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Coppola A, Rivolta GF, Quintavalle G, Matichecchia A, Riccardi F, Rossi R, Benegiamo A, Ranalli P, Coluccio V, Tagliaferri A. Six-Year, Real-World Use of Prophylaxis with Recombinant Factor IX-Albumin Fusion Protein (rIX-FP) in Persons with Hemophilia B: A Single-Center Retrospective-Prospective Study. J Clin Med 2024; 13:1518. [PMID: 38592343 PMCID: PMC10933977 DOI: 10.3390/jcm13051518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Extended half-life (EHL) factor IX (FIX) concentrates allow for prophylaxis with prolonged dosing intervals and high bleeding protection in persons with hemophilia B. Long-term real-world studies are lacking. Methods: In a retrospective-prospective study, the six-year use of prophylaxis with the EHL recombinant FIX-albumin fusion protein (rIX-FP) was analyzed, comparing outcomes with previous standard half-life (SHL) FIX in patients already on prophylaxis. Results: Prophylaxis with rIX-FP was prescribed in 15 patients (10 severe, 5 moderate; follow-up: 57 ± 17 months). Based on a pharmacokinetic assessment and clinical needs, the first regimen was 47 ± 7 IU/Kg every 9 ± 2 days. All but one patient remained on rIX-FP prophylaxis, adjusting infusion frequency and/or dose; the last prescribed frequency was ≥10 days in 10/13 patients, being reduced in seven and increased in four vs. the first regimen. The weekly FIX dose was unchanged; FIX trough levels were >5% in all patients. The annual infusion number and FIX IU/Kg significantly decreased (~60%) in eight patients previously on SHL FIX prophylaxis, with similar concentrate costs. Very low bleeding rates (most traumatic bleeds and the last quartile of the infusion interval), improved orthopedic and pain scores, unchanged HEAD-US scores and problem joints, and high treatment adherence (>90%) and satisfaction were registered. Conclusions: Personalized, carefully adjusted rIX-FP regimens contribute to the diffusion and optimization of prophylaxis in persons with severe and moderate hemophilia B, with long-term favorable bleeding, joint, and patient-reported outcomes.
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Affiliation(s)
- Antonio Coppola
- Regional Reference Center for Inherited Bleeding Disorders, University Hospital of Parma, 43126 Parma, Italy; (G.F.R.); (G.Q.); (A.M.); (F.R.); (A.T.)
| | - Gianna Franca Rivolta
- Regional Reference Center for Inherited Bleeding Disorders, University Hospital of Parma, 43126 Parma, Italy; (G.F.R.); (G.Q.); (A.M.); (F.R.); (A.T.)
| | - Gabriele Quintavalle
- Regional Reference Center for Inherited Bleeding Disorders, University Hospital of Parma, 43126 Parma, Italy; (G.F.R.); (G.Q.); (A.M.); (F.R.); (A.T.)
| | - Annalisa Matichecchia
- Regional Reference Center for Inherited Bleeding Disorders, University Hospital of Parma, 43126 Parma, Italy; (G.F.R.); (G.Q.); (A.M.); (F.R.); (A.T.)
| | - Federica Riccardi
- Regional Reference Center for Inherited Bleeding Disorders, University Hospital of Parma, 43126 Parma, Italy; (G.F.R.); (G.Q.); (A.M.); (F.R.); (A.T.)
| | - Rossana Rossi
- Coagulation Laboratory, Diagnostic Department, University Hospital of Parma, 43126 Parma, Italy; (R.R.); (A.B.)
| | - Anna Benegiamo
- Coagulation Laboratory, Diagnostic Department, University Hospital of Parma, 43126 Parma, Italy; (R.R.); (A.B.)
| | - Paola Ranalli
- Hemophilia and Blood Rare Disease Center, Oncohematology Department, Spirito Santo Civil Hospital, 65124 Pescara, Italy;
| | - Valeria Coluccio
- Hematology Unit, University Hospital of Modena, 41124 Modena, Italy;
| | - Annarita Tagliaferri
- Regional Reference Center for Inherited Bleeding Disorders, University Hospital of Parma, 43126 Parma, Italy; (G.F.R.); (G.Q.); (A.M.); (F.R.); (A.T.)
