demonstrating superior capacity of discrimination.</p><p><strong>Conclusions: </strong>BM basophil indices, particularly the baso/lym ratio, enhance MPN identification and outperform PB basophil indices in discriminating non-CML MPN from non-hematopoietic disorders. These findings indicate BM basophil analysis by FCM could serve as a potential tool for MPN screening.</p>","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565577","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":"Clinical Study on the Assessment of Infection-Induced Disseminated Intravascular Coagulation (DIC) and Its Prognosis in Neonates by Tissue-Type Plasminogen Activator-Plasminogen Activator Inhibitor-1 Complex.","authors":"Xu Wei, Jinlin Wu, Ge Zhang, Chuyang Lin, Lei Ye","doi":"10.1111/ijlh.14516","DOIUrl":"https://doi.org/10.1111/ijlh.14516","url":null,"abstract":"<p><strong>Background: </strong>Disseminated intravascular coagulation (DIC) is a critical complication in neonatal infections, necessitating early detection to reduce mortality. This study investigates the clinical utility of the tissue-type plasminogen activator-plasminogen activator inhibitor-1 complex (t-PAIC) in assessing infection-induced neonatal DIC.</p><p><strong>Methods: </strong>A retrospective analysis of 61 neonates with infections (July 2021-February 2023) at West China Second University Hospital categorized patients into DIC (n = 23) and non-DIC (n = 38) groups using the Chinese DIC scoring system (CDSS). Univariate, multivariate, ROC, and Kaplan-Meier analyses evaluated t-PAIC levels, and a nomogram model was developed. A prospective study (March 2023-January 2024) with 53 neonates validated the t-PAIC threshold for DIC prediction.</p><p><strong>Results: </strong>t-PAIC (OR = 1.332, p = 0.045), thrombin time (TT) (OR = 2.317, p = 0.014), and aspartate aminotransferase (AST) (OR = 1.008, p = 0.014) were independent DIC risk factors. t-PAIC predicted DIC with an AUC of 0.783 (p = 0.000), sensitivity of 0.652, and specificity of 0.816. A t-PAIC threshold ≥ 8.85 ng/mL increased DIC risk and mortality (HR = 3.434, p = 0.01). The nomogram combining t-PAIC, TT, and AST showed superior predictive performance (AUC = 0.896, sensitivity = 0.826, specificity = 0.842). The prospective study confirmed t-PAIC ≥ 8.85 ng/mL as a predictive marker for DIC (p < 0.05).</p><p><strong>Conclusion: </strong>t-PAIC is an independent DIC risk factor in neonates with infections. A t-PAIC level ≥ 8.85 ng/mL significantly increases DIC risk and mortality, highlighting its clinical utility in assessing infection-induced neonatal DIC.</p>","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565578","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":"Assessing the Persistence and Relevance of Small T-LGL Clones via TRBC1 in a Flowcytometric Lymphoid Screening Tube.","authors":"Nathan Debunne, Barbara Cauwelier, Helena Devos, Sylvia Snauwaert, Jan Emmerechts","doi":"10.1111/ijlh.14525","DOIUrl":"https://doi.org/10.1111/ijlh.14525","url":null,"abstract":"<p><strong>Introduction: </strong>Recently, monoclonal antibodies targeting one of the two mutually exclusive constant regions of the TCR β receptor chain (TRBC1 and TRBC2) have been proposed as a surrogate tool for assessing T-cell clonality by flowcytometry. The detection of T-cell clones is typically interpreted in the context of malignancy. However, small T-cell clones of uncertain significance (T-CUS) are frequently identified, posing diagnostic and clinical challenges. Since 2022, TRBC1 was incorporated as a marker for T-cell clonality in our flowcytometric lymphoid screening tube (LST), a tube designed to detect both B- and T-cell aberrancies in the blood of patients with clinical suspicion of hematological malignancy. The objective of the current study was to systematically evaluate the frequency and size of T-cell clones identified at initial diagnosis and to evaluate clonal evolution in follow-up samples.</p><p><strong>Methods: </strong>In this single-centre retrospective study (2022-2024), peripheral blood samples of 3495 unique patients were tested for T-cell clonality using TRBC1. The monotypic T-cell clones of > 50/μL were stratified into three groups: T-CUS1 (50-500 monotypic cells/μL), T-CUS2 (500-2000 monotypic cells/μL), and T-LGL (> 2000 monotypic cells/μL). Follow-up samples were obtained at least 6 months after initial testing (range: 6-30 months) and potential indicators of progression to T-CUS2 or T-LGL were evaluated.