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Choi YJ, Park JH, Cho S, Park H, Kim S, Kwon E, Cho HI, Nah EH. Reference intervals of cell population data parameters in Sysmex XN-Series and its patterns of changes from early adulthood to geriatric ages in South Korea. Int J Lab Hematol 2024; 46:466-473. [PMID: 38263481 DOI: 10.1111/ijlh.14231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/05/2024] [Indexed: 01/25/2024]
Abstract
INTRODUCTION Cell population data (CPD) parameters may be putative biomarkers for the screening of various diseases including some infections and myelodysplastic syndrome. This study aimed to establish the age- and sex-specific reference intervals (RIs) for the CPD parameters in the Korean population. METHODS The reference population for the RIs of CPD parameters comprised 124 856 subjects aged 20-99 years. CPD parameters were obtained from Sysmex XN-2000 (Kobe, Japan) datasets from 17 health promotion centers in 13 South Korean cities. We determined significant partitions for age and sex, and calculated RIs according to Clinical and Laboratory Standards Institute C28-A3 guidelines. RESULTS The side scattered light intensity in the neutrophil area and the lymphocyte area did not require sex-related partitioning except in those over the age of 50, among whom the lower limit (LL) and upper limit (UL) were lower in females. However, the side scattered light distribution width in the lymphocyte area required age- and sex-related partitioning, in which LL and UL were higher in females. The LL and UL of the fluorescent light distribution width were higher in males in the neutrophil area and higher in females in the lymphocyte area, but age-related partitioning was not required. The forward scattered light intensity in the neutrophil area, lymphocyte area, and monocyte area did not require age-related partitioning in males. CONCLUSION This study has determined comprehensive age- and sex-specific RIs for CPD parameters, which could help to prove the clinical significance of these parameters in the Sysmex XN-2000.
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Affiliation(s)
- Yong Jun Choi
- Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - Ju-Heon Park
- Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - Seon Cho
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, South Korea
| | - Hyeran Park
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, South Korea
| | - Suyoung Kim
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, South Korea
| | - Eunjoo Kwon
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, South Korea
| | - Han-Ik Cho
- MEDIcheck LAB, Korea Association of Health Promotion, Seoul, South Korea
| | - Eun-Hee Nah
- Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Hwasun, South Korea
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Kaneda M, Nagaoka K, Yoshida R, Iwasaki Y, Niimi H, Yamamoto Y. Time-dependent changes in cell population data obtained using Sysmex XN-series hematology analyzer in bacterial infections. J Infect Chemother 2024:S1341-321X(24)00083-7. [PMID: 38522794 DOI: 10.1016/j.jiac.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/28/2024] [Accepted: 03/06/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Time-dependent changes in cell populations during acute bacterial infections remain unclear. We assessed time-dependent changes in fluorescent light intensity of the neutrophil area (NE-SFL) and fluorescent light distribution width index of the neutrophil area (NE-WY) and their association with sepsis and bacteremia. METHODS Patients with acute bacterial infections were enrolled in this prospective, observational cohort study. Blood samples were collected from all patients at the onset of bacterial infections (day 0) and on days 1 and 3. Microbiological evaluation included the examination of blood bacterial load using PCR. Cell population data were assessed using an automated hematology analyzer (Sysmex series XN-2000). RESULTS Forty-three participants with acute bacterial infections were enrolled in the study. Twenty-five participants developed definite sepsis. All the participants improved after the onset of infection. NE-WY levels showed significant time-dependent changes in participants with sepsis, peaking on day 0 and significantly decreasing until day 3, whereas these changes were not statistically significant for NE-SFL. A significant correlation with the Sequential Organ Failure Assessment score was observed with NE-WY and NE-SFL in the entire cohort on days 0 and 1. However, only NE-WY showed a significant correlation with blood bacterial load on days 0 and 1. CONCLUSION This study demonstrated that NE-WY elevation in sepsis peaked earlier than NE-SFL, which may partly reflect the early bacterial invasion into circulation. These findings advocate caution in interpreting cell population data values as sepsis biomarkers and propose the potential of NE-WY as a therapeutic indicator.
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Affiliation(s)
- Makito Kaneda
- Department of Clinical Infectious Diseases, Toyama University Hospital, Toyama, Japan
| | - Kentaro Nagaoka
- Department of Clinical Infectious Diseases, Toyama University Hospital, Toyama, Japan.
| | - Rinako Yoshida
- Scientific Affairs, Medical & Scientific Affairs, Sysmex Corporation, Hyogo, Japan
| | - Yosuke Iwasaki
- Scientific Affairs, Medical & Scientific Affairs, Sysmex Corporation, Hyogo, Japan
| | - Hideki Niimi
- Department of Clinical Laboratory and Molecular Pathology, Toyama University Hospital, Toyama, Japan
| | - Yoshihiro Yamamoto
- Department of Clinical Infectious Diseases, Toyama University Hospital, Toyama, Japan
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Aoki M, Watanabe N, Taji Y, Ebihara Y. The Clinical Performance of Cell Population Data for Diagnosis of Bloodstream Infection in Cancer Patients. Cureus 2023; 15:e50857. [PMID: 38249249 PMCID: PMC10798876 DOI: 10.7759/cureus.50857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 01/23/2024] Open
Abstract
Background Bloodstream infection (BSI) induces a change in the number and morphology of blood cells. In this study, we compared cell population data (CPD) parameters between cancer patients with or without BSI to determine whether these parameters could serve as biomarkers of BSI. Methods Between April and June 2021, 43 BSI-negative and 22 BSI-positive cancer patients were enrolled in this study. We compared 18 CPD parameters and biomarkers between cancer patients with BSI-positive and BSI-negative. Results There were significant differences in the levels of several CPD parameters, including MO-WZ (p=0.040), MO-X (p<0.01), MO-Y (p=0.012), NE-SFL (p<0.01), and NE-WX (p=0.037), but not C-reactive protein (p=0.347) and procalcitonin (p=0.237) between BSI-positive and BSI-negative patients. The areas under the receiver-operating characteristic curves (AUCs) were above 0.7 for MO-X (0.762; 95% confidence intervals (CI): 0.624-0.901), NE-SFL (0.766; 95% CI: 0.625-0.880). And LY-WY (p=0.024) showed a significant difference between gram-negative and gram-positive BSI patients with high AUC (0.883; 95% CI: 0.703-1). Conclusion CPD parameters (MO-X and NE-SFL) provide additional information for discriminating between BSI-negative and BSI-positive BSI. And LY-WY provides useful information for discriminating between cancer patients with gram-negative BSI and gram-positive BSI.
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Affiliation(s)
- Masanori Aoki
- Clinical Laboratory, Saitama Medical University International Medical Center, Hidaka, JPN
| | - Noriyuki Watanabe
- Clinical Laboratory, Saitama Medical University International Medical Center, Hidaka, JPN
| | - Yoshitada Taji
- Clinical Laboratory, Saitama Medical University International Medical Center, Hidaka, JPN
| | - Yasuhiro Ebihara
- Laboratory Medicine, Saitama Medical University International Medical Center, Hidaka, JPN
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Elhadary M, Elshoeibi AM, Badr A, Elsayed B, Metwally O, Elshoeibi AM, Mattar M, Alfarsi K, AlShammari S, Alshurafa A, Yassin M. Revolutionizing chronic lymphocytic leukemia diagnosis: A deep dive into the diverse applications of machine learning. Blood Rev 2023; 62:101134. [PMID: 37758527 DOI: 10.1016/j.blre.2023.101134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 09/29/2023]
Abstract
Chronic lymphocytic leukemia (CLL) is a B cell neoplasm characterized by the accumulation of aberrant monoclonal B lymphocytes. CLL is the predominant type of leukemia in Western countries, accounting for 25% of cases. Although many patients remain asymptomatic, a subset may exhibit typical lymphoma symptoms, acquired immunodeficiency disorders, or autoimmune complications. Diagnosis involves blood tests showing increased lymphocytes and further examination using peripheral blood smear and flow cytometry to confirm the disease. With the significant advancements in machine learning (ML) and artificial intelligence (AI) in recent years, numerous models and algorithms have been proposed to support the diagnosis and classification of CLL. In this review, we discuss the benefits and drawbacks of recent applications of ML algorithms in the diagnosis and evaluation of patients diagnosed with CLL.
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Affiliation(s)
| | | | - Ahmed Badr
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Basel Elsayed
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Omar Metwally
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | | | - Mervat Mattar
- Internal Medicine and Clinical Hematology, Cairo University, Cairo, Egypt
| | - Khalil Alfarsi
- Department of Hematology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Salem AlShammari
- Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait, Kuwait
| | - Awni Alshurafa
- Hematology Section, Medical Oncology, National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Yassin
- Hematology Section, Medical Oncology, National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation, Doha, Qatar.
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Akbari P, Vuckovic D, Stefanucci L, Jiang T, Kundu K, Kreuzhuber R, Bao EL, Collins JH, Downes K, Grassi L, Guerrero JA, Kaptoge S, Knight JC, Meacham S, Sambrook J, Seyres D, Stegle O, Verboon JM, Walter K, Watkins NA, Danesh J, Roberts DJ, Di Angelantonio E, Sankaran VG, Frontini M, Burgess S, Kuijpers T, Peters JE, Butterworth AS, Ouwehand WH, Soranzo N, Astle WJ. A genome-wide association study of blood cell morphology identifies cellular proteins implicated in disease aetiology. Nat Commun 2023; 14:5023. [PMID: 37596262 PMCID: PMC10439125 DOI: 10.1038/s41467-023-40679-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 08/07/2023] [Indexed: 08/20/2023] Open
Abstract
Blood cells contain functionally important intracellular structures, such as granules, critical to immunity and thrombosis. Quantitative variation in these structures has not been subjected previously to large-scale genetic analysis. We perform genome-wide association studies of 63 flow-cytometry derived cellular phenotypes-including cell-type specific measures of granularity, nucleic acid content and reactivity-in 41,515 participants in the INTERVAL study. We identify 2172 distinct variant-trait associations, including associations near genes coding for proteins in organelles implicated in inflammatory and thrombotic diseases. By integrating with epigenetic data we show that many intracellular structures are likely to be determined in immature precursor cells. By integrating with proteomic data we identify the transcription factor FOG2 as an early regulator of platelet formation and α-granularity. Finally, we show that colocalisation of our associations with disease risk signals can suggest aetiological cell-types-variants in IL2RA and ITGA4 respectively mirror the known effects of daclizumab in multiple sclerosis and vedolizumab in inflammatory bowel disease.
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Affiliation(s)
- Parsa Akbari
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Wort's Causeway, Cambridge, CB1 8RN, UK
- Department of Human Genetics, The Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1HH, UK
- Medical Research Council Biostatistics Unit, University of Cambridge, East Forvie Building, Cambridge Biomedical Campus, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK
- The National Institute for Health and Care Research Blood and Transplant Unit in Donor Health and Genomics, Strangeways Research Laboratory, Strangeways Research Laboratory, University of Cambridge, Wort's Causeway, Cambridge, CB1 8RN, UK
| | - Dragana Vuckovic
- Department of Human Genetics, The Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1HH, UK
- The National Institute for Health and Care Research Blood and Transplant Unit in Donor Health and Genomics, Strangeways Research Laboratory, Strangeways Research Laboratory, University of Cambridge, Wort's Causeway, Cambridge, CB1 8RN, UK
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Luca Stefanucci
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
- National Health Service Blood and Transplant, Cambridge Centre, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Tao Jiang
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Wort's Causeway, Cambridge, CB1 8RN, UK
- The National Institute for Health and Care Research Blood and Transplant Unit in Donor Health and Genomics, Strangeways Research Laboratory, Strangeways Research Laboratory, University of Cambridge, Wort's Causeway, Cambridge, CB1 8RN, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, CB2 0BB, UK
| | - Kousik Kundu
- Department of Human Genetics, The Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1HH, UK
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
| | - Roman Kreuzhuber
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
| | - Erik L Bao
- Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, 1 Blackfan Circle, Boston, MA, 02115, USA
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Ave, Boston, MA, 02115, USA
- Broad Institute of MIT and Harvard, 415 Main St, Cambridge, MA, 02142, USA
- Harvard-MIT Health Sciences and Technology, Harvard Medical School, 77 Massachusetts Ave, Cambridge, MA, 02139, USA
| | - Janine H Collins
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
- National Health Service Blood and Transplant, Cambridge Centre, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
- Department of Haematology, Barts Health National Health Service Trust, London, E1 1BB, UK
| | - Kate Downes
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
- National Health Service Blood and Transplant, Cambridge Centre, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
| | - Luigi Grassi
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
- National Health Service Blood and Transplant, Cambridge Centre, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
- National Institute for Health and Care Research Cambridge BioResource, Box 229, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Jose A Guerrero
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
- National Health Service Blood and Transplant, Cambridge Centre, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
| | - Stephen Kaptoge
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Wort's Causeway, Cambridge, CB1 8RN, UK
- The National Institute for Health and Care Research Blood and Transplant Unit in Donor Health and Genomics, Strangeways Research Laboratory, Strangeways Research Laboratory, University of Cambridge, Wort's Causeway, Cambridge, CB1 8RN, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, CB2 0BB, UK
| | - Julian C Knight
- Wellcome Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, OX3 7BN, UK
| | - Stuart Meacham
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, CB10 1SD, UK
| | - Jennifer Sambrook
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
- National Institute for Health and Care Research Cambridge BioResource, Box 229, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Denis Seyres
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
- National Health Service Blood and Transplant, Cambridge Centre, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
- National Institute for Health and Care Research Cambridge BioResource, Box 229, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Oliver Stegle
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, CB10 1SD, UK
- European Molecular Biology Laboratory, Genome Biology Unit, 69117, Heidelberg, Germany
- Division of Computational Genomics and Systems Genetics, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Jeffrey M Verboon
- Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, 1 Blackfan Circle, Boston, MA, 02115, USA
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Ave, Boston, MA, 02115, USA
- Broad Institute of MIT and Harvard, 415 Main St, Cambridge, MA, 02142, USA
| | - Klaudia Walter
- Department of Human Genetics, The Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1HH, UK
| | - Nicholas A Watkins
- National Health Service Blood and Transplant, Cambridge Centre, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
| | - John Danesh
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Wort's Causeway, Cambridge, CB1 8RN, UK
- Department of Human Genetics, The Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1HH, UK
- The National Institute for Health and Care Research Blood and Transplant Unit in Donor Health and Genomics, Strangeways Research Laboratory, Strangeways Research Laboratory, University of Cambridge, Wort's Causeway, Cambridge, CB1 8RN, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, CB2 0BB, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
| | - David J Roberts
- The National Institute for Health and Care Research Blood and Transplant Unit in Donor Health and Genomics, Strangeways Research Laboratory, Strangeways Research Laboratory, University of Cambridge, Wort's Causeway, Cambridge, CB1 8RN, UK
- Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, Headley Way, Headington, Oxford, OX3 9DU, UK
- National Institute for Health Research Oxford Biomedical Research Centre-Haematology Theme, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, UK
- National Health Service Blood and Transplant, Oxford Centre, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, UK
| | - Emanuele Di Angelantonio
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Wort's Causeway, Cambridge, CB1 8RN, UK
- The National Institute for Health and Care Research Blood and Transplant Unit in Donor Health and Genomics, Strangeways Research Laboratory, Strangeways Research Laboratory, University of Cambridge, Wort's Causeway, Cambridge, CB1 8RN, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, CB2 0BB, UK
- Health Data Science Research Centre, Fondazione Human Technopole, Viale Rita Levi Montalcini 1, Milan, 20157, Italy
| | - Vijay G Sankaran
- Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, 1 Blackfan Circle, Boston, MA, 02115, USA
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Ave, Boston, MA, 02115, USA
- Broad Institute of MIT and Harvard, 415 Main St, Cambridge, MA, 02142, USA
| | - Mattia Frontini
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
- National Health Service Blood and Transplant, Cambridge Centre, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK
- Department of Clinical and Biomedical Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, RILD Building, Barrack Road, Exeter, EX2 5DW, UK
| | - Stephen Burgess
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Wort's Causeway, Cambridge, CB1 8RN, UK
- Medical Research Council Biostatistics Unit, University of Cambridge, East Forvie Building, Cambridge Biomedical Campus, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, CB2 0BB, UK
| | - Taco Kuijpers
- Department of Pediatric Immunology, Rheumatology and Infectious Disease, Emma Children's Hospital, Amsterdam University Medical Center, Amsterdam, CB2 0PT, UK
- Department of Blood Cell Research, Sanquin Research and Landsteiner Laboratory, Sanquin, University of Amsterdam, Amsterdam, Netherlands
| | - James E Peters
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
- Department of Immunology and Inflammation, Imperial College London, Commonwealth Building, The Hammersmith Hospital, Du Cane Road, London, W12 0NN, UK
| | - Adam S Butterworth
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Wort's Causeway, Cambridge, CB1 8RN, UK.