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Da Rin G, Benegiamo A, Di Fabio AM, Dima F, Francione S, Fanelli A, Germagnoli L, Lorubbio M, Marzoni A, Pajola R, Pipitone S, Rolla R, Seghezzi M, Baigorria Vaca MDC, Bartolini A, Buoro S. Multicentric evaluation of analytical performances digital morphology with respect to the reference methods by manual optical microscopy. J Clin Pathol 2020; 74:jclinpath-2020-206857. [PMID: 32928940 DOI: 10.1136/jclinpath-2020-206857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/19/2020] [Accepted: 07/20/2020] [Indexed: 01/06/2023]
Abstract
AIMS Optical microscopic (OM) evaluation of peripheral blood (PB) cells is still a crucial step of the laboratory haematological workflow. The morphological cell analysis is time-consuming and expensive and it requires skilled operator. To address these challenges, automated image-processing systems, as digital morphology (DM), were developed in the last few years. The aim of this multicentre study, performed according to international guidelines, is to verify the analytical performance of DM compared with manual OM, the reference method. METHODS Four hundred and ninety PB samples were evaluated. For each sample, two May Grunwald-stained and Giemsa-stained smears were performed and the morphological evaluation of cells was analysed with both DM and OM. In addition, the assessment times of both methods were recorded. RESULTS Comparison of DM versus OM methods was assessed with Passing-Bablok and Deming fit regression analysis: slopes ranged between 0.17 for atypical, reactive lymphocytes and plasma cells (LY(AT)) and 1.24 for basophils, and the intercepts ranged between -0.09 for blasts and 0.40 for LY(AT). The Bland-Altman bias ranged between -6.5% for eosinophils and 21.8% for meta-myemielocytes. The diagnostic agreement between the two methods was 0.98. The mean of assessment times were 150 s and 250 s for DM and OM, respectively. CONCLUSION DM shows excellent performance. Approximately only 1.6% of PB smears need the OM revision, giving advantages in terms of efficiency, standardisation and assessment time of morphological analysis of the cells. The findings of this study may provide useful information regarding the use of DM to improve the haematological workflow.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Rachele Pajola
- Ospedali Riuniti Padova Sud Schiavonia, Monselice, Italy
| | | | - Roberta Rolla
- Department of Health Sciences, University of Eastern Piedmont 'Amedeo Avogadro', Novara, Italy
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Gioia M, Da Rin G, Manenti B, Birindelli S, Ciardelli ML, Gentile R, Beretta G, Lorusso G, Avino D, Di Fabio AM, Dima F, Fanelli A, Lorubbio M, Francione S, Marincheva G, Marini A, Papa A, Giannelli E, Pajola R, Panzeri A, Pipitone S, Benegiamo A, Rolla R, Vidali M, Buoro S. Multicenter evaluation of analytical performances of platelet counts and platelet parameters: Carryover, precision, and stability. Int J Lab Hematol 2020; 42:552-564. [PMID: 32304271 DOI: 10.1111/ijlh.13204] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 03/23/2020] [Accepted: 03/25/2020] [Indexed: 02/05/2023]
Abstract
INTRODUCTION The correctness of the results of automated platelet analysis is still highly debated. The aim of this multicenter study, conducted according to international guidelines, was to verify the analytical performance of nine different types of hematology analyzers (HAs) in the automated platelet analysis. METHODS Four hundred eighty-six peripheral blood samples (PB), collected in K3 EDTA tubes, were analyzed by ABX Pentra, ADVIA2120i, BC-6800, BC-6800 Plus, Cell-DYN Sapphire, DxH800, XE-2100, XE-5000, XN-20 with PLT-F App. Within-run imprecision and between-run imprecision were carried out using PB and material control, respectively. The carryover, low limit of quantification (LoQ), and the PB stability were evaluated. RESULTS The carryover was absent for all HAs. The LoQ of PLT ranged between 2.0 (Cell-Dyn Sapphire) and 25.0 × 109 /L (ADVIA 2120i), while immature platelet fraction (IPF) ranged between 1.0 (XN-20) and 12.0 × 109 /L (XE-5000). The imprecision (%CV) increases as the platelet count decreases. No HAs showed desirable CVAPS for PLT counts less than 50.0 × 109 /L, with the exception of Cell-DYN Sapphire (CV 3.0% with PLT-O mean value of 26.7 × 109 /L), XN-20 (CV 2.4% with PLT-F mean value of 21.5 × 109 /L), and BC-6800 Plus (CV 1.9% with PLT-O mean value of 26.5 × 109 /L). The sample stability ranged between under two hours for MPV by ADVIA2120i and 8 hours for other PLT parameters and HAs. CONCLUSION The findings of this study may provide useful information regarding carryover, precision, and stability of platelet counts and parameters, especially in thrombocytopenic samples. Moreover, the stability of sample for platelet analysis is conditioned by the HA and by temperature and storage time.
