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Diallo L, Guindo A, Kéita I, Baraïka MA, Dembélé AK, Touré BA, Diallo DA. [Platelet count in the steady state phase and clinical severity of sickle cell disease in a reference centre for sickle cell disease in Mali]. Pan Afr Med J 2022; 43:52. [PMID: 36578815 PMCID: PMC9755550 DOI: 10.11604/pamj.2022.43.52.32674] [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: 12/02/2021] [Accepted: 09/11/2022] [Indexed: 12/30/2022] Open
Abstract
Risk factors associated with complications occurring in sickle cell disease are not fully elucidated. The purpose of this study was to evaluate the existence of an association between the clinical severity of sickle cell disease and platelet count in the steady state phase in patients with sickle cell disease followed up at the Center for Research and Control of Sickle Cell Disease in Bamako, Mali. We conducted a retrospective review of 40 medical records of patients aged 5 to 42 years with sickle cell disease at the Center for Research and Control of Sickle Cell Disease in Bamako, Mali. Clinical severity of sickle cell disease was assessed according to the criteria of VOC and/or hospitalizations < 2 or ≥ 2 per year. Data entry was carried out using the Excel 2013 version. The statistical tests used were the Chi2, Student and Mac Nemar tests. Of the 40 patients, 82.5% had haemolytic phenotype and 17.5% hyperviscous phenotype; complications of sickle cell disease were more frequent in the haemolytic phenotype group (p < 0.05). There was a significant association between mean platelet count ≥ 450 G/L in the steady state phase and the annual number of CVOs ≥ 2 (p = 0.002). This study shows that mean platelet count ≥ 450 G/L in sickle cell patients in the steady state phase could be a risk factor for the frequent occurrence of CVO. It underlines the importance of conducting prospective studies focusing on both hyperplateletosis and platelet activation markers in larger sample sizes, as well as therapeutic trials involving platelet activation inhibitors, such as Crizanlizumab, a humanised anti-P-selectin monoclonal antibodies.
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Affiliation(s)
- Lamine Diallo
- Centre de Recherche et de Lutte contre la Drépanocytose, Bamako, Mali
| | - Aldiouma Guindo
- Centre de Recherche et de Lutte contre la Drépanocytose, Bamako, Mali
| | - Ibrahima Kéita
- Centre de Recherche et de Lutte contre la Drépanocytose, Bamako, Mali
| | | | | | | | - Dapa Aly Diallo
- Centre de Recherche et de Lutte contre la Drépanocytose, Bamako, Mali,Corresponding author: Dapa Aly Diallo, Centre de Recherche et de Lutte contre la Drépanocytose, Bamako, Mali.
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Dembélé KC, Veyrat-Durebex C, Guindo A, Chupin S, Tessier L, Goïta Y, Baraïka MA, Diallo M, Touré BA, Homedan C, Mirebeau-Prunier D, Simard G, Diallo D, Cissé BM, Reynier P, Chao de la Barca JM. Sickle Cell Disease: Metabolomic Profiles of Vaso-Occlusive Crisis in Plasma and Erythrocytes. J Clin Med 2020; 9:jcm9041092. [PMID: 32290473 PMCID: PMC7230294 DOI: 10.3390/jcm9041092] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 12/19/2022] Open
Abstract
The metabolomic profile of vaso-occlusive crisis, compared to the basal state of sickle cell disease, has never been reported to our knowledge. Using a standardized targeted metabolomic approach, performed on plasma and erythrocyte fractions, we compared these two states of the disease in the same group of 40 patients. Among the 188 metabolites analyzed, 153 were accurately measured in plasma and 143 in red blood cells. Supervised paired partial least squares discriminant analysis (pPLS-DA) showed good predictive performance for test sets with median area under the receiver operating characteristic (AUROC) curves of 99% and mean p-values of 0.0005 and 0.0002 in plasma and erythrocytes, respectively. A total of 63 metabolites allowed discrimination between the two groups in the plasma, whereas 61 allowed discrimination in the erythrocytes. Overall, this signature points to altered arginine and nitric oxide metabolism, pain pathophysiology, hypoxia and energetic crisis, and membrane remodeling of red blood cells. It also revealed the alteration of metabolite concentrations that had not been previously associated with sickle cell disease. Our results demonstrate that the vaso-occlusive crisis has a specific metabolomic signature, distinct from that observed at steady state, which may be potentially helpful for finding predictive biomarkers for this acute life-threatening episode.
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Affiliation(s)
- Klétigui Casimir Dembélé
- Faculté de Pharmacie, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako BP 1805, Mali; (K.C.D.); (A.G.); (Y.G.); (M.A.B.); (B.M.C.)