- The National Institute for Health and Care Research Blood and Transplant Unit in Donor Health and Genomics, Strangeways Research Laboratory, Strangeways Research Laboratory, University of Cambridge, Wort's Causeway, Cambridge, CB1 8RN, UK.
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, CB2 0BB, UK.
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK.
| | - Willem H Ouwehand
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK.
- National Health Service Blood and Transplant, Cambridge Centre, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK.
- Department of Haematology, University College London Hospitals, WC1E 6AS, London, UK.
| | - Nicole Soranzo
- Department of Human Genetics, The Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, CB10 1HH, UK.
- The National Institute for Health and Care Research Blood and Transplant Unit in Donor Health and Genomics, Strangeways Research Laboratory, Strangeways Research Laboratory, University of Cambridge, Wort's Causeway, Cambridge, CB1 8RN, UK.
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK.
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
- Genomics Research Centre, Fondazione Human Technopole, Viale Rita Levi Montalcini 1, Milan, 20157, Italy.
| | - William J Astle
- Medical Research Council Biostatistics Unit, University of Cambridge, East Forvie Building, Cambridge Biomedical Campus, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK.
- The National Institute for Health and Care Research Blood and Transplant Unit in Donor Health and Genomics, Strangeways Research Laboratory, Strangeways Research Laboratory, University of Cambridge, Wort's Causeway, Cambridge, CB1 8RN, UK.
- National Health Service Blood and Transplant, Cambridge Centre, Cambridge Biomedical Campus, Long Road, Cambridge, CB2 0PT, UK.
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Wang Y, Wang Y, Ma J, Li Y, Cao L, Zhu T, Hu H, Liu H. YuPingFengSan ameliorates LPS-induced acute lung injury and gut barrier dysfunction in mice. JOURNAL OF ETHNOPHARMACOLOGY 2023; 312:116452. [PMID: 37019161 DOI: 10.1016/j.jep.2023.116452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/24/2023] [Accepted: 03/31/2023] [Indexed: 05/08/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Yupingfengsan (YPFS) is a traditional Chinese medicine decoction. YPFS comprises Astragalus mongholicus Bunge (Huangqi), Atractylodes rubra Dekker (Baizhu), and Saposhnikovia divaricata (Turcz.ex Ledeb.) Schischk (Fangfeng). YPFS is commonly used to treat chronic obstructive pulmonary disease, asthma, respiratory infections, and pneumonia, but the mechanism of action remains unclear. AIM OF THE STUDY Acute lung injury (ALI) and its severe form of acute respiratory distress syndrome (ARDS) cause morbidity and mortality in critical patients. YPFS is a commonly used herbal soup to treat respiratory and immune system diseases. Nevertheless, the effect of YPFS on ALI remains unclear. This study aimed to investigate the effect of YPFS on lipopolysaccharide (LPS)-induced ALI in mice and elucidate its potential molecular mechanisms. MATERIALS AND METHODS The major components of YPFS were detected by High-performance liquid chromatography (HPLC). C57BL/6J mice were given YPFS for seven days and then treated with LPS. IL-1β, IL-6, TNF-α, IL-8, iNOS, NLRP3, PPARγ, HO-1, ZO-1, Occludin, Claudin-1, AQP3, AQP4, AQP5, ENaCα, ENaCβ, EnaCγ mRNA in lung and ZO-1, Occludin, Claudin-1, AQP3, AQP4, AQP5, ENaCα, ENaCβ, and EnaCγ mRNA in colon tissues were measured by Real-Time Quantitative PCR (RT-qPCR). The expressions of TLR4, MyD88, NOD-like receptor thermal protein domain associated protein 3 (NLRP3), ASC, MAPK signaling pathway, Nrf2, and HO-1 in the lung were detected by Western blot. Plasma inflammatory factors Interleukin (IL)-1β, IL-6, and Tumor Necrosis Factor-α (TNF-α) were determined by Enzyme-linked Immunosorbent Assay (ELISA). Lung tissues were processed for H & E staining, and colon tissues for HE, WGA-FITC, and Alcian Blue staining. RESULTS The results showed that YPFS administration alleviated lung injury and suppressed the production of inflammatory factors, including IL-1β, IL-6, and TNF-α. Additionally, YPFS reduced pulmonary edema by promoting the expressions of aquaporin and sodium channel-related genes (AQP3, AQP4, AQP5, ENaCα, ENaCβ, and EnaCγ). Further, YPFS intervention exhibited a therapeutic effect on ALI by inhibiting the activation of the NLRP3 inflammasome and MAPK signaling pathways. Finally, YPFS improved gut barrier integrity and suppressed intestinal inflammation in LPS-challenged mice. CONCLUSIONS YPFS protected mice against LPS-induced ALI by attenuating lung and intestinal tissue damage. This study sheds light on the potential application of YPFS to treat ALI/ARDS.
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Affiliation(s)
- Yao Wang
- College of Basic Medical Sciences, Hubei University of Chinese Medicine, Huangjiahu West Road 16, Wuhan, 430065, PR China; College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Huangjiahu West Road 16, Wuhan, 430065, PR China
| | - Yanchun Wang
- Clinical College of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Huangjiahu West Road 16, Wuhan, 430065, PR China
| | - Jun Ma
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Huangjiahu West Road 16, Wuhan, 430065, PR China
| | - Yanan Li
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Huangjiahu West Road 16, Wuhan, 430065, PR China
| | - Lu Cao
- College of Basic Medical Sciences, Hubei University of Chinese Medicine, Huangjiahu West Road 16, Wuhan, 430065, PR China
| | - Tianxiang Zhu
- College of Basic Medical Sciences, Hubei University of Chinese Medicine, Huangjiahu West Road 16, Wuhan, 430065, PR China
| | - Haiming Hu
- College of Basic Medical Sciences, Hubei University of Chinese Medicine, Huangjiahu West Road 16, Wuhan, 430065, PR China.
| | - Hongtao Liu
- College of Basic Medical Sciences, Hubei University of Chinese Medicine, Huangjiahu West Road 16, Wuhan, 430065, PR China.
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Chang YH, Hsiao CT, Chang YC, Lai HY, Lin HH, Chen CC, Hsu LC, Wu SY, Shih HM, Hsueh PR, Cho DY. Machine learning of cell population data, complete blood count, and differential count parameters for early prediction of bacteremia among adult patients with suspected bacterial infections and blood culture sampling in emergency departments. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2023; 56:782-792. [PMID: 37244761 DOI: 10.1016/j.jmii.2023.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/06/2023] [Accepted: 05/06/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Bacteremia is a life-threatening complication of infectious diseases. Bacteremia can be predicted using machine learning (ML) models, but these models have not utilized cell population data (CPD). METHODS The derivation cohort from emergency department (ED) of China Medical University Hospital (CMUH) was used to develop the model and was prospectively validated in the same hospital. External validation was performed using cohorts from ED of Wei-Gong Memorial Hospital (WMH) and Tainan Municipal An-Nan Hospital (ANH). Adult patients who underwent complete blood count (CBC), differential count (DC), and blood culture tests were enrolled in the present study. The ML model was developed using CBC, DC, and CPD to predict bacteremia from positive blood cultures obtained within 4 h before or after the acquisition of CBC/DC blood samples. RESULTS This study included 20,636 patients from CMUH, 664 from WMH, and 1622 patients from ANH. Another 3143 patients were included in the prospective validation cohort of CMUH. The CatBoost model achieved an area under the receiver operating characteristic curve of 0.844 in the derivation cross-validation, 0.812 in the prospective validation, 0.844 in the WMH external validation, and 0.847 in the ANH external validation. The most valuable predictors of bacteremia in the CatBoost model were the mean conductivity of lymphocytes, nucleated red blood cell count, mean conductivity of monocytes, and neutrophil-to-lymphocyte ratio. CONCLUSIONS ML model that incorporated CBC, DC, and CPD showed excellent performance in predicting bacteremia among adult patients with suspected bacterial infections and blood culture sampling in emergency departments.
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Affiliation(s)
- Yu-Hsin Chang
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chiung-Tzu Hsiao
- Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Chang Chang
- Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Hsin-Yu Lai
- Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Hsiu-Hsien Lin
- Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chien-Chih Chen
- Department of Laboratory, Wei-Gong Memorial Hospital, Miaoli City, Taiwan
| | - Lin-Chen Hsu
- Department of Laboratory, An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Shih-Yun Wu
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hong-Mo Shih
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan.
| | - Po-Ren Hsueh
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan; Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan.
| | - Der-Yang Cho
- Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan.
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Miyajima Y, Niimi H, Ueno T, Matsui A, Higashi Y, Kojima N, Kono M, Iwasaki Y, Nagaoka K, Yamamoto Y, Kitajima I. Predictive value of cell population data with Sysmex XN-series hematology analyzer for culture-proven bacteremia. Front Med (Lausanne) 2023; 10:1156889. [PMID: 37324133 PMCID: PMC10267328 DOI: 10.3389/fmed.2023.1156889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/10/2023] [Indexed: 06/17/2023] Open
Abstract
Background Cell population data (CPD) parameters related to neutrophils, such as fluorescent light intensity (NE-SFL) and fluorescent light distribution width index (NE-WY), have emerged as potential biomarkers for sepsis. However, the diagnostic implication in acute bacterial infection remains unclear. This study assessed the diagnostic value of NE-WY and NE-SFL for bacteremia in patients with acute bacterial infections, and those associations with other sepsis biomarkers. Methods Patients with acute bacterial infections were enrolled in this prospective observational cohort study. For all patients, a blood sample, with at least two sets of blood cultures, were collected at the onset of infection. Microbiological evaluation included examination of the blood bacterial load using PCR. CPD was assessed using Automated Hematology analyzer Sysmex series XN-2000. Serum levels of procalcitonin (PCT), interleukin-6 (IL-6), presepsin, and CRP were also assessed. Results Of 93 patients with acute bacterial infection, 24 developed culture-proven bacteremia and 69 did not. NE-SFL and NE-WY were significantly higher in patients with bacteremia than in those without bacteremia (p < 0.005, respectively), and were significantly correlated with the bacterial load determined by PCR (r = 0.384 and r = 0.374, p < 0.005, respectively). To assess the diagnostic value for bacteremia, receiver operating characteristic curve analysis was used. NE-SFL and NE-WY showed an area under the curve of 0.685 and 0.708, respectively, while those of PCT, IL-6, presepsin, and CRP were 0.744, 0.778, 0.685, and 0.528, respectively. Correlation analysis showed that the levels of NE-WY and NE-SFL were strongly correlated with PCT and IL-6 levels. Conclusion This study demonstrated that NE-WY and NE-SFL could predict bacteremia in a manner that may be different from that of other indicators. These findings suggest there are potential benefits of NE-WY/NE-SFL in predicting severe bacterial infections.
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Affiliation(s)
- Yuki Miyajima
- Department of Clinical Infectious Diseases, Toyama University Hospital, Toyama, Japan
| | - Hideki Niimi
- Department of Clinical Laboratory and Molecular Pathology, Toyama University Hospital, Toyama, Japan
| | - Tomohiro Ueno
- Department of Clinical Laboratory and Molecular Pathology, Toyama University Hospital, Toyama, Japan
| | - Atsushi Matsui
- First Department of Internal Medicine, Toyama University Hospital, Toyama, Japan
| | - Yoshitsugu Higashi
- Department of Clinical Infectious Diseases, Toyama University Hospital, Toyama, Japan
| | - Nozomi Kojima
- Gene Technology Group, Reagent Engineering, Sysmex Corporation, Hyogo, Japan
| | - Mari Kono
- R&D Center Asia Pacific, Sysmex Asia Pacific Pte Ltd, Singapore, Singapore
| | - Yosuke Iwasaki
- Scientific Research, Scientific Affairs, Sysmex Corporation, Hyogo, Japan
| | - Kentaro Nagaoka
- Department of Clinical Infectious Diseases, Toyama University Hospital, Toyama, Japan
| | - Yoshihiro Yamamoto
- Department of Clinical Infectious Diseases, Toyama University Hospital, Toyama, Japan
| | - Isao Kitajima
- Department of Clinical Laboratory and Molecular Pathology, Toyama University Hospital, Toyama, Japan
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Nguyen M, Stiel L, Guilloteau A, Bahr PA, Masson D, Thomas C, Blot M, Guy J, Fontaine C, Durand B, Bouhemad B, Guinot PG. Leukocyte cell population data in patients with cardiac surgery and cardiopulmonary bypass: A potential readily available tool to monitor immunity. Front Immunol 2023; 13:1101937. [PMID: 36741408 PMCID: PMC9892932 DOI: 10.3389/fimmu.2022.1101937] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/30/2022] [Indexed: 01/21/2023] Open
Abstract
Purpose Cardiac surgery with cardiopulmonary bypass triggers sterile inflammation that is responsible for post-operative morbidity. Automated flow cytometry devices used for leucocyte count provide cell population data (CPD) regarding fluorescence intensity, size and granularity of leukocytes that have never been studied in the context of sterile inflammation. Our objective was to explore leukocyte cell population data in patients undergoing cardiac surgery with cardiopulmonary bypass in order to determine whether CPD could be used to monitor immune cell activation. Methods This is an ancillary study of a cohort of patients undergoing cardiac surgery with cardiopulmonary bypass. Cell population data (CPD) extracted from a routine automated flow cytometer were analyzed (Fluorescence targeted to nucleic acids). The time points of interest were: pre-operative, postoperative and 5 days after surgery. The variations in those parameters were studied. Data were then compared between patients according to the occurrence of a composite criteria (supra-ventricular arrythmia, stroke, acute renal failure, and/or death). Results Data from 1453 patients were analyzed. The neutrophil count, fluorescence granularity (NE-SCC), intensity (NE-SFL) and size (NE-FSC) increased with surgery. Heterogeneity of neutrophils decreased in terms of fluorescence granularity (NE-WX) and size (NE-WZ) but increased in terms of intensity (NE-WY). The lymphocyte count decreased with surgery. While fluorescence granularity (LY-X) and size increased (LY-Z), Lymphocyte intensity decreased (LY-Y). Lymphocytes were less heterogeneous in terms of their granularity, size and intensity after surgery (LY-WX, LY-WY, LY-WZ). Patients who developed the composite complication criteria had a higher pre-operative neutrophil count (5.08 [3.89;6.95] vs 4.76 [3.60;6.13], p = 0.02; AUC = 0.56 [0.51;0.60]), and more heterogeneous neutrophils in terms of fluorescence granularity (NE-WX, AUC = 0.57 [0.52;0.62]) and intensity (NE-WY, AUC 0.61 [0.56;0.65]). Those patients also had lower pre-operative lymphocyte count (1.49 [1.10;1.14] vs 1.81 [1.39;2.39], p<0.01, AUC = 0.61 [0.57;0.66]) and fluorescence granularity (LY-X, AUC = 0.57 [0.53;0.62]). NE-WX, NE-WY and LY-X were associated with post-operative complications after adjustment on the EuroSCORE 2 (adjusted odd ratio of 1.01 [1.00;1.02]; 1.01 [1.00;1.01] and 1.08 [1.02;1.15] respectively). Conclusion Cardiac surgery with cardiopulmonary bypass was associated with substantial alterations of CPD probably reflecting leukocytes activation in sterile inflammation. Pre-operative NE-WX, NE-WY and LY-X biomarkers levels were associated with post-operative complications, independently of the EuroSCORE 2. Such routine, unexploited and low cost parameters might represent useful tools likely to monitor immune function and predict outcomes for patients undergoing cardiac surgery. Our findings requires validation on a larger external cohort.