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Affiliation(s)
- Maria Gioia
- Clinical Chemistry Laboratory, Abele Ajello Hospital, Mazara del Vallo, Italy
| | - Giorgio Da Rin
- Medicine Laboratory, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Barbara Manenti
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Sarah Birindelli
- Clinical Pathology Unit, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Maria Laura Ciardelli
- Clinical Chemistry Laboratory, Policlinico San Matteo-IRCCS, University of Pavia, Pavia, Italy
| | - Roberto Gentile
- Clinical Chemistry Laboratory, Policlinico San Matteo-IRCCS, University of Pavia, Pavia, Italy
| | - Gianluca Beretta
- Clinical Chemistry Laboratory, Policlinico San Pietro - Istituti Ospedalieri Bergamaschi, San Pietro, Italy
| | - Giuseppe Lorusso
- Clinical Chemistry Laboratory, Policlinico San Pietro - Istituti Ospedalieri Bergamaschi, San Pietro, Italy
| | - Daniela Avino
- Hematological diagnostic Laboratory, P. O. "A. Tortora", Pagani, Italy
| | | | - Francesco Dima
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | | | - Maria Lorubbio
- Laboratory Department, Azienda Ospedaliera Careggi, Florence, Italy
| | - Sara Francione
- Department of Clinical Chemistry and Microbiology, ASL Novara, Borgomanero, Italy
| | - Galina Marincheva
- Department of Clinical Chemistry and Microbiology, ASL Novara, Borgomanero, Italy
| | - Alessandra Marini
- Department of Clinical Chemistry, Versilia Hospital, Lido di Camaiore, Italy
| | - Angela Papa
- Laboratory Medicine, Fondazione G. Monasterio CNR Regione Toscana, Pisa, Italy
| | - Elena Giannelli
- Laboratory Medicine, Fondazione G. Monasterio CNR Regione Toscana, Pisa, Italy
| | - Rachele Pajola
- Clinical Chemistry Laboratory, Ospedali Riuniti Padova Sud Schiavonia, Italy
| | - Andrea Panzeri
- Clinical Pathology Unit, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Silvia Pipitone
- Clinical Chemistry and Hematology Laboratory, University Hospital of Parma, Parma, Italy
| | - Anna Benegiamo
- Clinical Chemistry and Hematology Laboratory, University Hospital of Parma, Parma, Italy
| | - Roberta Rolla
- Clinical Chemistry Laboratory, Department of Health Sciences, Maggiore Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Matteo Vidali
- Clinical Chemistry Laboratory, Department of Health Sciences, Maggiore Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Sabrina Buoro
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
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Da Rin G, Vidali M, Balboni F, Benegiamo A, Borin M, Ciardelli ML, Dima F, Di Fabio A, Fanelli A, Fiorini F, Francione S, Germagnoli L, Gioia M, Lari T, Lorubbio M, Marini A, Papa A, Seghezzi M, Solarino L, Pipitone S, Tilocca E, Buoro S. Performance evaluation of the automated nucleated red blood cell count of five commercial hematological analyzers. Int J Lab Hematol 2017; 39:663-670. [PMID: 28990291 DOI: 10.1111/ijlh.12722] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 06/26/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Recent automated hematology analyzers (HAs) can identify and report nucleated red blood cells (NRBC) count as a separate population out of white blood cells (WBC). The aim of this study was