- Centre de Recherche et de Lutte contre la Drépanocytose, Bamako BP 1805, Mali; (M.D.); (B.A.T.); (D.D.)
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (S.C.); (L.T.); (C.H.); (D.M.-P.); (G.S.); (J.M.C.d.l.B.)
- Unité Mixte de Recherche MITOVASC, Centre National de la Recherche Scientifique (CNRS) 6015, Institut National de la Santé et de la Recherche Médicale (INSERM) U1083, Université d’Angers, 49933 Angers, France
| | - Charlotte Veyrat-Durebex
- Unité Mixte de Recherche, Institut National de la Santé et de la Recherche Médicale (INSERM) U1253, iBRAIN, Université de Tours, 37000 Tours, France;
- Service de Biochimie et Biologie Moléculaire, Centre Hospitalier Universitaire, 37000 Tours, France
| | - Aldiouma Guindo
- Faculté de Pharmacie, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako BP 1805, Mali; (K.C.D.); (A.G.); (Y.G.); (M.A.B.); (B.M.C.)
- Centre de Recherche et de Lutte contre la Drépanocytose, Bamako BP 1805, Mali; (M.D.); (B.A.T.); (D.D.)
| | - Stéphanie Chupin
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (S.C.); (L.T.); (C.H.); (D.M.-P.); (G.S.); (J.M.C.d.l.B.)
| | - Lydie Tessier
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (S.C.); (L.T.); (C.H.); (D.M.-P.); (G.S.); (J.M.C.d.l.B.)
| | - Yaya Goïta
- Faculté de Pharmacie, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako BP 1805, Mali; (K.C.D.); (A.G.); (Y.G.); (M.A.B.); (B.M.C.)
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (S.C.); (L.T.); (C.H.); (D.M.-P.); (G.S.); (J.M.C.d.l.B.)
- Unité Mixte de Recherche MITOVASC, Centre National de la Recherche Scientifique (CNRS) 6015, Institut National de la Santé et de la Recherche Médicale (INSERM) U1083, Université d’Angers, 49933 Angers, France
| | - Mohamed Ag Baraïka
- Faculté de Pharmacie, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako BP 1805, Mali; (K.C.D.); (A.G.); (Y.G.); (M.A.B.); (B.M.C.)
- Centre de Recherche et de Lutte contre la Drépanocytose, Bamako BP 1805, Mali; (M.D.); (B.A.T.); (D.D.)
| | - Moussa Diallo
- Centre de Recherche et de Lutte contre la Drépanocytose, Bamako BP 1805, Mali; (M.D.); (B.A.T.); (D.D.)
| | - Boubacari Ali Touré
- Centre de Recherche et de Lutte contre la Drépanocytose, Bamako BP 1805, Mali; (M.D.); (B.A.T.); (D.D.)
| | - Chadi Homedan
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (S.C.); (L.T.); (C.H.); (D.M.-P.); (G.S.); (J.M.C.d.l.B.)
| | - Delphine Mirebeau-Prunier
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (S.C.); (L.T.); (C.H.); (D.M.-P.); (G.S.); (J.M.C.d.l.B.)
- Unité Mixte de Recherche MITOVASC, Centre National de la Recherche Scientifique (CNRS) 6015, Institut National de la Santé et de la Recherche Médicale (INSERM) U1083, Université d’Angers, 49933 Angers, France
| | - Gilles Simard
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (S.C.); (L.T.); (C.H.); (D.M.-P.); (G.S.); (J.M.C.d.l.B.)
| | - Dapa Diallo
- Centre de Recherche et de Lutte contre la Drépanocytose, Bamako BP 1805, Mali; (M.D.); (B.A.T.); (D.D.)
| | - Bakary Mamadou Cissé
- Faculté de Pharmacie, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako BP 1805, Mali; (K.C.D.); (A.G.); (Y.G.); (M.A.B.); (B.M.C.)
| | - Pascal Reynier
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (S.C.); (L.T.); (C.H.); (D.M.-P.); (G.S.); (J.M.C.d.l.B.)
- Unité Mixte de Recherche MITOVASC, Centre National de la Recherche Scientifique (CNRS) 6015, Institut National de la Santé et de la Recherche Médicale (INSERM) U1083, Université d’Angers, 49933 Angers, France
- Correspondence: ; Tel.: +33-2-4135-3314
| | - Juan Manuel Chao de la Barca
- Département de Biochimie et Génétique, Centre Hospitalier Universitaire, 49933 Angers, France; (S.C.); (L.T.); (C.H.); (D.M.-P.); (G.S.); (J.M.C.d.l.B.)
