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Vedrenne A, Devin C, Delcominette F, Habarou F, Vasse M. Detection of monoclonal B-lymphocytosis: interest of cellular population data and CytoDiff™ analysis. Clin Chem Lab Med 2020; 58:e83-e86. [PMID: 31605577 DOI: 10.1515/cclm-2019-0914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 09/12/2019] [Indexed: 11/15/2022]
Affiliation(s)
| | - Clotilde Devin
- Service de Biologie Clinique, Hôpital Foch, Suresnes, France
| | | | | | - Marc Vasse
- Service de Biologie Clinique, Hôpital Foch, Suresnes, France
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Zhang ML, Guo AX, Kadauke S, Dighe AS, Baron JM, Sohani AR. Machine Learning Models Improve the Diagnostic Yield of Peripheral Blood Flow Cytometry. Am J Clin Pathol 2020; 153:235-242. [PMID: 31603184 DOI: 10.1093/ajcp/aqz150] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES Peripheral blood flow cytometry (PBFC) is useful for evaluating circulating hematologic malignancies (HM) but has limited diagnostic value for screening. We used machine learning to evaluate whether clinical history and CBC/differential parameters could improve PBFC utilization. METHODS PBFC cases with concurrent/recent CBC/differential were split into training (n = 626) and test (n = 159) cohorts. We classified PBFC results with abnormal blast/lymphoid populations as positive and used two models to predict results. RESULTS Positive PBFC results were seen in 58% and 21% of training cases with and without prior HM (P < .001). % neutrophils, absolute lymphocyte count, and % blasts/other cells differed significantly between positive and negative PBFC groups (areas under the curve [AUC] > 0.7). Among test cases, a decision tree model achieved 98% sensitivity and 65% specificity (AUC = 0.906). A logistic regression model achieved 100% sensitivity and 54% specificity (AUC = 0.919). CONCLUSIONS We outline machine learning-based triaging strategies to decrease unnecessary utilization of PBFC by 35% to 40%.
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Affiliation(s)
- M Lisa Zhang
- Department of Pathology, Massachusetts General Hospital, Boston
| | - Alan X Guo
- Independent Researcher, Boston, MA, Philadelphia
| | - Stephan Kadauke
- Department of Pathology, University of Pennsylvania, Philadelphia
| | - Anand S Dighe
- Department of Pathology, Massachusetts General Hospital, Boston
| | - Jason M Baron
- Department of Pathology, Massachusetts General Hospital, Boston
| | - Aliyah R Sohani
- Department of Pathology, Massachusetts General Hospital, Boston
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Gari M, Dakhakhni M, Gari A, Alshihri E, Al-Jahdali R, Narasimhan K, Liang S, Al-Sayes F, Kalamegam G, Chaudhary A, Abuzenadah A, Al-Qahtani M. Incidence and potential causative factors associated with chronic benign neutropenia in the Kingdom of Saudi Arabia. BMC Proc 2015; 9:S1. [PMID: 25810761 PMCID: PMC4332021 DOI: 10.1186/1753-6561-9-s2-s1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Benign neutropenia often presents in certain populations without any genotype nor phenotype. Middle East countries are among the regions where endemic cases of chronic benign neutropenia are reported in the general population with an incidence of approximately between 10-15%. Not many studies have been performed to ascertain the cause or burden associated with this condition. The objective of the current study was to identify the frequency and characterize the consequences of chronic benign neutropenia in the country of Saudi Arabia. Results Benign neutropenia was found to be high in the Saudi Arabia general population (up to 20%), with an average neutrophil count of 1.48 (range 0.99 – 1.95 × 109cells/L), with Saudis having a higher incidence of chronic benign neutropenia compared to non-Saudis (p = <0.05). Complete blood count analyses showed significant difference in the total white cell count of neutrophils (p < 0.0001), WBC (p < 0.0001), lymphocytes (p < 0.001), monocytes (p < 0.001), eosinophils (p = 0.013) as well as the CD19 B cells (p = 0.008). Conclusions Our study is the first to carefully quantitate benign neutropenia in Saudi Arabia. We identified that this condition is prevalent in the middle aged population (18 years to 55 years). These individuals not only had lower neutrophil counts, but also reduced peripheral blood cells types, especially the B-lymphocyte population (CD19 subset). As B-lymphocytes are involved in antibody production and antigen recognition, a decrease might easily predispose the individuals to infectious agents. As such more mechanistic studies need to be undertaken to understand the cause and potential long-term consequences of benign neutropenia.