</p><p><strong>Results: </strong>The majority of T-CUS clones (22/36, 61%) were not detected (< 50 monotypic cells/μL) at follow-up, thereby demonstrating the importance of evaluation of the persistance of small T-cell clones. Fifteen percent of patients with a T-CUS1 progressed to T-CUS2, but none to T-LGL (95% CI: 0%-15%). 22% (95% CI: 3%-60%) of T-CUS2 patients evolved to T-LGL, all of which showed aberrant expression of CD57. In the patient group who showed evolution to T-CUS2 or T-LGL, significantly lower hemoglobin levels and neutrophil counts were observed at the time of T-CUS detection. Additionally, in this group, comparable increases in monotypic T-cell clones were observed over time, with a main increment of 90 monotypic cells/μL per month (95% CI: 34%-145%).</p><p><strong>Conclusions: </strong>The low number of persistence observed in T-CUS at follow-up highlights the need for cautious interpretation of small T-cell clones (T-CUS1). Low hemoglobin and neutrophil counts at diagnosis might indicate higher risk for progression and need for closer follow-up.</p>","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531973","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":"Machine Learning for Discriminating Microcytic Hypochromic Anemia Based on Erythrocyte Parameters.","authors":"Jing Lv, Jinmi Li, Xiaodong Ren, Qing Huang, Shaoli Deng","doi":"10.1111/ijlh.14524","DOIUrl":"https://doi.org/10.1111/ijlh.14524","url":null,"abstract":"<p><strong>Introduction: </strong>Thalassemia trait (TT) and iron deficiency anemia (IDA) are two common types of microcytic hypochromic anemia (MHA), but current diagnostic methods have limitations. This research sought to employ machine learning (ML) algorithms to identify MHA using erythrocyte parameters to distinguish between TT and IDA.</p><p><strong>Methods: </strong>One hundred and ninety-three subjects with MHA (98 TT and 95 IDA) were retrospectively analyzed. The cohort was randomized to training set (60%), validation set (20%) and test set (20%). Erythrocyte parameters were collected on an automated hematology analyzer (DxH800, Beckman Coulter), and five ML algorithms were selected to build discriminant models, including Random Forest, XGBoost, logistic regression, AdaBoost and LightGBM. In the assessment of discriminant performance of different models, indicators including sensitivity, specificity, accuracy, AUC, NPV, PPV, cutoff, F1 score and Kappa coefficients were utilized.</p><p><strong>Results: </strong>Among the five ML algorithms aforementioned, the Random Forest and logistic regression models presented excellent discriminant performance, outperforming other models in the testing set, with the AUC value, sensitivity, specificity, and ACC of 0.977, 0.928, 0.953, and 0.940 for Random Forest, and 0.978, 0.879, 0.979, 0.928 for logistic regression. Eight vital peripheral erythrocyte parameters were finally selected, including RBC, RDW, MCV, MCHC, RDWSD, HGB, MAF, and LHD.</p><p><strong>Conclusion: </strong>We successfully developed a discriminant model using ML algorithms based on erythrocyte parameters to identify MHA rapidly from TT or IDA, which may assist patients in taking preventive measures.</p>","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531977","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":"Evaluating Unghosted Cells (UGC): An Automated Blood Cell Counter-Derived Novel Red Cell Research Parameter for Its Clinical Utility and Diagnostic Implications Across a Spectrum of Pathological Conditions.","authors":"Anita Giri, Praveen Sharma, Dikshat Gopal Gupta, Minakshi Gupta, Pulkit Rastogi, Srinivasan Peyam, Aashima Arora, Alka Rani Khadwal, Elena Sukacheva, Prashant Sharma, Reena Das","doi":"10.1111/ijlh.14521","DOIUrl":"https://doi.org/10.1111/ijlh.14521","url":null,"abstract":"<p><strong>Introduction: </strong>Automated estimation of poikilocytes by automated hematology analyzers remains challenging. The unghosted cells (UGC) parameter in Beckman Coulter UniCel DxH 800 analyzers has been reported to correlate with target cells and other conditions with increased erythrocytic osmotic resistance like microcytosis/hypochromia, sickle cells, and post splenectomy. We assessed UGCs' reference range and potential clinical utility in a specialist hematology laboratory.