- Unité Mixte de Recherche MITOVASC, Centre National de la Recherche Scientifique (CNRS) 6015, Institut National de la Santé et de la Recherche Médicale (INSERM) U1083, Université d’Angers, 49933 Angers, France
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Diallo DA, Guindo A, Touré BA, Sarro YS, Sima M, Tessougué O, Baraika MA, Guindo P, Traoré M, Diallo M, Dorie A. [Targeted newborn screening for sickle-cell anemia: Sickling test (Emmel test) boundaries in the prenatal assessment in West African area]. Rev Epidemiol Sante Publique 2018; 66:181-185. [PMID: 29625861 DOI: 10.1016/j.respe.2018.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 06/16/2017] [Revised: 12/11/2017] [Accepted: 02/21/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Newborn screening for sickle cell anemia is necessary in Africa where the disease is more frequent. Hemoglobin electrophoresis is used for screening, but is limited by a high cost and difficult access. Sickling test (Emmel test), which is more affordable and technically more accessible, is often requested for prenatal assessment of pregnant women in West African areas to reserve screening for newborns from mothers in whom the positive sickling test attests the presence of hemoglobin S. This study aims to evaluate the number of undetected sickle cell anemia newborns by a screening policy targeting only newborns from mothers in whom a sickling test would have been positive. METHODS From 2010 to 2012, in Bamako, Mali, West Africa, 2489 newborns were routinely screened for sickle cell anemia at the umbilical cord or heel by isoelectrofocusing and, if necessary, by high-performance liquid chromatography. These newborns were born from 2420 mothers whose hemoglobin was studied by isoelectrofocusing. The data was recorded and processed using Excel software version 14.0.0. We calculated the frequency of the sickle cell gene in mothers and newborns as well as the number of SCA newborns from heterozygous or C homozygous mothers. RESULTS Of the 2489 newborns, 16 had sickle cell anemia (6 SS and 10 SC); 198 had the sickle cell trait; 139 were AC and 1 was CC. Of the 10 newborns with SC profile, 3 were born from mothers not carrying the S gene but the C gene of hemoglobin and in which an Emmel test would have been negative. CONCLUSION Targeted newborn screening, based on the results of sickling test in pregnant women, would misdiagnose more than one of six sickle cell anemia newborns who would not benefit from early care. Cost-effectiveness studies of routine newborn screening for sickle cell anemia should lead to a better screening strategy in contexts where hemoglobin S and other hemoglobin defect genes coexist.
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Affiliation(s)
- D A Diallo
- Centre de recherche et de lutte contre la drépanocytose (CRLD), Point G, Commune III, 03 BP : 186 Bko 03, Bamako, Mali.
| | - A Guindo
- Centre de recherche et de lutte contre la drépanocytose (CRLD), Point G, Commune III, 03 BP : 186 Bko 03, Bamako, Mali
| | - B A Touré
- Centre de recherche et de lutte contre la drépanocytose (CRLD), Point G, Commune III, 03 BP : 186 Bko 03, Bamako, Mali
| | - Y S Sarro
- Centre de recherche et de lutte contre la drépanocytose (CRLD), Point G, Commune III, 03 BP : 186 Bko 03, Bamako, Mali
| | - M Sima
- Service de gynécologie et d'obstétrique, CHU du Point G, BP : 333 Bamako, Mali
| | - O Tessougué
- Centre de recherche et de lutte contre la drépanocytose (CRLD), Point G, Commune III, 03 BP : 186 Bko 03, Bamako, Mali
| | - M A Baraika
- Centre de recherche et de lutte contre la drépanocytose (CRLD), Point G, Commune III, 03 BP : 186 Bko 03, Bamako, Mali
| | - P Guindo
- Centre de recherche et de lutte contre la drépanocytose (CRLD), Point G, Commune III, 03 BP : 186 Bko 03, Bamako, Mali
| | - M Traoré
- Centre de santé de référence de la Commune V, Bamako, Mali
| | - M Diallo
- Centre de recherche et de lutte contre la drépanocytose (CRLD), Point G, Commune III, 03 BP : 186 Bko 03, Bamako, Mali
| | - A Dorie
- Centre de recherche et de lutte contre la drépanocytose (CRLD), Point G, Commune III, 03 BP : 186 Bko 03, Bamako, Mali
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Guindo A, Touré BA, Guindo P, Baraika MA, Sarro YS, Fané B, Tessougué O, Dorie A, Traoré K, Diallo DA. Transmission of Plasmodium falciparum by red blood cell transfusions in the management of sickle cell disease patients in Mali. Transfus Med 2016; 26:153-5. [PMID: 27003788 DOI: 10.1111/tme.12294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 02/11/2016] [Accepted: 02/25/2016] [Indexed: 11/29/2022]
Affiliation(s)
- A Guindo