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Affiliation(s)
- Mamdooh Gari
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Research, King Abdulaziz University PO Box 80216, Jeddah 21589, Saudi Arabia ; Centre for Excellence in Genomic Medicine Research, King Abdulaziz University PO Box 80216, Jeddah 21589, Saudi Arabia
| | - Mohammed Dakhakhni
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Research, King Abdulaziz University PO Box 80216, Jeddah 21589, Saudi Arabia
| | - Abdullah Gari
- Faculty of Medicine, Department of Hematology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Erada Alshihri
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Research, King Abdulaziz University PO Box 80216, Jeddah 21589, Saudi Arabia
| | - Rowan Al-Jahdali
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Research, King Abdulaziz University PO Box 80216, Jeddah 21589, Saudi Arabia
| | - Kothandaraman Narasimhan
- Centre for Excellence in Genomic Medicine Research, King Abdulaziz University PO Box 80216, Jeddah 21589, Saudi Arabia
| | - Shen Liang
- Biostatistics Unit at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Fatin Al-Sayes
- Faculty of Medicine, Department of Hematology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Gauthaman Kalamegam
- Centre for Excellence in Genomic Medicine Research, King Abdulaziz University PO Box 80216, Jeddah 21589, Saudi Arabia
| | - Adeel Chaudhary
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Research, King Abdulaziz University PO Box 80216, Jeddah 21589, Saudi Arabia ; Centre for Excellence in Genomic Medicine Research, King Abdulaziz University PO Box 80216, Jeddah 21589, Saudi Arabia
| | - Adel Abuzenadah
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Research, King Abdulaziz University PO Box 80216, Jeddah 21589, Saudi Arabia ; Centre for Excellence in Genomic Medicine Research, King Abdulaziz University PO Box 80216, Jeddah 21589, Saudi Arabia
| | - Mohammed Al-Qahtani
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Research, King Abdulaziz University PO Box 80216, Jeddah 21589, Saudi Arabia ; Centre for Excellence in Genomic Medicine Research, King Abdulaziz University PO Box 80216, Jeddah 21589, Saudi Arabia
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Oberley MJ, Fitzgerald S, Yang DT, Morgan A, Johnson J, Leith C. Value-based flow testing of chronic lymphoproliferative disorders: a quality improvement project to develop an algorithm to streamline testing and reduce costs. Am J Clin Pathol 2014; 142:411-8. [PMID: 25125633 DOI: 10.1309/ajcp0swzj6gbdhpf] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVES Flow cytometry is essential for the evaluation of lymphoproliferative disorders (LPDs) and their classification. Flow panels routinely incorporate a large array of antibodies, making testing complex and expensive; such panels are likely unnecessary in benign cases or those with straightforward diagnoses. Our aim was to develop a more cost-effective testing strategy based on a retrospective analysis of flow studies for possible LPDs in blood. METHODS We identified LPD frequencies and types, as well as associated results with patient age and absolute lymphocyte count. RESULTS We found that the likelihood of LPDs increased with patient age and absolute lymphocyte count and that CD5-positive LPD was the most common LPD diagnosed in our institution (71% of LPDs). Using these data, we devised flow-testing algorithms with a screening test for patients at low risk of disease and a focus on CD5-positive LPD detection, with reflexing as needed. CONCLUSIONS We project this approach will result in a 40% decrease in antibody utilization.
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Affiliation(s)
- Matthew J. Oberley
- Department of Pathology and Laboratory Medicine, Children’s Hospital of Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles
| | - Sean Fitzgerald
- Department of Pathology, University of Texas Medical Branch, Galveston
| | - David T. Yang
- Department of Pathology and Laboratory Medicine, Children’s Hospital of Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles
| | - Adam Morgan
- Department of Pathology, St Mary’s Hospital, Madison, WI
| | - Joyce Johnson
- Flow Cytometry Laboratory, University of Wisconsin Hospital and Clinics, Madison
| | - Catherine Leith
- Department of Pathology and Laboratory Medicine, University of Wisconsin, Madison
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te Raa GD, Tonino SH, Remmerswaal EBM, van Houte AJ, Koene HR, van Oers MH, Kater AP. Chronic lymphocytic leukemia specific T-cell subset alterations are clone-size dependent and not present in monoclonal B lymphocytosis. Leuk Lymphoma 2012; 53:2321-5. [DOI: 10.3109/10428194.2012.698277] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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