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Affiliation(s)
- Maxime Nguyen
- Department of Anaesthesiology and Intensive Care, Dijon University Hospital, Dijon, France,University of Burgundy and Franche-Comté, LNC UMR1231, Dijon, France,INSERM, LNC UMR1231, Dijon, France,LipSTIC LabEx, Dijon, France,*Correspondence: Maxime Nguyen,
| | - Laure Stiel
- INSERM, LNC UMR1231, Dijon, France,LipSTIC LabEx, Dijon, France,Service de Réanimation Médicale, Groupe Hospitalier de la Région Mulhouse Sud Alsace, Mulhouse, France
| | - Adrien Guilloteau
- Clinical Research Support Unit, Dijon University Hospital, Dijon, France
| | - Pierre-Alain Bahr
- Department of Anaesthesiology and Intensive Care, Dijon University Hospital, Dijon, France
| | - David Masson
- University of Burgundy and Franche-Comté, LNC UMR1231, Dijon, France,INSERM, LNC UMR1231, Dijon, France,LipSTIC LabEx, Dijon, France
| | - Charles Thomas
- University of Burgundy and Franche-Comté, LNC UMR1231, Dijon, France,INSERM, LNC UMR1231, Dijon, France,LipSTIC LabEx, Dijon, France
| | - Mathieu Blot
- University of Burgundy and Franche-Comté, LNC UMR1231, Dijon, France,INSERM, LNC UMR1231, Dijon, France,LipSTIC LabEx, Dijon, France,Department of Infectiology, Dijon University Hospital, Dijon, France
| | - Julien Guy
- Cytometry Core Facility, University of Burgundy Franche-Comté, Dijon, France
| | - Cécile Fontaine
- Department of Anaesthesiology and Intensive Care, Dijon University Hospital, Dijon, France
| | - Bastien Durand
- Department of Anaesthesiology and Intensive Care, Dijon University Hospital, Dijon, France
| | - Belaid Bouhemad
- Department of Anaesthesiology and Intensive Care, Dijon University Hospital, Dijon, France,University of Burgundy and Franche-Comté, LNC UMR1231, Dijon, France,INSERM, LNC UMR1231, Dijon, France,LipSTIC LabEx, Dijon, France
| | - Pierre-Grégoire Guinot
- Department of Anaesthesiology and Intensive Care, Dijon University Hospital, Dijon, France,University of Burgundy and Franche-Comté, LNC UMR1231, Dijon, France,INSERM, LNC UMR1231, Dijon, France,LipSTIC LabEx, Dijon, France
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Vaughan J, Wiggill T, Lawrie D, Machaba M, Patel M. The prognostic impact of monocyte fluorescence, immunosuppressive monocytes and peripheral blood immune cell numbers in HIV-associated Diffuse Large B-cell Lymphoma. PLoS One 2023; 18:e0280044. [PMID: 36630466 PMCID: PMC9833596 DOI: 10.1371/journal.pone.0280044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 12/20/2022] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Diffuse large B-cell lymphoma (DLBCL) is a high grade non-Hodgkin lymphoma which is common among immunodeficient people. Derangements of peripheral blood immune cells have been described to have a prognostic impact in DLBCL in high income countries, including a monocytosis, the ratios of lymphocytes to both monocytes (L:M) and neutrophils (N:L), as well as the numbers of regulatory T-cells (Tregs) and immunosuppressive monocytes (HLA-DRlow monos). To date, the impact of these variables has not been assessed in the setting of HIV-associated DLBCL (HIV-DLBCL), which is among the most common malignancies seen in people living with HIV. In this study, we assessed these factors in a cohort of South African patients with DLBCL and a high HIV-seropositivity-rate. In addition, we evaluated the prognostic value of monocyte activation (as reflected by monocyte fluorescence (MO-Y) on a Sysmex haematology analyser). This parameter has to date not been assessed in the setting of DLBCL. METHODS A full blood count and differential count as well as flow cytometry for HLA-DRlow monocyte and Treg enumeration were performed in patients with incident DLBCL referred to the Chris Hani Baragwanath Academic Hospital in Johannesburg, South Africa between November 2019 and May 2022. Additional clinical and laboratory data were recorded from the patient charts and laboratory information system. RESULTS Seventy-six patients were included, of whom 81.3% were people living with HIV with a median CD4 count of 148 cells/ul. Most patients had advanced stage disease (74.8%) and were predominantly treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)-based chemotherapy (without Rituximab). At a median follow-up period of 19 months, the median survival time was 3.5 months, with a 12-month survival rate of 27.0%. All of the immune-cell-related variables (with the exception of the CD4 count) were similar between the people living with HIV and the HIV-negative individuals. In contrast to previous studies, a high monocyte count, the L:M and increased numbers of HLA-DRlow monocytes were not significantly associated with survival in HIV-DLBCL, while a neutrophilia (>8 x 109/L), the N:L (>6:1), high numbers of Tregs (≥5.17% of CD4s) and lymphopenia (<1.3 x 109/L) were. In addition, increased monocyte fluorescence (MO-Y >115.5) was associated with superior outcomes, which we speculate to reflect a more robust antitumour immune response among individuals with high levels of monocyte activation. On Cox Proportional hazard analysis, immune-cell factors independently associated with survival included a CD4 count <150 cells/ul and a neutrophilia. CONCLUSION The monocyte count, L:M and the number of HLA-DRlow monos are not strong prognostic indicators in HIV-DLBCL, while a low CD4 count and neutrophilia are. Elevation of the MO-Y shows some promise as a potential biomarker of antitumour immunity; further study in this regard would be of interest.
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Affiliation(s)
- Jenifer Vaughan
- Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- National Health Laboratory Services, Johannesburg, South Africa
- * E-mail:
| | - Tracey Wiggill
- Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- National Health Laboratory Services, Johannesburg, South Africa
| | - Denise Lawrie
- Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- National Health Laboratory Services, Johannesburg, South Africa
| | - Merriam Machaba
- Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- National Health Laboratory Services, Johannesburg, South Africa
| | - Moosa Patel
- Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Clinical Haematology Unit, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
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Hoffmann JJML, Urrechaga E. Recent advances in laboratory hematology reflected by a decade of CCLM publications. Clin Chem Lab Med 2022; 61:829-840. [PMID: 36285728 DOI: 10.1515/cclm-2022-0962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/15/2022]
Abstract
Abstract
On the occasion of the 60th anniversary of Clinical Chemistry and Laboratory Medicine (CCLM) we present a review of recent developments in the discipline of laboratory hematology as these are reflected by papers published in CCLM in the period 2012–2022. Since data on CCLM publications from 1963 to 2012 are also available, we were able to make a comparison between the two periods. This interestingly revealed that the share of laboratory hematology papers has steadily increased and reached now 16% of all papers published in CCLM. It also became evident that blood coagulation and fibrinolysis, erythrocytes, platelets and instrument and method evaluation constituted the ‘hottest’ topics with regard to number of publications. Some traditional, characteristic CCLM categories like reference intervals, standardization and harmonization, were more stable and probably will remain so in the future. With the advent of important newer topics, like new coagulation assays and drugs and cell population data generated by hematology analyzers, laboratory hematology is anticipated to remain a significant discipline in CCLM publications.
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Affiliation(s)
| | - Eloísa Urrechaga
- Biocruces Bizkaia Health Research Institute , Baracaldo , Spain
- Core Laboratory, Hospital Galdakao Usansolo , Vizcaya , Spain
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Moreno-Torres V, Royuela A, Múñez-Rubio E, Gutierrez-Rojas Á, Mills-Sánchez P, Ortega A, Tejado-Bravo S, García-Sanz J, Muñoz-Serrano A, Calderón-Parra J, Fernández-Cruz A, Ramos-Martínez A. Red blood cell distribution width as prognostic factor in sepsis: A new use for a classical parameter. J Crit Care 2022; 71:154069. [PMID: 35667275 DOI: 10.1016/j.jcrc.2022.154069] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 05/06/2022] [Accepted: 05/14/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE To evaluate Red blood cell distribution width (RDW) as a sepsis prognostic biomarker. METHODS 203 septic patients admitted to the ICU. Analysis of RDW dynamics, hospital mortality discrimination ability and the added value when incorporated to the SOFA, LODS, SAPS-II and APACHE-II scores using the AUC-ROC. RESULTS Non-survivors presented higher RDW values during the first week after ICU admission (p = 0.048). Only SOFA and RDW were independently associated with mortality when adjusted by Charlson, immunosuppression, nosocomial infection, NEWS2, SAPS-II, septic shock and haemoglobin (p < 0.05). After adjustment, AUC-ROC was 0.827, 0.822, 0.824, 0.834 and 0.812 for each model including admission, 24, 48 and 72-h and 7-days RDW, respectively. When added to the scores, 24-h RDW and admission RDW improved their discrimination ability (SOFA AUC-ROC = 0.772 vs 0.812 SOFA + admission RDW, p = 0.041; LODS AUC-ROC = 0.687 vs 0.710, p = 0.002; SAPS-II AUC-ROC = 0.734 vs 0.785, p = 0.021; APACHE-II AUC-ROC = 0.672 vs 0.755, p = 0.003). Admission RDW with SOFA presented the better discrimination ability for mortality. CONCLUSION RDW is an independent prognostic marker of death in septic patients admitted in the ICU that improves SOFA, LODS, APACHE-II and SAPS-II discrimination ability. This parameter could be incorporated to the prognostic scores as a marker of systemic dysfunction and dysregulated inflammatory response.
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Affiliation(s)
- Víctor Moreno-Torres
- Internal Medicine Service, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda. C/Joaquín Rodrigo 2, Majadahonda, Madrid, Spain.
| | - Ana Royuela
- Clinical Biostatistics Unit, Health Research Institute Puerta de Hierro-Segovia de Arana, CIBERESP, Madrid, Spain. C/Joaquín Rodrigo 2, Majadahonda, Madrid, Spain
| | - Elena Múñez-Rubio
- Internal Medicine Service, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda. C/Joaquín Rodrigo 2, Majadahonda, Madrid, Spain
| | - Ángela Gutierrez-Rojas
- Internal Medicine Service, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda. C/Joaquín Rodrigo 2, Majadahonda, Madrid, Spain
| | - Patricia Mills-Sánchez
- Internal Medicine Service, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda. C/Joaquín Rodrigo 2, Majadahonda, Madrid, Spain
| | - Alfonso Ortega
- Intensive Care Unit Department, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda. C/Joaquín Rodrigo 2, Majadahonda, Madrid, Spain
| | - Sandra Tejado-Bravo
- Intensive Care Unit Department, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda. C/Joaquín Rodrigo 2, Majadahonda, Madrid, Spain
| | - Javier García-Sanz
- Intensive Care Unit Department, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda. C/Joaquín Rodrigo 2, Majadahonda, Madrid, Spain
| | - Alejandro Muñoz-Serrano
- Internal Medicine Service, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda. C/Joaquín Rodrigo 2, Majadahonda, Madrid, Spain
| | - Jorge Calderón-Parra
- Internal Medicine Service, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda. C/Joaquín Rodrigo 2, Majadahonda, Madrid, Spain
| | - Ana Fernández-Cruz
- Internal Medicine Service, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda. C/Joaquín Rodrigo 2, Majadahonda, Madrid, Spain
| | - Antonio Ramos-Martínez
- Internal Medicine Service, IDIPHIM (University Hospital Puerta de Hierro Research Institute), Hospital Universitario Puerta de Hierro Majadahonda. C/Joaquín Rodrigo 2, Majadahonda, Madrid, Spain
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Domerecka W, Kowalska-Kępczyńska A, Homa-Mlak I, Michalak A, Mlak R, Mazurek M, Cichoż-Lach H, Małecka-Massalska T. The Usefulness of Extended Inflammation Parameters and Systemic Inflammatory Response Markers in the Diagnostics of Autoimmune Hepatitis. Cells 2022; 11:cells11162554. [PMID: 36010631 PMCID: PMC9406892 DOI: 10.3390/cells11162554] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/02/2022] [Accepted: 08/16/2022] [Indexed: 11/22/2022] Open
Abstract
(1) Introduction: Autoimmune hepatitis (AIH) is a chronic disease. A persistent autoimmune reaction in the liver is significantly related to the systemic inflammatory response. Extended Inflammation Parameters (EIP) can be used to assess the activation of immune cells such as activated neutrophils (NEUT-RI and NEUT-GI) and activated lymphocytes (RE-LYMP and AS-LYMP) in the phase of active inflammation. The role of the systemic inflammatory response markers should also be emphasised, especially: NLR, PLR, and RLR, which have recently been widely studied as markers in autoimmune skin diseases or liver diseases. (2) Materials and Methods: The study included 30 patients with AIH and 30 healthy volunteers. The parameters of the EIP group (RE-LYMP, AS-LYMP, NEUT-RI, NEUT-GI), calculated haematological indices Red Blood Cell Distribution Width-to-Platelet Ratio (RPR), Mean Platelet Volume-to-Platelet Ratio (MPR), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Red Blood Cell Distribution Width-to-Lymphocyte Ratio (RLR), and selected blood morphological and biochemical indices were analysed. The aim of the study was to assess the usefulness of the EIP and systemic inflammatory response markers in the diagnostics of AIH. (3) Results: Compared to the controls, the patients with AIH showed significantly higher EIP values: NEUT-RI (48.05 vs. 43.30), NEUT-GI (152.65 vs. 147.40), RE-LYMP (0.07 vs. 0.03), and the inflammatory response markers: MPR (0.05 vs. 0.04), RPR (0.07 vs. 0.05), and NLR (2.81 vs. 1.42. Among the examined markers, EIP has significant diagnostic potential: NEUT-RI (AUC = 0.86), NEUT-GI (AUC = 0.80), and RE-LYMP (AUC = 0.78), and so do calculated haematological indices, i.e., MPR (AUC = 0.75), PLR (AUC = 1.00), and RLR (AUC = 1.00) Moreover, the importance of NEUT-GI (AUC = 0.89), MPR (AUC = 0.93), PLR (AUC = 0.86), RPR (AUC = 0.91), and FIB-4 (AUC = 0.83) in the detection of liver fibrosis in the course of AIH has also been proven. (4) Conclusions: EIP and systemic inflammatory response markers may turn out to be useful in detecting AIH and in looking for features of already developed liver cirrhosis in its course.