to investigate the analytical performances of NRBC enumeration on five top of the range HAs. METHODS We evaluated the within-run and between-day precision, limit of blank (LoB), limit of detection (LoD), and limit of quantitation (LoQ) of XE-2100 and XN-module (Sysmex), ADVIA 2120i (Siemens), BC-6800 (Mindray), and UniCel DxH 800 (Beckman Coulter). Automated NRBC counts were also compared with optical microscopy (OM). RESULTS The limits of detection for NRBC of the BC-6800, XN-module, XE-2100, UniCel DxH 800, and ADVIA 2120i are 0.035×109 /L, 0.019×109 /L, 0.067×109 /L, 0.038×109 /L, and 0.167×109 /L, respectively. Our data indicated excellent performance in terms of precision. The agreement with OM was excellent for BC-6800, XN-module, and XE-2100 (Bias 0.023, 0.019, and 0.033×109 /L, respectively). ADVIA 2120i displayed a significant constant error and UniCel DxH 800 both proportional and small constant error. CONCLUSION Regards to NRBC counting, the performances shown by BC-6800, XN-module, and XE-2100 are excellent also a low count, ADVIA 2120i and UniCel DxH 800 need to be improved.
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Affiliation(s)
- G Da Rin
- Laboratory Medicine, San Bassiano Hospital, ASL 7 Pedemontana, Bassano del Grappa, Italy
| | - M Vidali
- Immunohematology and Transfusion Medicine Service, Hospital SS. Trinità, Borgomanero, Italy
| | - F Balboni
- Laboratory Medicine, Istituto Fiorentino di Cura e Assistenza (IFCA), Firenze, Italy
| | - A Benegiamo
- Laboratory of Clinical Chemistry and Hematology, Hospital of Parma, Parma, Italy
| | - M Borin
- Clinical Chemistry Laboratory and Microbiology, ASL NO, Borgomanero, Italy
| | - M L Ciardelli
- Clinical Chemistry Laboratory, IRCCS Policlinico San Matteo, Pavia, Italy
| | - F Dima
- Clinical Chemistry Laboratory, AOUI Verona, Verona, Italy
| | - A Di Fabio
- Clinical Chemistry Laboratory, Hospital Civile, Avezzano, Italy
| | - A Fanelli
- General Laboratory, University Hospital Careggi, Firenze, Italy
| | - F Fiorini
- Clinical Pathology Laboratory, USL Nordovest, Toscana, Italy
| | - S Francione
- Clinical Chemistry Laboratory and Microbiology, ASL NO, Borgomanero, Italy
| | | | - M Gioia
- Clinical Chemistry Laboratory, Hospital Abele Ajello, Mazara del Vallo, Italy
| | - T Lari
- Clinical Chemistry Laboratory, Hospital Versilia, Azienda Toscana Nord ovest, Lido di Camaiore, Italy
| | - M Lorubbio
- Laboratory Medicine, Fondazione G. Monasterio CNR Regione Toscana, Pisa, Italy
| | - A Marini
- Clinical Chemistry Laboratory, Hospital Versilia, Azienda Toscana Nord ovest, Lido di Camaiore, Italy
| | - A Papa
- Laboratory Medicine, Fondazione G. Monasterio CNR Regione Toscana, Pisa, Italy
| | - M Seghezzi
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - L Solarino
- Laboratory Medicine I, P.O. V.Emanuele, A.U.O "Policlinico-V.Emanuele", Catania, Italy
| | - S Pipitone
- Laboratory of Clinical Chemistry and Hematology, Hospital of Parma, Parma, Italy
| | - E Tilocca
- Laboratory Medicine I, P.O. V.Emanuele, A.U.O "Policlinico-V.Emanuele", Catania, Italy
| | - S Buoro
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