</p><p><strong>Materials and methods: </strong>We prospectively enrolled 520 participants, encompassing healthy individuals (n = 45), β-thalassemia trait (n = 196), hemoglobinopathies (n = 104), iron deficiency anemia (n = 88), liver disease (n = 46), spherocytosis (n = 18), and neonatal cord blood samples (n = 23). Peripheral blood EDTA samples were analyzed. UGC data were correlated with peripheral smear findings. In addition, red cell parameters including UGC were compared to differentiate β-thalassemia trait (βTT) from iron deficiency.</p><p><strong>Results: </strong>UGCs were undetectable or present in very low numbers in healthy individuals (range 0%-0.01%). They demonstrated a significant positive correlation with manual target cell counts on peripheral smear (correlation coefficient, r = 0.64, p < 0.001). The highest UGC levels were observed in those with liver disease, with a median value of 0.395% (range: 0%-8.23%). All non-control subgroups, except for spherocytosis, showed significantly increased UGC% (p < 0.0001) vis-à-vis healthy individuals. A novel formula at a cut-off of 0.77 demonstrated 86.22% sensitivity and 93.10% specificity in differentiating βTT and IDA.</p><p><strong>Conclusions: </strong>UGC% represents an innovative, automated hematological red cell research parameter capable of screening target cells and quantifying them. UGC shows significant potential for clinical diagnostic applications across a wide range of disorders characterized by target cells, facilitating differential diagnoses in clinical practice.</p>","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531976","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":"Uncovering Hidden Traces of K₂EDTA Contamination in Citrated Blood Samples: A Novel Approach Using Fibrinogen Clot Waveform Graphs.","authors":"Ozben Ozden Isiklar, Evin Kocaturk, Kevser Setenay Oner, Ibrahim Ozkan Alatas","doi":"10.1111/ijlh.14519","DOIUrl":"https://doi.org/10.1111/ijlh.14519","url":null,"abstract":"<p><strong>Background: </strong>Preanalytical mistakes in coagulation assays to a great extent affect diagnostic results. K₂EDTA contamination is one of the preanalytical mistakes that significantly interferes with assays of prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, and thrombin time (TT).</p><p><strong>Objective: </strong>To assess how different levels of K₂EDTA contamination influence coagulation test results and to evaluate the effectiveness of clot waveform analysis in identifying such contamination in citrated blood samples.</p><p><strong>Methods: </strong>Contamination was introduced at varying concentrations (5%, 13%, 17%, 29%, 33%, 43%, and 100%) in citrated whole blood samples from 36 healthy volunteers. Coagulation assays for aPTT, PT, fibrinogen, and TT were performed using the Sysmex CN 6000 analyzer. Clot waveform analysis was used to detect contamination.</p><p><strong>Results: </strong>The results revealed significant differences from the reference ranges for aPTT at contamination above 17% K₂EDTA and at 29% in PT and fibrinogen. As far as TT is concerned, significant changes were found from a contamination of 33%. Notably, fibrinogen second-derivative graphs showed min2 values above 0.31, with a sensitivity of 80.3%, specificity of 99.3%, and an area under the curve (AUC) of 0.94. These changes indicated a high likelihood of K₂EDTA contamination.</p><p><strong>Conclusions: </strong>K₂EDTA contamination above 17% can significantly alter coagulation test results, potentially leading to diagnostic inaccuracies. Clot waveform analysis, particularly fibrinogen second-derivative graphs, can detect contamination, and proper sample collection guidelines are crucial for accuracy.</p>","PeriodicalId":94050,"journal":{"name":"International journal of laboratory hematology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531978","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}