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Affiliation(s)
- Weronika Domerecka
- Chair and Department of Human Physiology, Medical University of Lublin, 11 Radziwillowska Str., 20-080 Lublin, Poland
- Correspondence:
| | - Anna Kowalska-Kępczyńska
- Department of Biochemical Diagnostics, Chair of Laboratory Diagnostics, Medical University of Lublin, 20-081 Lublin, Poland
| | - Iwona Homa-Mlak
- Chair and Department of Human Physiology, Medical University of Lublin, 11 Radziwillowska Str., 20-080 Lublin, Poland
| | - Agata Michalak
- Department of Gastroenterology with Endoscopy Unit, 8 Jaczewskiego Str., 20-090 Lublin, Poland
| | - Radosław Mlak
- Chair and Department of Human Physiology, Medical University of Lublin, 11 Radziwillowska Str., 20-080 Lublin, Poland
| | - Marcin Mazurek
- Chair and Department of Human Physiology, Medical University of Lublin, 11 Radziwillowska Str., 20-080 Lublin, Poland
| | - Halina Cichoż-Lach
- Department of Gastroenterology with Endoscopy Unit, 8 Jaczewskiego Str., 20-090 Lublin, Poland
| | - Teresa Małecka-Massalska
- Chair and Department of Human Physiology, Medical University of Lublin, 11 Radziwillowska Str., 20-080 Lublin, Poland
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Automated Detection of Dysplasia: Data Mining from Our Hematology Analyzers. Diagnostics (Basel) 2022; 12:diagnostics12071556. [PMID: 35885462 PMCID: PMC9315627 DOI: 10.3390/diagnostics12071556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 12/03/2022] Open
Abstract
Myelodysplastic syndromes (MDSs) are clonal hematopoietic diseases of the elderly, characterized by chronic cytopenia, ineffective and dysplastic hematopoiesis, recurrent genetic abnormalities and increased risk of progression to acute myeloid leukemia. Diagnosis on a complete blood count (CBC) can be challenging due to numerous other non-neoplastic causes of cytopenias. New generations of hematology analyzers provide cell population data (CPD) that can be exploited to reliably detect MDSs from a routine CBC. In this review, we first describe the different technologies used to obtain CPD. We then give an overview of the currently available data regarding the performance of CPD for each lineage in the diagnostic workup of MDSs. Adequate exploitation of CPD can yield very strong diagnostic performances allowing for faster diagnosis and reduction of time-consuming slide reviews in the hematology laboratory.
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15
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Truslow JG, Goto S, Homilius M, Mow C, Higgins JM, MacRae CA, Deo RC. Cardiovascular Risk Assessment Using Artificial Intelligence-Enabled Event Adjudication and Hematologic Predictors. Circ Cardiovasc Qual Outcomes 2022; 15:e008007. [PMID: 35477255 PMCID: PMC9208816 DOI: 10.1161/circoutcomes.121.008007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Researchers routinely evaluate novel biomarkers for incorporation into clinical risk models, weighing tradeoffs between cost, availability, and ease of deployment. For risk assessment in population health initiatives, ideal inputs would be those already available for most patients. We hypothesized that common hematologic markers (eg, hematocrit), available in an outpatient complete blood count without differential, would be useful to develop risk models for cardiovascular events. METHODS We developed Cox proportional hazards models for predicting heart attack, ischemic stroke, heart failure hospitalization, revascularization, and all-cause mortality. For predictors, we used 10 hematologic indices (eg, hematocrit) from routine laboratory measurements, collected March 2016 to May 2017 along with demographic data and diagnostic codes. As outcomes, we used neural network-based automated event adjudication of 1 028 294 discharge summaries. We trained models on 23 238 patients from one hospital in Boston and evaluated them on 29 671 patients from a second one. We assessed calibration using Brier score and discrimination using Harrell's concordance index. In addition, to determine the utility of high-dimensional interactions, we compared our proportional hazards models to random survival forest models. RESULTS Event rates in our cohort ranged from 0.0067 to 0.075 per person-year. Models using only hematology indices had concordance index ranging from 0.60 to 0.80 on an external validation set and showed the best discrimination when predicting heart failure (0.80 [95% CI, 0.79-0.82]) and all-cause mortality (0.78 [0.77-0.80]). Compared with models trained only on demographic data and diagnostic codes, models that also used hematology indices had better discrimination and calibration. The concordance index of the resulting models ranged from 0.75 to 0.85 and the improvement in concordance index ranged up to 0.072. Random survival forests had minimal improvement over proportional hazards models. CONCLUSIONS We conclude that low-cost, ubiquitous inputs, if biologically informative, can provide population-level readouts of risk.
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Affiliation(s)
- James G Truslow
- One Brave Idea and Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA (J.G.T., S.G., M.H., C.A.M., R.C.D.)
| | - Shinichi Goto
- One Brave Idea and Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA (J.G.T., S.G., M.H., C.A.M., R.C.D.).,Department of Medicine (S.G., M.H., C.A.M., R.C.D.), Harvard Medical School, Boston, MA
| | - Max Homilius
- Department of Medicine (S.G., M.H., C.A.M., R.C.D.), Harvard Medical School, Boston, MA
| | - Christopher Mow
- Center for Systems Biology, Massachusetts General Hospital (C.M., J.M.H.), Harvard Medical School, Boston, MA.,Partners Healthcare Enterprise Research Information Systems, Boston, MA (C.M.)
| | - John M Higgins
- Center for Systems Biology, Massachusetts General Hospital (C.M., J.M.H.), Harvard Medical School, Boston, MA.,Department of Pathology, Massachusetts General Hospital (J.M.H.), Harvard Medical School, Boston, MA.,Department of Systems Biology (J.M.H.), Harvard Medical School, Boston, MA
| | - Calum A MacRae
- One Brave Idea and Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA (J.G.T., S.G., M.H., C.A.M., R.C.D.).,Department of Medicine (S.G., M.H., C.A.M., R.C.D.), Harvard Medical School, Boston, MA
| | - Rahul C Deo
- One Brave Idea and Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA (J.G.T., S.G., M.H., C.A.M., R.C.D.).,Department of Medicine (S.G., M.H., C.A.M., R.C.D.), Harvard Medical School, Boston, MA
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16
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Drumheller B, Gebre K, Lockhart B, Margolskee E, Obstfeld A, Paessler M, Pillai V. Haematology laboratory parameters to assess efficacy of CD19-, CD22-, CD33-, and CD123-directed chimeric antigen receptor T-cell therapy in haematological malignancies. Int J Lab Hematol 2022; 44:750-758. [PMID: 35419923 DOI: 10.1111/ijlh.13850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/01/2022] [Accepted: 03/27/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Chimeric antigen receptor (CAR) T cell products are available to treat relapsed/refractory B-lymphoblastic leukaemia/lymphoma (B-ALL), diffuse large B-cell lymphoma, mantle-cell lymphoma, and myeloma. CAR products vary by their target epitope and constituent molecules. Hence, there are no common laboratory assays to assess CAR T cell expansion in the clinical setting. We investigated the utility of common haematology laboratory parameters to measure CAR T cell expansion and response. METHODS Archived CellaVision images, absolute lymphocyte counts, and Sysmex CPD parameters spanning 1 month after CD19-CAR, UCAR19, CD22-CAR, CD33-CAR, and UCAR123 therapy were compared against donor lymphocyte infused control patients. Additionally, CellaVision images gathered during acute EBV infection were analysed. RESULTS CellaVision images revealed a distinct sequence of three lymphocyte morphologies, common among CD19-CAR, CD22-CAR and UCAR19. This lymphocyte sequence was notably absent in CAR T cell non-responders and stem-cell transplantation controls, but shared some features seen during acute EBV infection. CD19-CAR engraftment kinetics monitored by quantitative PCR show an expansion and persistence phase and mirror CD19-CAR ALC kinetics. We show other novel CAR T cell therapies (UCAR19, CD22-CAR, CD33-CAR and UCAR123) display similar ALC expansion in responders and diminished ALC expansion in non-responders. Furthermore, the CPD parameter LY_WY fluorescence increased within the first week after CD19-CAR infusion, preceding the peak absolute lymphocyte count (ALC) by 3.7 days. CONCLUSION Autologous and allogeneic CAR T cell therapy produce unique changes in common haematology laboratory parameters and could be a useful surrogate to follow CAR T-cell expansion after infusion.
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Affiliation(s)
- Bradley Drumheller
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kirubel Gebre
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Brian Lockhart
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Elizabeth Margolskee
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Amrom Obstfeld
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Michele Paessler
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Vinodh Pillai
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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17
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Li S, Yu C, Jie H, Han X, Zou S, Tan Q, Luo S, Chen Y, Wang J. Neutrophil side fluorescence: a new indicator for predicting the severity of patients with bronchiectasis. BMC Pulm Med 2022; 22:107. [PMID: 35346147 PMCID: PMC8962496 DOI: 10.1186/s12890-022-01893-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 03/09/2022] [Indexed: 12/01/2022] Open
Abstract
Background Neutrophilic inflammation in the airway is a hallmark of bronchiectasis. Neutrophil extracellular traps (NETs) have been reported to play an important role in the occurrence and development of bronchiectasis. Neutrophil side fluorescence is one of the characteristics of neutrophils that can reflect the activation of neutrophils and the formation of NETs. Objective To explore the relationship between the values of neutrophil side fluorescence (NEUT-SFL) in the peripheral blood of bronchiectasis patients, and the severity of the disease. Methods 82 patients with bronchiectasis from the Department of Respiratory and Critical Medicine, at the Third Affiliated Hospital of Southern Medical University and were scored with Bronchiectasis Severity Index (BSI) (2019–2021). The clinical data such as the value of NEUT-SFL, neutrophil count, C-reactive protein, and procalcitonin levels were collected and retrospectively analyzed. NEUT-SFL values neutrophil count from 28 healthy subjects were also used to ascertain cut-off values. Results Based on the BSI scores, patients were divided into three categories as mild (32%), moderate (29%), and severe (39%). Our results showed that the values of NEUT-SFL were higher in bronchiectasis patients compared to healthy controls. The levels of NEUT-SFL positively correlated with the high BSI scores in patients (P = 0.037, r = 0.23) and negatively correlated with the lung function in these patients (r = − 0.35, P = 0.001). The area under the ROC curve was 0.813, the best cut-off was 42.145, indicating that NEUT-SFL values > 42.145 can potentially predict the severity of bronchiectasis. Conclusions The values of NEUT-SFL in the peripheral blood can be used for predicting the severity of bronchiectasis.
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Affiliation(s)
- Shiqi Li
- Department of Respiration, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Chunxiao Yu
- Department of Gastroenterology, The Seventh Affiliated Hospital, Southern Medical University, Foshan, China
| | - Hongyu Jie
- Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China.,Department of Rheumatology and Immunology, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Xinai Han
- Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China.,Department of Rheumatology and Immunology, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Shujing Zou
- Department of Respiration, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Quanguang Tan
- Department of Respiration, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Shugeng Luo
- Department of Internal Medicine, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Youming Chen
- Department of Clinical Laboratory, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China.
| | - Jinhong Wang
- Department of Respiration, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China. .,Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China.
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18
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Lemkus L, Lawrie D, Vaughan J. The utility of extended differential parameters as a biomarker of bacteremia at a tertiary academic hospital in persons with and without HIV infection in South Africa. PLoS One 2022; 17:e0262938. [PMID: 35176042 PMCID: PMC8853519 DOI: 10.1371/journal.pone.0262938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/07/2022] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Extended differential parameters (EDPs) are generated with the automated differential count by Sysmex XN-series automated hematology analysers, and include the immature granulocyte count (IG%), the neutrophil fluorescent light intensity (NE-SFL) and the neutrophil fluorescent light distribution width (NE-WY). These have been proposed as early biomarkers of bacteremia. This study aimed to evaluate the NE-SFL, NE-WY and IG% in comparison to neutrophil CD64 (nCD64) expression (as a high quality sepsis biomarker) among patients with suspected bacterial sepsis at the Chris Hani Baragwanath Academic Hospital in Johannesburg, South Africa. METHODS A daily search of the laboratory information system identified samples submitted for a blood culture (BC) and a concurrent full blood count (FBC). Automated differential counts using a Sysmex XN-9000 haematology analyser and neutrophil CD64 expression by flow cytometry were assessed on the residual FBC samples. RESULTS A total of 151 samples were collected, of which 83 were excluded due to equivocal results with regards to the presence of bacterial infection. The remaining 68 samples included 23 with bacteremia, 28 with evidence of non-bacteremic bacterial infection, 13 with no evidence of bacterial infection and 4 with Tuberculosis. HIV status was documented in 90 of the patients, with a seropositivity rate of 57.8%. The EDPs were all significantly higher among patients with bacteremia as compared to those without bacterial infection, but on ROC curve analyses, only the NE-SFL showed good performance (AUC>0.8) for discriminating cases with bacteremia from those without bacterial infection at a cut-off value of 49.75. In comparison to the nCD64, the NE-SFL showed moderate agreement (kappa = 0.5). On stratification of the ROC analysis by HIV status, the NE-SFL showed superior performance among persons with HIV infection (AUC = 1), while the automated IG% showed better performance among the patients without HIV infection (AUC = 0.9). CONCLUSION In this study, EDPs showed differential performance as biomarkers for bacteremia according to HIV-status in the South African setting, with the most promising results seen with the NE-SFL and IG% parameters among people with and without HIV infection, respectively. Further assessment of these parameters without pre-selection of patients likely to have infection is required to further determine their clinical utility, particularly among patients with underlying inflammatory conditions or malignancy.