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Pipitone S, Germagnoli L, Da Rin G, Di Fabio A, Fanelli A, Fiorini F, Francione S, Marini A, Papa A, Benegiamo A, Lari T, Siviero F, Lorubbio M, Borin M, Seghezzi M, Ciardelli ML, Dima F, Gioia M, Buoro S. Comparing the performance of three panels rules of blood smear review criteria on an Italian multicenter evaluation. Int J Lab Hematol 2017; 39:645-652. [DOI: 10.1111/ijlh.12720] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 06/20/2017] [Indexed: 11/29/2022]
Affiliation(s)
- S. Pipitone
- Clinical Chemistry and Hematology Laboratory; University Hospital of Parma; Parma Italy
| | | | - G. Da Rin
- Department of Laboratory Medicine ASL 3; Bassano del Grappa Italy
| | - A. Di Fabio
- Clinical Chemistry Laboratory; Avezzano Civic Hospital; Avezzano Italy
| | - A. Fanelli
- Laboratory Department; Azienda Ospedaliera Careggi; Florence Italy
| | - F. Fiorini
- Department of Clinical Pathology; USL Toscana Nordovest; Pisa Italy
| | - S. Francione
- Department of Clinical Chemistry and Microbiology; ASL Novara; Borgomanero Italy
| | - A. Marini
- Department of Clinical Chemistry; Versilia Hospital; Lido di Camaiore Italy
| | - A. Papa
- Department of Laboratory Medicine; CNR Fondazione Toscana Gabriele Monasterio; Pisa Italy
| | - A. Benegiamo
- Clinical Chemistry and Hematology Laboratory; University Hospital of Parma; Parma Italy
| | - T. Lari
- Department of Clinical Chemistry; Versilia Hospital; Lido di Camaiore Italy
| | - F. Siviero
- Department of Laboratory Medicine ASL 3; Bassano del Grappa Italy
| | - M. Lorubbio
- Laboratory Department; Azienda Ospedaliera Careggi; Florence Italy
| | - M. Borin
- Department of Clinical Chemistry and Microbiology; ASL Novara; Borgomanero Italy
| | - M. Seghezzi
- Clinical Chemistry Laboratory; Papa Giovanni XXIII Hospital; Bergamo Italy
| | - M. L. Ciardelli
- Clinical Chemistry Laboratory; Policlinico San Matteo-IRCCS; University of Pavia; Pavia Italy
| | - F. Dima
- Laboratory of Clinical Biochemistry; University of Verona and Azienda Ospedaliera Universitaria Integrata Verona; Verona Italy
| | - M. Gioia
- Clinical Chemistry Laboratory; Abele Ajello Hospital; Mazara del Vallo Italy
| | - S. Buoro
- Clinical Chemistry Laboratory; Papa Giovanni XXIII Hospital; Bergamo Italy
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Lippi G, Pavesi F, Benegiamo A, Pipitone S. What Do Hemolyzed Whole-Blood Specimens Look Like? Analysis with a CellaVision DM96 Automated Image Analysis System. ACTA ACUST UNITED AC 2015; 20:60-3. [DOI: 10.1177/2211068214559644] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lippi G, Cattabiani C, Benegiamo A, Gennari D, Pavesi F, Caleffi A, Pipitone S. Evaluation of the Fully Automated Hematological Analyzer Sysmex XE-5000 for Flow Cytometric Analysis of Peritoneal Fluid. ACTA ACUST UNITED AC 2013; 18:240-4. [DOI: 10.1177/2211068212471833] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Lippi G, Cattabiani C, Benegiamo A, Gennari D, Pavesi F, Caleffi A, Pipitone S. Evaluation of white blood cell count in peritoneal fluid with five different hemocytometers. Clin Biochem 2013; 46:173-6. [DOI: 10.1016/j.clinbiochem.2012.10.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 10/16/2012] [Accepted: 10/24/2012] [Indexed: 02/01/2023]
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