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Affiliation(s)
- Lauren Lemkus
- Department of Molecular Medicine and Haematology, University of the Witwatersrand, Johannesburg, South Africa
- National Health Laboratory Services, Johannesburg, South Africa
| | - Denise Lawrie
- Department of Molecular Medicine and Haematology, University of the Witwatersrand, Johannesburg, South Africa
- National Health Laboratory Services, Johannesburg, South Africa
| | - Jenifer Vaughan
- Department of Molecular Medicine and Haematology, University of the Witwatersrand, Johannesburg, South Africa
- National Health Laboratory Services, Johannesburg, South Africa
- * E-mail:
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19
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Haider RZ, Ujjan IU, Khan NA, Urrechaga E, Shamsi TS. Beyond the In-Practice CBC: The Research CBC Parameters-Driven Machine Learning Predictive Modeling for Early Differentiation among Leukemias. Diagnostics (Basel) 2022; 12:diagnostics12010138. [PMID: 35054304 PMCID: PMC8774626 DOI: 10.3390/diagnostics12010138] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 11/20/2022] Open
Abstract
A targeted and timely treatment can be a beneficial tool for patients with hematological emergencies (particularly acute leukemias). The key challenges in the early diagnosis of leukemias and related hematological disorders are their symptom-sharing nature and prolonged turnaround time as well as the expertise needed in reporting confirmatory tests. The present study made use of the potential morphological and immature fraction-related parameters (research items or cell population data) generated during complete blood cell count (CBC), through artificial intelligence (AI)/machine learning (ML) predictive modeling for early (at the pre-microscopic level) differentiation of various types of leukemias: acute from chronic as well as myeloid from lymphoid. The routine CBC parameters along with research CBC items from a hematology analyzer in the diagnosis of 1577 study subjects with hematological neoplasms were collected. The statistical and data visualization tools, including heat-map and principal component analysis (PCA,) helped in the evaluation of the predictive capacity of research CBC items. Next, research CBC parameter-driven artificial neural network (ANN) predictive modeling was developed to use the hidden trend (disease’s signature) by increasing the auguring accuracy of these potential morphometric parameters in differentiation of leukemias. The classical statistics for routine and research CBC parameters showed that as a whole, all study items are significantly deviated among various types of leukemias (study groups). The CPD parameter-driven heat-map gave clustering (separation) of myeloid from lymphoid leukemias, followed by the segregation (nodding) of the acute from the chronic class of that particular lineage. Furthermore, acute promyelocytic leukemia (APML) was also well individuated from other types of acute myeloid leukemia (AML). The PCA plot guided by research CBC items at notable variance vindicated the aforementioned findings of the CPD-driven heat-map. Through training of ANN predictive modeling, the CPD parameters successfully differentiate the chronic myeloid leukemia (CML), AML, APML, acute lymphoid leukemia (ALL), chronic lymphoid leukemia (CLL), and other related hematological neoplasms with AUC values of 0.937, 0.905, 0.805, 0.829, 0.870, and 0.789, respectively, at an agreeably significant (10.6%) false prediction rate. Overall practical results of using our ANN model were found quite satisfactory with values of 83.1% and 89.4.7% for training and testing datasets, respectively. We proposed that research CBC parameters could potentially be used for early differentiation of leukemias in the hematology–oncology unit. The CPD-driven ANN modeling is a novel practice that substantially strengthens the predictive potential of CPD items, allowing the clinicians to be confident about the typical trend of the “disease fingerprint” shown by these automated potential morphometric items.
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Affiliation(s)
- Rana Zeeshan Haider
- Baqai Institute of Hematology, Baqai Medical University, Karachi 75340, Pakistan
- National Institute of Blood Disease (NIBD), Karachi 75300, Pakistan
- Correspondence: ; Tel.: +92-343-507-1271
| | - Ikram Uddin Ujjan
- Department of Pathology, Liaquat University of Medical and Health Sciences, Jamshoro 76090, Pakistan;
| | - Najeed Ahmed Khan
- Department of Computer Science, NED University of Engineering and Technology, Karachi 75270, Pakistan;
| | - Eloisa Urrechaga
- Core Laboratory, Galdakao-Usansolo Hospital, 48960 Galdakao, Spain;
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20
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Jeon K, Lee N, Jeong S, Park MJ, Song W. Immature granulocyte percentage for prediction of sepsis in severe burn patients: a machine leaning-based approach. BMC Infect Dis 2021; 21:1258. [PMID: 34915849 PMCID: PMC8680375 DOI: 10.1186/s12879-021-06971-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Of the existing sepsis markers, immature granulocytes (IG) most frequently reflect the presence of an infection. The importance of IG as an early predictor of sepsis and bacteremia is evaluated differently for each study. This study aimed to evaluate the effectiveness of the Sysmex XN series' IG% as an independent prognostic indicator of sepsis using machine learning. METHODS A total of 2465 IG% results from 117 severe burn patients in the intensive care unit of one institution were retrospectively analyzed. We evaluated the IG% for sepsis using the receiver operating characteristic, logistic regression, and partial dependence plot analyses. Clinical characteristics and other laboratory markers associated with sepsis, including WBC, procalcitonin, and C-reactive protein, were compared with the IG% values. RESULTS Twenty-six of the 117 patients were diagnosed with sepsis. The median IG% value was 2.6% (95% CI: 1.4-3.1). The area under the receiver operating characteristic curve was 0.77 (95% CI: 0.78-0.84) and the optimal cut-off value was 3%, with a sensitivity of 76.9% and specificity of 68.1%. The partial dependence plot of IG% on predicting sepsis showed that an IG% < 4% had low predictability, but increased thereafter. The interaction plot of IG% and C-reactive protein showed an increase in sepsis probability at an IG% of 6% and C-reactive protein of 160 mg/L. CONCLUSIONS IG% is moderately useful for predicting sepsis. However, since it can be determined from routine laboratory test results and requires no additional intervention or cost, it could be particularly useful as an auxiliary marker.
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Affiliation(s)
- Kibum Jeon
- Department of Laboratory Medicine, Hallym University Hangang Sacred Heart Hospital, 12 Beodeunaru-ro 7-gil, Yeongdeungpo-gu, Seoul, 150719, South Korea
| | - Nuri Lee
- Department of Laboratory Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 22, Singil-ro 1, Yeongdeungpo-gu, Seoul, 07440, South Korea.
| | - Seri Jeong
- Department of Laboratory Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 22, Singil-ro 1, Yeongdeungpo-gu, Seoul, 07440, South Korea
| | - Min-Jeong Park
- Department of Laboratory Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 22, Singil-ro 1, Yeongdeungpo-gu, Seoul, 07440, South Korea
| | - Wonkeun Song
- Department of Laboratory Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 22, Singil-ro 1, Yeongdeungpo-gu, Seoul, 07440, South Korea
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21
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NEUT-SFL in Patients with COVID-ARDS: A Novel Biomarker for Thrombotic Events? DISEASE MARKERS 2021; 2021:4361844. [PMID: 34840629 PMCID: PMC8612800 DOI: 10.1155/2021/4361844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/24/2021] [Accepted: 10/23/2021] [Indexed: 11/25/2022]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an enveloped RNA virus first identified in December 2019 in Wuhan, China, and responsible for coronavirus disease 2019 (COVID-19). The ongoing COVID-19 pandemic is impacting healthcare worldwide. Patients who develop coagulopathy have worse outcomes. The pathophysiology of COVID-19 suggests a strong interplay between hemostasis and immune cells, especially neutrophils. Our purpose was to assess neutrophil fluorescence as a potential biomarker of deep vein thrombosis (DVT) in patients with COVID-acute respiratory distress syndrome (COVID-ARDS). Sixty-one patients with COVID-ARDS admitted to the four intensive care units (ICUs) of a French general hospital were included in this prospective study. Neutrophil activation was assessed by measuring neutrophil fluorescence (NEUT-Side Fluorescence Light, NEUT-SFL) with a specific fluorescent dye staining analyzed by a routine automated flow cytometer Sysmex XN-3000™ (Sysmex, Kobe, Japan). DVT was diagnosed by complete duplex ultrasound (CDU). We found that NEUT-SFL was elevated on admission in patients with COVID-ARDS (49.76 AU, reference value 46.40 AU, p < 0.001), but did not differ between patients with DVT (49.99 AU) and those without (49.52 AU, p = 0.555). NEUT-SFL is elevated in patients with COVID-ARDS, reflecting neutrophil activation, but cannot be used as a marker of thrombosis. Because neutrophils are at interface between immune response and hemostasis through release of neutrophil extracellular traps, monitoring their activation could be an interesting approach to improve our management of coagulopathy during COVID-ARDS. Further research is needed to better understand the pathophysiology of COVID-19 and identify high-performance biomarkers.
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22
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The Value of a Complete Blood Count (CBC) for Sepsis Diagnosis and Prognosis. Diagnostics (Basel) 2021; 11:diagnostics11101881. [PMID: 34679578 PMCID: PMC8534992 DOI: 10.3390/diagnostics11101881] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/08/2021] [Accepted: 10/10/2021] [Indexed: 12/28/2022] Open
Abstract
Sepsis represents an important global health burden due to its high mortality and morbidity. The rapid detection of sepsis is crucial in order to prevent adverse outcomes and reduce mortality. However, the diagnosis of sepsis is still challenging and many efforts have been made to identify reliable biomarkers. Unfortunately, many investigated biomarkers have several limitations that do not support their introduction in clinical practice, such as moderate diagnostic and prognostic accuracy, long turn-around time, and high-costs. Complete blood count represents instead a precious test that provides a wealth of information on individual health status. It can guide clinicians to early-identify patients at high risk of developing sepsis and to predict adverse outcomes. It has several advantages, being cheap, easy-to-perform, and available in all wards, from the emergency department to the intensive care unit. Noteworthy, it represents a first-level test and an alteration of its parameters must always be considered within the clinical context, and the eventual suspect of sepsis must be confirmed by more specific investigations. In this review, we describe the usefulness of basic and new complete blood count parameters as diagnostic and prognostic biomarkers of sepsis.
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23
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Małecka-Giełdowska M, Fołta M, Wiśniewska A, Czyżewska E, Ciepiela O. Cell Population Data and Serum Polyclonal Immunoglobulin Free Light Chains in the Assessment of COVID-19 Severity. Viruses 2021; 13:v13071381. [PMID: 34372587 PMCID: PMC8310347 DOI: 10.3390/v13071381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/03/2021] [Accepted: 07/07/2021] [Indexed: 12/26/2022] Open
Abstract
Distinguishing between severe and nonsevere COVID-19 to ensure adequate healthcare quality and efficiency is a challenge for the healthcare system. The aim of this study was to assess the usefulness of CBC parameters together with analysis of FLC serum concentration in risk stratification of COVID-19. Materials and methods: CBC was analyzed in 735 COVID ICU, COVID non-ICU, and non-COVID ICU cases. FLC concentration was analyzed in 133 of them. Results: COVID ICU had neutrophils and lymphocytes with the greatest size, granularity, and nucleic acid content. Significant differences in concentrations of κ and λ FLCs were shown between COVID ICU and COVID non-ICU. However, no difference was found in the κ/λ ratio between these groups, and the ratio stayed within the reference value, which indicates the presence of polyclonal FLCs. FLC κ measurement has significant power to distinguish between severe COVID-19 and nonsevere COVID-19 (AUC = 0.7669), with a sensitivity of 86.67% and specificity of 93.33%. The κ coefficients’ odds ratio of 3.0401 was estimated. Conclusion: It can be concluded that the results obtained from the measure of free light immunoglobulin concentration in serum are useful in distinguishing between severe and nonsevere COVID-19.
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Affiliation(s)
- Milena Małecka-Giełdowska
- Department of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland; (A.W.); (E.C.); (O.C.)
- Central Laboratory of Central Teaching Hospital, University Clinical Center of Medical University of Warsaw, 02-097 Warsaw, Poland
- Correspondence: ; Tel.: +48-22-599-2105
| | - Maria Fołta
- Students Scientific Group of Laboratory Medicine, Department of Laboratory Medicine, Faculty of Pharmacy, Medical University of Warsaw, 02-097 Warsaw, Poland;
| | - Agnieszka Wiśniewska
- Department of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland; (A.W.); (E.C.); (O.C.)
- Central Laboratory of Central Teaching Hospital, University Clinical Center of Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Emilia Czyżewska
- Department of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland; (A.W.); (E.C.); (O.C.)
- Central Laboratory of Central Teaching Hospital, University Clinical Center of Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Olga Ciepiela
- Department of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland; (A.W.); (E.C.); (O.C.)
- Central Laboratory of Central Teaching Hospital, University Clinical Center of Medical University of Warsaw, 02-097 Warsaw, Poland
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24
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Extended Inflammation Parameters (EIP) as Markers of Immune System Cell Activation in Psoriasis. Int J Inflam 2021; 2021:9216528. [PMID: 34234939 PMCID: PMC8219407 DOI: 10.1155/2021/9216528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/05/2021] [Indexed: 02/08/2023] Open
Abstract
Psoriasis is an inflammatory, autoimmune disease that affects approximately 2% of the population. The inflammation in psoriasis can be systemic, so despite a predominantly cutaneous manifestation, it also affects the internal organs. The diagnosis and monitoring of the disease are based on the clinical picture. To assess the disorders of other organs, additional tests need to be performed. Recently, the examination of blood morphology has been enriched with modern haematological parameters, i.e., Extended Inflammation Parameters (EIP), which include RE-LYMPH (activated lymphocytes), AS-LYMPH (antibody-producing B lymphocytes), and NEUT-RI and NEUT-GI (activated neutrophils). In the study, higher values of new haematological parameters were observed in individuals with psoriasis than in healthy controls. A higher EIP value was noted in the group of individuals with plaque psoriasis than in the group of individuals with psoriatic arthritis. Implementation of these parameters into routine laboratory analysis will likely make it possible to estimate the severity of the inflammation and improve its assessment.
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Kubyshkin VA, Samokhodskaya LM, Korolev YM. THE ROLE OF MARKERS OF SYSTEMIC INFLAMMATORY RESPONSE IN THE POSTOPERATIVE PERIOD. REVIEW. SURGICAL PRACTICE 2021. [DOI: 10.38181/2223-2427-2021-1-30-38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Despite all the achievements of modern surgery, the number of postoperative infectious complications in the world remains high. Their occurrence leads to a longer period of patients’ hospitalization, requires the use of additional medical and diagnostic measures, which ultimately leads to higher treatment costs and significant financial losses in the health care system. Therefore, it is important to identify postoperative complications at an early stage, even before the development of pronounced clinical symptoms, and to predict their possible development in a certain category of patients. For these purposes, scientists try to use various laboratory markers. In this paper, we analyzed both well-known indicators of the inflammatory response, such as: C-reactive protein, albumin, their ratio, procalcitonin and interleukin-6, and relatively new parameters that research teams are trying to apply for these purposes: neutrophil granularity intensity and neutrophil reactivity intensity, pancreatic stone protein and pancreatitis-associated protein. We tried to collect the most complete information available at the moment, evaluate the opinions of researchers, identify contradictions in their works and try to explain their cause. As a result, it turned out that even the markers of inflammation known for many years are not absolutely specific for postoperative infectious complications. We concluded that most of the laboratory parameters described in this article can be used to some extent in the early diagnosis of postoperative infectious complications, but if we want to obtain more complete information in this area of knowledge, it is necessary to conduct new largescale studies.
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Affiliation(s)
- V. A. Kubyshkin
- Federal State Budget Educational Institution of Higher Education M.V. Lomonosov Moscow State University, Faculty of Medicine (Lomonosov MSU)
| | - L. M. Samokhodskaya
- Federal State Budget Educational Institution of Higher Education M.V. Lomonosov Moscow State University, Faculty of Medicine (Lomonosov MSU); Medical Scientific Educational Centre, Lomonosov Moscow State University
| | - Yu. M. Korolev
- Federal State Budget Educational Institution of Higher Education M.V. Lomonosov Moscow State University, Faculty of Medicine (Lomonosov MSU)
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Biban P, Teggi M, Gaffuri M, Santuz P, Onorato D, Carpenè G, Gregori D, Lippi G. Cell Population Data (CPD) for Early Recognition of Sepsis and Septic Shock in Children: A Pilot Study. Front Pediatr 2021; 9:642377. [PMID: 33777867 PMCID: PMC7989813 DOI: 10.3389/fped.2021.642377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/11/2021] [Indexed: 01/30/2023] Open
Abstract
Objectives: Innovative Cell Population Data (CPD) have been used as early biomarkers for diagnosing sepsis in adults. We assessed the usefulness of CPD in pediatric patients with sepsis/septic shock, in terms of early recognition and outcome prediction. We revised 54 patients (0-15 y) admitted to our Pediatric Intensive Care Unit (PICU) for sepsis/septic shock during a 4-year period. Twenty-eight patients were excluded, 26 septic patients were enrolled (G1). Forty children admitted for elective surgery served as controls (G2). Data on five selected CPD parameters, namely neutrophils fluorescence intensity (NE-SFL), monocytes cells complexity (MO-X), monocytes fluorescence intensity (MO-Y), monocytes complexity and width of dispersion of events measured (MO-WX), and monocytes cells size and width dispersion (MO-WZ), were obtained at time of PICU admission (t0) by a hematological analyzer (Sysmex XN 9000®). As the primary outcome we evaluated the relevance of CPD for diagnosing sepsis/septic shock on PICU admission. Furthermore, we investigated if CPD at t0 were correlated with C-reactive protein (CRP), patient survival, or complicated sepsis course. Results: On PICU admission (t0), NE-SFL, MO-WX, and MO-Y were higher in sepsis/septic shock patients compared to controls. NE-SFL values were correlated with CRP values in G1 patients (r = 0.83). None of the five CPD parameters was correlated with survival or complicated sepsis course. Conclusion: We found higher values of NE-SFL, MO-WX, and MO-Y in children with sepsis/septic shock upon PICU admission. These parameters may be a promising adjunct for early sepsis diagnosis in pediatric populations. Larger, prospective studies are needed to confirm our preliminary observations.
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Affiliation(s)
- Paolo Biban
- Pediatric Intensive Care Unit, Division of Pediatric Critical and Emergency Care, Verona University Hospital, Verona, Italy
| | - Martina Teggi
- Pediatric Intensive Care Unit, Division of Pediatric Critical and Emergency Care, Verona University Hospital, Verona, Italy
| | - Marcella Gaffuri
- Pediatric Intensive Care Unit, Division of Pediatric Critical and Emergency Care, Verona University Hospital, Verona, Italy
| | - Pierantonio Santuz
- Pediatric Intensive Care Unit, Division of Pediatric Critical and Emergency Care, Verona University Hospital, Verona, Italy
| | - Diletta Onorato
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Giovanni Carpenè
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University Hospital of Padua, Padova, Italy
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
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Linssen J, Ermens A, Berrevoets M, Seghezzi M, Previtali G, van der Sar-van der Brugge S, Russcher H, Verbon A, Gillis J, Riedl J, de Jongh E, Saker J, Münster M, Munnix IC, Dofferhof A, Scharnhorst V, Ammerlaan H, Deiteren K, Bakker SJ, Van Pelt LJ, Kluiters-de Hingh Y, Leers MP, van der Ven AJ. A novel haemocytometric COVID-19 prognostic score developed and validated in an observational multicentre European hospital-based study. eLife 2020; 9:63195. [PMID: 33241996 PMCID: PMC7732342 DOI: 10.7554/elife.63195] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 11/25/2020] [Indexed: 01/08/2023] Open
Abstract
COVID-19 induces haemocytometric changes. Complete blood count changes, including new cell activation parameters, from 982 confirmed COVID-19 adult patients from 11 European hospitals were retrospectively analysed for distinctive patterns based on age, gender, clinical severity, symptom duration, and hospital days. The observed haemocytometric patterns formed the basis to develop a multi-haemocytometric-parameter prognostic score to predict, during the first three days after presentation, which patients will recover without ventilation or deteriorate within a two-week timeframe, needing intensive care or with fatal outcome. The prognostic score, with ROC curve AUC at baseline of 0.753 (95% CI 0.723-0.781) increasing to 0.875 (95% CI 0.806-0.926) on day 3, was superior to any individual parameter at distinguishing between clinical severity. Findings were confirmed in a validation cohort. Aim is that the score and haemocytometry results are simultaneously provided by analyser software, enabling wide applicability of the score as haemocytometry is commonly requested in COVID-19 patients.
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Affiliation(s)
| | | | | | | | | | | | - Henk Russcher
- Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Annelies Verbon
- Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Judith Gillis
- Leiden University Medical Center, Leiden, Netherlands
| | - Jürgen Riedl
- Albert Schweitzer Hospital, Dordrecht, Netherlands
| | - Eva de Jongh
- Albert Schweitzer Hospital, Dordrecht, Netherlands
| | | | | | | | | | | | | | | | - Stephan Jl Bakker
- University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Lucas Joost Van Pelt
- University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Blomme S, Boeckx N, Brusselmans C, Claerhout H, Van Laer C. The integration of Sysmex XN-9100' WPC channel reflex testing in the detection of reactive versus malignant blood samples. Int J Lab Hematol 2020; 43:191-198. [PMID: 33001578 DOI: 10.1111/ijlh.13352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/30/2020] [Accepted: 09/08/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Sysmex XN-9100™ (Sysmex, Kobe, Japan) system has an optional White Progenitor Cell (WPC) channel. While the White Differentiation (WDF) channel reports a combined flag for blasts/abnormal lymphocytes, WPC channel specifies flagging into a separate flag for each cell type or removes the flag entirely. Aim of this study was to evaluate the added value of this WPC channel in the detection of malignant samples. METHODS Routine blood samples analyzed on Sysmex XE-5000 with flagging for either blasts, abnormal lymphocytes, or atypical lymphocytes (n = 630) were selected for testing on Sysmex XN-9100, resulting in a reflex WPC analysis in 420 samples. All samples were microscopically evaluated with DI-60 digital cell imaging analyzer. RESULTS WPC reflex testing resulted in a suspect flag ("blasts" and/or "abnormal lymphocytes") in 334 samples, which was confirmed microscopically in 38% (128/334). In all true positive samples, WPC correctly classified the initial WDF flag in either "blasts" flag or "abnormal lymphocytes?" flag in 75%. Only 12% (50/420) of WDF "blasts/abnormal lymphocytes" positive samples became negative after WPC reflex testing. Subgroup analysis showed differences between the "pediatric" versus "adult" groups and the "hematological/chemotherapy" versus "nonhematological/nonchemotherapy" groups in specificity and smear reduction. CONCLUSION Overall, WPC reflex testing showed good sensitivity (99%); however, the specificity remains poor (29%). Using reflex WPC to the WDF channel resulted in a 12% reduction of the smear review rate. Although the WPC channel offers different interesting advantages, additional topics and a specific workflow should be applied to optimize the use of this channel.
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Affiliation(s)
- Siska Blomme
- Clinical Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Nancy Boeckx
- Clinical Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.,Departement of Oncology, KU Leuven, Leuven, Belgium
| | - Caroline Brusselmans
- Clinical Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Helena Claerhout
- Clinical Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Christine Van Laer
- Clinical Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.,Departement of Cardiovascular Sciences, Center for Molecular and Vascular Biology, KU Leuven, Leuven, Belgium
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29
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Rolla R, Vidali M, Puricelli C, Scotta AM, Pedrinelli A, Pergolini P, Pirisi M, Dianzani U, Rigamonti C. Reduced activity of B lymphocytes, recognised by Sysmex XN-2000™ haematology analyser, predicts mortality in patients with coronavirus disease 2019. Int J Lab Hematol 2020; 43:e5-e8. [PMID: 32893487 DOI: 10.1111/ijlh.13331] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/28/2020] [Accepted: 08/07/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Roberta Rolla
- Clinical Chemistry Laboratory, Department of Health Sciences, University of Eastern Piedmont Amedeo Avogadro, Novara, Italy
| | - Matteo Vidali
- Clinical Chemistry Laboratory, Department of Health Sciences, University of Eastern Piedmont Amedeo Avogadro, Novara, Italy
| | - Chiara Puricelli
- Clinical Chemistry Laboratory, Department of Health Sciences, University of Eastern Piedmont Amedeo Avogadro, Novara, Italy
| | - Anna Maria Scotta
- Clinical Chemistry Laboratory, Department of Health Sciences, University of Eastern Piedmont Amedeo Avogadro, Novara, Italy
| | - Anita Pedrinelli
- Division of Internal Medicine, Department of Translational Medicine, University of Eastern Piedmont Amedeo Avogadro, Novara, Italy
| | - Patrizia Pergolini
- Clinical Chemistry Laboratory, Department of Health Sciences, University of Eastern Piedmont Amedeo Avogadro, Novara, Italy
| | - Mario Pirisi
- Division of Internal Medicine, Department of Translational Medicine, University of Eastern Piedmont Amedeo Avogadro, Novara, Italy
| | - Umberto Dianzani
- Clinical Chemistry Laboratory, Department of Health Sciences, University of Eastern Piedmont Amedeo Avogadro, Novara, Italy
| | - Cristina Rigamonti
- Division of Internal Medicine, Department of Translational Medicine, University of Eastern Piedmont Amedeo Avogadro, Novara, Italy
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Shekhar R, Pai S, Srinivasan VK, Srinivas V, Adhikary R, Bhavana MV. Alterations in leucocyte cell population data in bacteraemia: A study from a tertiary care hospital in India. Int J Lab Hematol 2020; 43:e1-e4. [PMID: 32845052 DOI: 10.1111/ijlh.13327] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 07/22/2020] [Accepted: 08/05/2020] [Indexed: 01/21/2023]
Affiliation(s)
- Roshini Shekhar
- Hematopathology Division, Department of Laboratory Medicine, Manipal Hospital, Bengaluru, India
| | - Swati Pai
- Hematopathology Division, Department of Laboratory Medicine, Manipal Hospital, Bengaluru, India
| | - Vishrut K Srinivasan
- Hematopathology Division, Department of Laboratory Medicine, Manipal Hospital, Bengaluru, India
| | - Venkatappa Srinivas
- Hematopathology Division, Department of Laboratory Medicine, Manipal Hospital, Bengaluru, India
| | - Ranjeeta Adhikary
- Microbiology Division, Department of Laboratory Medicine, Manipal Hospital, Bengaluru, India
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31
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Urrechaga E. Reviewing the value of leukocytes cell population data (CPD) in the management of sepsis. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:953. [PMID: 32953753 PMCID: PMC7475430 DOI: 10.21037/atm-19-3173] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Sepsis is a medical emergency that describes the body's systemic immune response to an infection and can lead to end-stage organic dysfunction and death. Despite the advances in understanding the pathophysiology of this syndrome and therapies, sepsis remains one of the leading causes of morbidity and mortality in critically ill patients. Early diagnosis and rapid intervention are essential to improve outcomes, which inspired the concept "golden hour," during which the correction of shock and organic dysfunction can improve the patients' outcomes. But the initial presentation of sepsis is often nonspecific and its severity is difficult to assess. Anomalies in temperature, heart and respiratory rates and leukocyte counts are manifestations of systemic inflammatory response syndrome (SIRS). Diagnosis, management and follow-up of patients with sepsis remains a challenge, and diverse biomarkers have been proposed for the timely diagnosis and prognosis of septic patients: lactic acid, procalcitonin (PCT), C-reactive protein, immature granulocytes. The host's initial response to infection is a humoral, cellular and neuroendocrine reaction to infection, and leukocytes interact with endothelial cells. The new generation of hematological analyzers incorporates technological innovations allowing to expand the information derived from the complete blood count: new leukocyte derived parameters are emerging as potentially useful markers in different clinical situations. Additional research parameters cell population data (CPD), characterizing different leukocyte populations have become available, and preliminary observations suggest their utility in the diagnosis of sepsis. This review emphasizes the value of CPD, reported by modern cellular counters for early recognition of sepsis, and therefore the potential improvement in patient outcomes.
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Affiliation(s)
- Eloísa Urrechaga
- Biocruces Bizkaia Health Research Institute, Cruces Plaza, Bizkaia, Spain
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Arora P, Gupta PK, Lingaiah R, Mukhopadhyay AK. Volume, conductivity, and scatter parameters of leukocytes as early markers of sepsis and treatment response. J Lab Physicians 2020; 11:29-33. [PMID: 30983799 PMCID: PMC6437820 DOI: 10.4103/jlp.jlp_102_18] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION: Morphologic changes in the size and granularity of leukocytes seen in sepsis could be measured using the volume, conductivity, and scatter (VCS parameters) from the automated hematology analyzers. The objective of this study is to find the clinical usefulness of VCS parameters as possible indicators of sepsis and to determine the effect of treatment on these parameters. METHODS: This observational study was conducted in a tertiary level hospital in India. Hemogram and VCS parameters obtained from LH 750 (Beckman coulter, Fullerton, CA) from 134 proven blood culture-positive cases of sepsis were reviewed on the day of culture positivity (day 0), day 3, and day 7 were analyzed and compared with those of samples from otherwise healthy 100 participants. Statistical analysis of data was done, and cutoff value was established using receiver-operator characteristic curve. RESULTS: Out of 134 culture-positive cases, 55.2% (n = 74) Gram-negative and 44.8% (n = 60) Gram-positive bacteria were isolated. The mean neutrophil volume (MNV) and mean monocyte volume (MMV) were higher in the sepsis group compared to that of the control group (165.43 ± 18.21 vs. 140.59 ± 7.6, P = 0.001 for MNV and 179.8 ± 14.16 vs. 164.54 ± 9.6, P = 0.001 for MMV). A significant decrease in MNV and MMV was observed with the initiation of the treatment. Significant changes in scatter and conductivity parameters were also noticed. A cutoff value of 150.2 for MNV gave a sensitivity and specificity of 79.1% and 95%, respectively, with an area under the curve (AUC) of 92.3%. With a cutoff of 168.3, MMV had a sensitivity of 80.6% and specificity of 77.5%, AUC of 83%. CONCLUSION: VCS parameters such as MNV and MMV can be easily obtained by an automated hematology analyzer and could be used for early detection and therapeutic response in sepsis.
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Affiliation(s)
- Parul Arora
- Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Praveen Kumar Gupta
- Department of Laboratory Medicine, Primus Super Speciality Hospital, New Delhi, India
| | - Raghavendra Lingaiah
- Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Asok Kumar Mukhopadhyay
- Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
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Hu ZD, Lippi G, Montagnana M. Diagnostic and prognostic value of red blood cell distribution width in sepsis: A narrative review. Clin Biochem 2020; 77:1-6. [DOI: 10.1016/j.clinbiochem.2020.01.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/21/2019] [Accepted: 01/06/2020] [Indexed: 02/06/2023]
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Prodjosoewojo S, Riswari SF, Djauhari H, Kosasih H, van Pelt LJ, Alisjahbana B, van der Ven AJ, de Mast Q. A novel diagnostic algorithm equipped on an automated hematology analyzer to differentiate between common causes of febrile illness in Southeast Asia. PLoS Negl Trop Dis 2019; 13:e0007183. [PMID: 30870415 PMCID: PMC6435198 DOI: 10.1371/journal.pntd.0007183] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 03/26/2019] [Accepted: 01/23/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Distinguishing arboviral infections from bacterial causes of febrile illness is of great importance for clinical management. The Infection Manager System (IMS) is a novel diagnostic algorithm equipped on a Sysmex hematology analyzer that evaluates the host response using novel techniques that quantify cellular activation and cell membrane composition. The aim of this study was to train and validate the IMS to differentiate between arboviral and common bacterial infections in Southeast Asia and compare its performance against C-reactive protein (CRP) and procalcitonin (PCT). METHODOLOGY/PRINCIPAL FINDINGS 600 adult Indonesian patients with acute febrile illness were enrolled in a prospective cohort study and analyzed using a structured diagnostic protocol. The IMS was first trained on the first 200 patients and subsequently validated using the complete cohort. A definite infectious etiology could be determined in 190 of 463 evaluable patients (41%), including 89 arboviral infections (81 dengue and 8 chikungunya), 94 bacterial infections (26 murine typhus, 16 salmonellosis, 6 leptospirosis and 46 cosmopolitan bacterial infections), 3 concomitant arboviral-bacterial infections, and 4 malaria infections. The IMS detected inflammation in all but two participants. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the IMS for arboviral infections were 69.7%, 97.9%, 96.9%, and 77.3%, respectively, and for bacterial infections 77.7%, 93.3%, 92.4%, and 79.8%. Inflammation remained unclassified in 19.1% and 22.5% of patients with a proven bacterial or arboviral infection. When cases of unclassified inflammation were grouped in the bacterial etiology group, the NPV for bacterial infection was 95.5%. IMS performed comparable to CRP and outperformed PCT in this cohort. CONCLUSIONS/SIGNIFICANCE The IMS is an automated, easy to use, novel diagnostic tool that allows rapid differentiation between common causes of febrile illness in Southeast Asia.
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Affiliation(s)
- Susantina Prodjosoewojo
- Health Research Unit, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Department of Internal Medicine, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Silvita F. Riswari
- Health Research Unit, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Hofiya Djauhari
- Health Research Unit, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Herman Kosasih
- Indonesia Research Partnership of Infectious Disease (INA-RESPOND), Jakarta, Indonesia
| | - L. Joost van Pelt
- Department of Laboratory Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | - Bachti Alisjahbana
- Health Research Unit, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Department of Internal Medicine, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Andre J. van der Ven
- Department of Internal Medicine, Radboud Center for Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands
| | - Quirijn de Mast
- Department of Internal Medicine, Radboud Center for Infectious Diseases, Radboud university medical center, Nijmegen, The Netherlands
- * E-mail:
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Urrechaga E, Bóveda O, Aguirre U. Improvement in detecting sepsis using leukocyte cell population data (CPD). ACTA ACUST UNITED AC 2018; 57:918-926. [DOI: 10.1515/cclm-2018-0979] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 11/20/2018] [Indexed: 01/03/2023]
Abstract
Abstract
Background
The cell population data (CPD) parameters reported by XN analyzers (Sysmex Corporation, Kobe, Japan) reflect the size and internal structure of leukocytes. We explored whether CPD values could contribute to recognize those patients with fever at risk to develop sepsis. A profile of sepsis was developed combining CPD parameters and other markers.
Methods
We recruited 295 patients at the onset of fever, with infection confirmed by positive cultures. We studied the diagnostic performance of the CPD parameters in the differential diagnosis of sepsis vs. non-systemic bacterial infection using receiver operating characteristic (ROC) curve analysis. Additionally, the K-means unsupervised clustering method was applied. Once the clusters had been defined, the relationship between them and the CPD parameter values was assessed with the non-parametric Wilcoxon test. Lastly, the relationship between the clusters obtained and the categorical variables was examined with the χ2-test (or Fisher’s exact test).
Results
ROC analysis demonstrated that NE-FSL, NE-WY, NE-WZ and MO-WZ had areas under the curve (AUCs) >0.700 for predicting sepsis. Using the K-means clustering algorithm, 80 patients (66.67%) were assigned to Cluster 1 and the others to Cluster 2. Out of 80 of patients in Cluster 1, 45 (56.25%) presented a PCT value ≥2 ng/mL, whereas almost 80% of Cluster 2 patients had a PCT <2 ng/mL. Cluster 1 was characterized by high NE-SFL, NE-WY, MO-X, MO-WX and MO-Z values (p<0.05).
Conclusions
CPD related to monocyte complexity and neutrophil activation were found to be significant, with high values suggesting sepsis.
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Affiliation(s)
- Eloísa Urrechaga
- CORE Laboratory , Hospital Galdakao – Usansolo , Galdakao, Vizcaya , Spain
| | - Oihane Bóveda
- CORE Laboratory , Hospital Galdakao – Usansolo , Galdakao, Vizcaya , Spain
| | - Urko Aguirre
- Research Unit, REDISSEC, Health Services Research on Chronic Patients Network , Hospital Galdakao – Usansolo , Galdakao, Vizcaya , Spain
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36
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Seghezzi M, Buoro S, Previtali G, Moioli V, Manenti B, Simon-Lopez R, Ottomano C, Lippi G. A Preliminary Proposal for Quality Control Assessment and Harmonization of Leukocytes Morphology-structural Parameters (cell Population Data Parameters). J Med Biochem 2018; 37:486-498. [PMID: 30584409 PMCID: PMC6298477 DOI: 10.2478/jomb-2018-0005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 02/21/2018] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The cell population data (CPD) measured by Sysmex XN-9000 can be used for screening many hematological and non-hematological disorders. Since little information is available on harmonization of CPD among different instrumentation and clinical laboratories, this study aimed at assessing the current degree of CPD harmonization between separate Sysmex XN modules allocated to the same laboratory. METHODS A total number of 78291 data were used for verification of within-run imprecision, analyzers harmonization, reference ranges and assessment of blood sample stability of CPD parameters, including results of daily quality control testing and those generated in samples collected from blood donors and healthy volunteers. RESULTS Within-run imprecision of CPD parameters ranged between 0.4 and 14.1%. Good agreement was found among five different XN-modules, especially when values were adjusted after calculation of instrument-specific alignment factors. The bias of all parameters remained always lower than the reference change values in samples stored for up to 8 hours, regardless of storage temperature. CONCLUSIONS The imprecision of CPD parameters was acceptable, except for those reflecting the dispersion of cellular clusters. Due to the lack of reference control materials, we showed that the use of data generated on a large number of normal routine samples (i.e., a Moving Average population) may be a reliable approach for testing analyzers harmonization. Nevertheless, availability of both calibration and quality control materials for these parameters is highly advisable in the future. We finally showed that whole blood samples may be stable for up to 2-4 hours for most CPD parameters.
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Affiliation(s)
- Michela Seghezzi
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Sabrina Buoro
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Giulia Previtali
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Valentina Moioli
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Barbara Manenti
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | | | | | - Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
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Buoro S, Carobene A, Seghezzi M, Manenti B, Pacioni A, Ceriotti F, Ottomano C, Lippi G. Short- and medium-term biological variation estimates of leukocytes extended to differential count and morphology-structural parameters (cell population data) in blood samples obtained from healthy people. Clin Chim Acta 2017; 473:147-156. [DOI: 10.1016/j.cca.2017.07.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 07/08/2017] [Indexed: 10/19/2022]
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Furundarena JR, Uranga A, Sainz MR, González C, Uresandi N, Argoitia N, Araiz M. Usefulness of the lymphocyte positional parameters in the Sysmex XN haematology analyser in lymphoproliferative disorders and mononucleosis syndrome. Int J Lab Hematol 2017; 40:41-48. [PMID: 28868635 DOI: 10.1111/ijlh.12726] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 07/15/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The lymphocyte positional parameters included in Sysmex XN have been suggested as useful means to differentiate lymphoproliferative disorders (LPD), mononucleosis syndrome (MNS) and other lymphocytoses. METHODS We evaluated Sysmex XN analysers, which supply 6 lymphocyte positional parameters that can be measured in the WDF scattergram: LY-X, LY-Y, LY-Z, LY-WX, LY-WY and LY-WZ. RESULTS We collected 301 samples from normal controls, polyclonal lymphocytosis, MNS and LPD. MNS and monoclonal expansion of T granular lymphocyte (T-GL) diagnostic groups accumulated higher numbers of significant differences in the mean values in comparison with the other groups. We propose a new algorithm that can differentiate T-GL cases from other diagnostic groups with an SE of 67.5%, an SP of 98.2%, a PPV of 87.1% and an NPV of 94.3%. Another algorithm showed its efficiency to differentiate MNS cases from other diagnostic groups with an SE of 63.6%, an SP of 97.5%, a PPV of 70.0% and an NPV of 96.7%. In 38.5% of all cases, the analyser did not generate any morphologic flag. Abnormal results in lymphocyte positional parameters were useful to detect 72.5% of these samples. CONCLUSION The lymphocyte positional parameters provided by Sysmex XN analysers are useful to differentiate expansions of T-GLs from other LPD and to differentiate MNS cases from other diagnostic groups. In addition, these parameters are very useful for detecting changes in the lymphocytes that make it necessary to review blood smears in samples without morphological flagging.
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Affiliation(s)
- J R Furundarena
- Hematology Laboratory, Donostia Unibertsitate Ospitalea, Donostia, Spain
| | - A Uranga
- Hematology Laboratory, Donostia Unibertsitate Ospitalea, Donostia, Spain
| | - M R Sainz
- Hematology Laboratory, Donostia Unibertsitate Ospitalea, Donostia, Spain
| | - C González
- Hematology Laboratory, Donostia Unibertsitate Ospitalea, Donostia, Spain
| | - N Uresandi
- Hematology Laboratory, Donostia Unibertsitate Ospitalea, Donostia, Spain
| | - N Argoitia
- Hematology Laboratory, Donostia Unibertsitate Ospitalea, Donostia, Spain
| | - M Araiz
- Hematology Laboratory, Donostia Unibertsitate Ospitalea, Donostia, Spain
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Buoro S, Manenti B, Seghezzi M, Dominoni P, Barbui T, Ghirardi A, Carobbio A, Marchesi G, Riva I, Nasi A, Ottomano C, Lippi G. Innovative haematological parameters for early diagnosis of sepsis in adult patients admitted in intensive care unit. J Clin Pathol 2017; 71:330-335. [DOI: 10.1136/jclinpath-2017-204643] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 07/26/2017] [Accepted: 07/27/2017] [Indexed: 01/01/2023]
Abstract
AimsThis study was aimed to investigate the role of erythrocyte, platelet and reticulocyte (RET) parameters, measured by new haematological analyser Sysmex XN and C reactive protein (CRP), for early diagnosis of sepsis during intensive care unit (ICU) stay.MethodsThe study population consisted of 62 ICU patients, 21 of whom developed sepsis during ICU stay and 41 who did not. The performance for early diagnosing of sepsis was calculated as area under the curve (AUC) of receiver operating characteristics curves analysis.ResultsCompared with CRP (AUC 0.81), immature platelet fraction (IPF) (AUC 0.82) showed comparable efficiency for identifying the onset of sepsis. The association with the risk of developing sepsis during ICU stay was also assessed. One day before the onset of sepsis, a decreased of RET% was significantly associated with the risk of developing sepsis (OR=0.35, 95% CI 0.14 to 0.87), whereas an increased of IPF absolute value (IPF#) was significantly associated with the risk of developing sepsis (OR=1.13, 95% CI 1.03 to 1.24) 2 days before the onset of sepsis. The value of CRP was not predictive of sepsis at either time points.ConclusionsIPF# and RET% may provide valuable clinical information for predicting the risk of developing sepsis, thus allowing early management of patients before the onset of clinically evident systemic infections.
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Urrechaga E, Bóveda O, Aguirre U. Role of leucocytes cell population data in the early detection of sepsis. J Clin Pathol 2017; 71:259-266. [PMID: 28821583 DOI: 10.1136/jclinpath-2017-204524] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 07/06/2017] [Accepted: 07/11/2017] [Indexed: 11/03/2022]
Abstract
AIMS The cell population data (CPD) parameters reported by XN analyser (Sysmex, Kobe, Japan) reflect the size and internal structure of leucocytes. We aimed to assess the clinical utility of these parameters as biomarkers for the early diagnosis of sepsis. METHODS The study group (G1) included 586 controls (no quantitative or morphological alterations in the complete blood count) and 137 patients diagnosed with sepsis. The reliability of the model was evaluated using a validation group (G2) of 212 controls and 60 patients with sepsis. The optimal cut-off for the diagnosis of sepsis and the OR for CPD were established using a univariate logistic regression. A multivariate logistic regression model was then created. The OR and area under the curve were recorded. A risk stratification scale (neutrophils and monocytes (NEMO)) for diagnosing sepsis was established on the basis of the coefficients of the multivariate model. RESULTS MO-X and neutrophils fluorescence intensity (NE-SFL) were found to be the most relevant of the CPD in predicting sepsis applying multivariate analysis to G1.NEMO score was composed using the above-mentioned CPD and subsequently stratified into three risk groups: mild (≤3), moderate (4≤NEMO≤5) and high (≥6). The OR for patients with a score of 4-5 was 10 and 249 for a score of ≥6. When applied to G2, the positive predictive value was 84.8 % and the negative predictive value was 96.0%. CONCLUSIONS CPD are potentially useful for the early diagnosis of sepsis. Their values were used to compose in NEMO score can help in rapid and reliable decision making.
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Affiliation(s)
- Eloísa Urrechaga
- CORE Laboratory, Hospital Galdakao-Usansolo, Galdakao Vizcaya, Spain
| | - Oihane Bóveda
- CORE Laboratory, Hospital Galdakao-Usansolo, Galdakao Vizcaya, Spain
| | - Urko Aguirre
- Research Unit, REDISSEC, Health Services Research on Chronic Patients Network, Hospital Galdakao-Usansolo, Galdakao Vizcaya, Spain
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Neutrophil Fluorescence: A New Indicator of Cell Activation During Septic Shock-Induced Disseminated Intravascular Coagulation. Crit Care Med 2017; 44:e1132-e1136. [PMID: 27441905 DOI: 10.1097/ccm.0000000000001851] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To investigate the contribution of neutrophil activation as innate immune cells during septic shock-induced disseminated intravascular coagulation. DESIGN Prospective study. SETTING One University Hospital ICU. PARTICIPANTS Hundred patients with septic shock. Thirty-five patients had disseminated intravascular coagulation according to Japanese Association for Acute Medicine 2006 score. INTERVENTION None. MEASUREMENTS AND MAIN RESULTS Neutrophil chromatin decondensation was assessed by measuring neutrophil fluorescence (NEUT-side-fluorescence light) labeled by a fluorochrome-based polymethine reagent using a routine automated flow cytometer Sysmex XN20 (Sysmex, Kobe, Japan) and neutrophil-derived CD66b microparticles by prothrombinase assay. Measurements in disseminated intravascular coagulation and no disseminated intravascular coagulation patients showed that a mean value of NEUT-side-fluorescence light above 57.3 arbitrary units had a sensitivity of 90.91% and a specificity of 80.60% for disseminated intravascular coagulation diagnosis. NEUT-side-fluorescence light was correlated to the CD66b microparticles/neutrophil count, a surrogate of neutrophil activation associated with septic shock-induced disseminated intravascular coagulation. CONCLUSION NEUT-side-fluorescence light, routinely available, could prove an accurate biomarker of neutrophil activation.
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Park SH, Kim HH, Kim IS, Yi J, Chang CL, Lee EY. Cell Population Data NE-SFL and MO-WX From Sysmex XN-3000 Can Provide Additional Information for Exclusion of Acute Promyelocytic Leukemia From Other Acute Myeloid Leukemias: A Preliminary Study. Ann Lab Med 2017; 36:607-10. [PMID: 27578517 PMCID: PMC5011117 DOI: 10.3343/alm.2016.36.6.607] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 06/15/2016] [Accepted: 07/20/2016] [Indexed: 11/19/2022] Open
Affiliation(s)
- Sang Hyuk Park
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
| | - Hyung Hoi Kim
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
| | - In Suk Kim
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jongyoun Yi
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Chulhun L Chang
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Eun Yup Lee
- Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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Buoro S, Seghezzi M, Vavassori M, Dominoni P, Apassiti Esposito S, Manenti B, Mecca T, Marchesi G, Castellucci E, Azzarà G, Ottomano C, Lippi G. Clinical significance of cell population data (CPD) on Sysmex XN-9000 in septic patients with our without liver impairment. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:418. [PMID: 27942509 DOI: 10.21037/atm.2016.10.73] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND This study evaluated the clinical significance of cell population data (CPD) parameters obtained on Sysmex XN-9000 in septic patients admitted to intensive care unit (ICU) and stratified according to liver function. METHODS The study population consisted in 84 patients, 44 of whom did not develop sepsis (NS), whereas the remaining 40 developed sepsis (SE) (n=24) or septic shock (SS) (n=16). Two hundred ostensibly healthy blood donors [healthy subjects (HS)], undergoing routine blood testing before a regular blood donation, were studied. RESULTS Except for neutrophils and lymphocytes cell size (NE-FCS and LY-Z), all other CPD values were significantly different in ICU patients compared to HS. Neutrophils and monocytes fluorescence intensity (NE-SFL and MO-X) values were significantly higher in SS compared to sepsis and not develop sepsis patients. The value of many parameters was also different according to liver function. Overall, MO-X and neutrophils fluorescence intensity (NE-SFL) exhibited the best performance for diagnosing sepsis in all patients (AUC, 0.75 and 0.72), as well as in those with (AUC, 0.95 and 0.89) or without (AUC, 0.72 for both) liver impairment. These parameters were also significantly correlated with Sequential Organ Failure Assessment (SOFA) score. CONCLUSIONS This study suggested that some novel CPD parameters (namely NE-SFL and MO-X) may provide useful information for diagnosis and management of sepsis.
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Affiliation(s)
- Sabrina Buoro
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Michela Seghezzi
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Mauro Vavassori
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Paola Dominoni
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | | | - Barbara Manenti
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Tommaso Mecca
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | | | | | | | | | - Giuseppe Lippi
- Department of Clinical Biochemistry, University of Verona, Verona, Italy
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Henriot I, Launay E, Boubaya M, Cremet L, Illiaquer M, Caillon H, Desjonquères A, Gillet B, Béné MC, Eveillard M. New parameters on the hematology analyzer XN-10 (SysmexTM) allow to distinguish childhood bacterial and viral infections. Int J Lab Hematol 2016; 39:14-20. [DOI: 10.1111/ijlh.12562] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 07/11/2016] [Indexed: 12/11/2022]
Affiliation(s)
- I. Henriot
- Hematology Biology Department; Nantes University Hospital; Nantes France
| | - E. Launay
- Department of Pediatrics; Nantes University Hospital; Nantes France
| | - M. Boubaya
- Clinical Research Department; Hôpitaux Universitaires Paris-Seine-Saint-Denis; Hôpital Avicenne, AP-HP; Bobigny France
| | - L. Cremet
- Bacteriology Department; Nantes University Hospital; Nantes France
| | - M. Illiaquer
- Virology Department; Nantes University Hospital; Nantes France
| | - H. Caillon
- Biochemistry Department; Nantes University Hospital; Nantes France
| | - A. Desjonquères
- Hematology Biology Department; Nantes University Hospital; Nantes France
| | - B. Gillet
- Hematology Biology Department; Nantes University Hospital; Nantes France
| | - M. C. Béné
- Hematology Biology Department; Nantes University Hospital; Nantes France
| | - M. Eveillard
- Hematology Biology Department; Nantes University Hospital; Nantes France
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Buoro S, Mecca T, Azzarà G, Apassiti Esposito S, Seghezzi M, Vavassori M, Crippa A, Marchesi G, Castellucci E, Ottomano C, Lippi G. Extended leukocyte differential count and C-reactive protein in septic patients with liver impairment: diagnostic approach to evaluate sepsis in intensive care unit. ANNALS OF TRANSLATIONAL MEDICINE 2015; 3:244. [PMID: 26605290 DOI: 10.3978/j.issn.2305-5839.2015.09.41] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Sepsis is still a major cause of death in intensive care units (ICUs) worldwide. Patients with liver impairment express an imbalanced cytokine response which alters common sepsis biphasic nature. Cytokines measurement is expensive, often unavailable, whereas leukocytes (WBC) evaluation performed through hematology analyzers can provide a practical strategy for monitoring inflammatory response. METHODS A total of 200 healthy subjects (HS) and 84 patients (18 with, 66 without liver impairment) admitted to ICU, were assessed for International Sepsis Definitions, Sequential Organ Failure Assessment (SOFA) and Model for End-Stage Liver Disease (MELD) scores. We tested 1,022 peripheral blood samples using Sysmex XN-9000, estimating diagnostic accuracy of leukocyte differential count and nontraditional parameters through receiver operating characteristics (ROC) curves analysis compared to clinical classification. RESULTS Median value of all-leukocyte parameters was different in ICU patients compared to HS. Leukocytes, neutrophils (NE) and immature granulocytes (IGs) in sepsis and septic shock (SS) were higher than no sepsis (NS), with an area under the curve: 0.81, 0.82 and 0.78 respectively. Lymphocytes (LY) and monocytes (MO) were significantly associated with liver impairment. CONCLUSIONS Diagnostic accuracy of all-leukocyte parameters may provide valuable information for diagnosis and follow-up of sepsis in ICU patients, especially those with liver impairment.
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Affiliation(s)
- Sabrina Buoro
- 1 Laboratory of Clinical Chemistry, 2 Intensive Care Unit, 3 Department of Urology, Hospital Papa Giovanni XXIII, Bergamo, Italy ; 4 CAM Laboratory S.p.A., Monza, Italy ; 5 Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Tommaso Mecca
- 1 Laboratory of Clinical Chemistry, 2 Intensive Care Unit, 3 Department of Urology, Hospital Papa Giovanni XXIII, Bergamo, Italy ; 4 CAM Laboratory S.p.A., Monza, Italy ; 5 Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Giovanna Azzarà
- 1 Laboratory of Clinical Chemistry, 2 Intensive Care Unit, 3 Department of Urology, Hospital Papa Giovanni XXIII, Bergamo, Italy ; 4 CAM Laboratory S.p.A., Monza, Italy ; 5 Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Sara Apassiti Esposito
- 1 Laboratory of Clinical Chemistry, 2 Intensive Care Unit, 3 Department of Urology, Hospital Papa Giovanni XXIII, Bergamo, Italy ; 4 CAM Laboratory S.p.A., Monza, Italy ; 5 Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Michela Seghezzi
- 1 Laboratory of Clinical Chemistry, 2 Intensive Care Unit, 3 Department of Urology, Hospital Papa Giovanni XXIII, Bergamo, Italy ; 4 CAM Laboratory S.p.A., Monza, Italy ; 5 Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Mauro Vavassori
- 1 Laboratory of Clinical Chemistry, 2 Intensive Care Unit, 3 Department of Urology, Hospital Papa Giovanni XXIII, Bergamo, Italy ; 4 CAM Laboratory S.p.A., Monza, Italy ; 5 Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Alberto Crippa
- 1 Laboratory of Clinical Chemistry, 2 Intensive Care Unit, 3 Department of Urology, Hospital Papa Giovanni XXIII, Bergamo, Italy ; 4 CAM Laboratory S.p.A., Monza, Italy ; 5 Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Gianmariano Marchesi
- 1 Laboratory of Clinical Chemistry, 2 Intensive Care Unit, 3 Department of Urology, Hospital Papa Giovanni XXIII, Bergamo, Italy ; 4 CAM Laboratory S.p.A., Monza, Italy ; 5 Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Enrico Castellucci
- 1 Laboratory of Clinical Chemistry, 2 Intensive Care Unit, 3 Department of Urology, Hospital Papa Giovanni XXIII, Bergamo, Italy ; 4 CAM Laboratory S.p.A., Monza, Italy ; 5 Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Cosimo Ottomano
- 1 Laboratory of Clinical Chemistry, 2 Intensive Care Unit, 3 Department of Urology, Hospital Papa Giovanni XXIII, Bergamo, Italy ; 4 CAM Laboratory S.p.A., Monza, Italy ; 5 Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Giuseppe Lippi
- 1 Laboratory of Clinical Chemistry, 2 Intensive Care Unit, 3 Department of Urology, Hospital Papa Giovanni XXIII, Bergamo, Italy ; 4 CAM Laboratory S.p.A., Monza, Italy ; 5 Section of Clinical Biochemistry, University of Verona, Verona, Italy
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Buoro S, Mecca T, Azzarà G, Seghezzi M, Dominoni P, Crippa A, Ottomano C, Lippi G. Cell Population Data and reflex testing rules of cell analysis in pleural and ascitic fluids using body fluid mode on Sysmex XN-9000. Clin Chim Acta 2015; 452:92-8. [PMID: 26554518 DOI: 10.1016/j.cca.2015.11.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 10/19/2015] [Accepted: 11/06/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND Although optical microscopy (OM) remains the reference technique for analysis of ascitic (AF) and pleural (PF) fluids, novel hematological analyzers are equipped with modules for body fluid (BF) analysis. This study was aimed to analyze the performance of XN-BF module in Sysmex XN-9000, and to develop validation rules for automated cell counts in BFs. METHODS The evaluation of XN-BF module included assessment of carryover, Limit of Blank (LoB), Limit of Detection (LoD), Limit of Quantitation (LoQ), linearity, data comparison with OM, and development of rules for assisting the validation of automated analysis of BFs and activating reflex testing. RESULTS The carryover was negligible. The LoB, LoD, LoQ and linearity were always excellent. The comparison with OM was characterized by Pearson's correlations ranging from r=0.50 to r=0.99 (p<0.001), modest bias and high diagnostic concordance (Area Under the Curve between 0.85 and 0.99). The use of instrument-specific cut-offs further increased diagnostic concordance. The implementation of reflex testing rules based on XN-BF data increased sensitivity and specificity of BFs classification to 0.98 and 0.95. CONCLUSIONS Our results suggest that the XN-BF module on Sysmex-9000 may be a suitable alternative to OM for screening BF samples, especially when specific validation rules are used.
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Affiliation(s)
- Sabrina Buoro
- Chemical Chemistry Laboratory Hospital Papa Giovanni XXIII, Bergamo, Italy.
| | - Tommaso Mecca
- Chemical Chemistry Laboratory Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Giovanna Azzarà
- Chemical Chemistry Laboratory Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Michela Seghezzi
- Chemical Chemistry Laboratory Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Paola Dominoni
- Chemical Chemistry Laboratory Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Alberto Crippa
- Chemical Chemistry Laboratory Hospital Papa Giovanni XXIII, Bergamo, Italy
| | | | - Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
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Kim H, Hur M, Choi SG, Oh KM, Moon HW, Yun YM. Comparison of white blood cell counts by WNR, WDF, and WPC channels in Sysmex XN hematology analyzer. Int J Lab Hematol 2015; 37:869-75. [DOI: 10.1111/ijlh.12421] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 07/31/2015] [Indexed: 11/28/2022]
Affiliation(s)
- H. Kim
- Department of Laboratory Medicine; Konkuk University School of Medicine; Seoul Korea
| | - M. Hur
- Department of Laboratory Medicine; Konkuk University School of Medicine; Seoul Korea
| | - S.-G. Choi
- Department of Laboratory Medicine; Konkuk University School of Medicine; Seoul Korea
| | - K.-M. Oh
- Department of Nursing; Konkuk University Medical Center; Seoul Korea
| | - H.-W. Moon
- Department of Laboratory Medicine; Konkuk University School of Medicine; Seoul Korea
| | - Y.-M. Yun
- Department of Laboratory Medicine; Konkuk University School of Medicine; Seoul Korea
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Monneret G, Venet F. Sepsis-induced immune alterations monitoring by flow cytometry as a promising tool for individualized therapy. CYTOMETRY PART B-CLINICAL CYTOMETRY 2015; 90:376-86. [PMID: 26130241 DOI: 10.1002/cyto.b.21270] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 06/16/2015] [Accepted: 06/25/2015] [Indexed: 12/20/2022]
Abstract
Septic syndromes remain a major although largely under-recognized health care problem and represent the first cause of mortality in intensive care units. While sepsis has, for long, been solely described as inducing a tremendous systemic inflammatory response, novel findings indicate that sepsis indeed initiates a more complex immunologic response that varies over time, with the concomitant occurrence of both pro- and anti-inflammatory mechanisms. As a resultant, after a short proinflammatory phase, septic patients enter a stage of protracted immunosuppression. This is illustrated in those patients by reactivation of dormant viruses (CMV or HSV) or infections due to pathogens, including fungi, which are normally pathogenic solely in immunocompromised hosts. Although mechanisms are not totally understood, these alterations might be directly responsible for worsening outcome in patients who survived initial resuscitation as nearly all immune functions are deeply compromised. Indeed, the magnitude and persistence over time of these dysfunctions have been associated with increased mortality and health-care associated infection rate. Consequently, new promising therapeutic avenues are currently emerging from those recent findings such as adjunctive immunostimulation (IFN-γ, GM-CSF, IL-7, anti-PD1/L1 antibodies) for the most immunosuppressed patients. Nevertheless, as there is no clinical sign of immune dysfunctions, the prerequisite for such therapeutic intervention relies on our capacity in identifying the patients who could benefit from immunostimulation. To date, the most robust biomarkers of sepsis-induced immunosuppression are measured by flow cytometry. Of them, the decreased expression of monocyte HLA-DR appears as a "gold standard." This review reports on the mechanisms sustaining sepsis-induced immunosuppression and its related biomarkers measurable by flow cytometry. The objective is to integrate the most recent facts in an up-to-date account of clinical results, flow cytometry aspects as well as issues in results standardization for multicenter studies. © 2015 International Clinical Cytometry Society.
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Affiliation(s)
- Guillaume Monneret
- Cellular Immunology Laboratory, Hospices Civils De Lyon, Hôpital E Herriot, Lyon, France
- Université Claude Bernard Lyon I, Immunology Department, Lyon, France
- TRIGGERSEP (TRIal Group for Global Evaluation and Research in SEPsis)/F-CRIN Network, France
| | - Fabienne Venet
- Cellular Immunology Laboratory, Hospices Civils De Lyon, Hôpital E Herriot, Lyon, France
- Université Claude Bernard Lyon I, Immunology Department, Lyon, France
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Cornet E, Boubaya M, Troussard X. Contribution of the new XN-1000 parameters NEUT-RI and NEUT-WY for managing patients with immature granulocytes. Int J Lab Hematol 2015; 37:e123-6. [PMID: 25923650 DOI: 10.1111/ijlh.12372] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- E Cornet
- Laboratory of Haematology, CHU Caen, Caen, France. .,Medical School, University of Caen, Caen, France.
| | - M Boubaya
- Avicenne Hospital, Unité de Recherche Clinique, Bobigny, France
| | - X Troussard
- Laboratory of Haematology, CHU Caen, Caen, France.,Medical School, University of Caen, Caen, France
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