- Centre de Recherche et de Lutte contre la Drépanocytose (CRLD), Bamako, Mali
| | - B A Touré
- Centre de Recherche et de Lutte contre la Drépanocytose (CRLD), Bamako, Mali
| | - P Guindo
- Centre de Recherche et de Lutte contre la Drépanocytose (CRLD), Bamako, Mali
| | - M A Baraika
- Centre de Recherche et de Lutte contre la Drépanocytose (CRLD), Bamako, Mali
| | - Y S Sarro
- Centre de Recherche et de Lutte contre la Drépanocytose (CRLD), Bamako, Mali
| | - B Fané
- Centre de Recherche et de Lutte contre la Drépanocytose (CRLD), Bamako, Mali
| | - O Tessougué
- Centre de Recherche et de Lutte contre la Drépanocytose (CRLD), Bamako, Mali
| | - A Dorie
- Centre de Recherche et de Lutte contre la Drépanocytose (CRLD), Bamako, Mali.,International Technical Expert of French Cooperation, Bamako, Mali
| | - K Traoré
- National Malaria Control Program, Ministry of Health, Bamako, Mali
| | - D A Diallo
- Centre de Recherche et de Lutte contre la Drépanocytose (CRLD), Bamako, Mali.,Service d'hématologie oncologie médicale, CHU du Point G, Bamako, Mali
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Diarra AB, Guindo A, Kouriba B, Dorie A, Diabaté DT, Diawara SI, Fané B, Touré BA, Traoré A, Gulbis B, Diallo DA. [Sickle cell anemia and transfusion safety in Bamako, Mali. Seroprevalence of HIV, HBV and HCV infections and alloimmunization belonged to Rh and Kell systems in sickle cell anemia patients]. Transfus Clin Biol 2013; 20:476-81. [PMID: 23916574 DOI: 10.1016/j.tracli.2013.04.111] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 04/26/2013] [Indexed: 11/18/2022]
Abstract
Red cell transfusion is one of the main treatments in sickle cell disease. However there are potential risks of blood transfusions. In order to propose strategies to improve blood safety in sickle cell disease in Mali, we conducted a prospective study of 133 patients with sickle cell anemia recruited at the sickle cell disease research and control center of Bamako, November 2010 to October 2011. The study aimed to determine the prevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections by serum screening and the frequency of red cell alloimmunization before and after blood transfusion. The diagnosis of sickle cell syndrome was made by HPLC, the detection of markers of viral infection was performed by ELISA, and the diagnosis of alloimmunization was conducted by the Indirect Coombs test. Prevalence of viral infections observed at the time of enrolment of patients in the study was 1%, 3% and 1% respectively for HIV, HBV and HCV. Three cases of seroconversion after blood transfusion were detected, including one for HIV, one for HBV and one another for HCV in sickle cell anemia patients. All these patients had received blood from occasional donors. The red cell alloimmunization was observed in 4.4% of patients. All antibodies belonged to Rh system only. Blood transfusion safety in sickle cell anemia patients in Mali should be improved by the introduction of at least the technique for detecting the viral genome in the panel of screening tests and a policy of transfusions of blood units only from regular blood donors.
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Affiliation(s)
- A B Diarra
- Centre national de transfusion sanguine, BP : E-344, Bamako, Mali.
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Ly M, Antoine M, Dembélé AK, Levy P, Rodenas A, Touré BA, Badiaga Y, Dembélé BK, Bagayogo DC, Diallo YL, Koné AA, Callard P, Bernaudin JF, Diallo DA. High incidence of triple-negative tumors in sub-saharan Africa: a prospective study of breast cancer characteristics and risk factors in Malian women seen in a Bamako university hospital. Oncology 2012; 83:257-63. [PMID: 22964749 DOI: 10.1159/000341541] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 06/18/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Few studies have been conducted on breast cancer in Sub-Saharan Africa and their results have been suspected to be impaired by artefacts. This prospective study was designed to determine tumor and patient characteristics in Mali with control of each methodological step. These data are necessary to define breast cancer treatment guidelines in this country. METHODS Clinical and tumor characteristics and known risk factors were obtained in a consecutive series of 114 patients. Each technical step for the determination of tumor characteristics [histology, TNM, grade, estrogen (ER) and progesterone receptors (PR), HER2, and Ki67] was controlled. RESULTS Patients had a mean age of 46 years. Most tumors were invasive ductal carcinomas (94%), T3-T4 (90%) with positive nodes (91%), grade III (78%), and ER (61%) and PR (72%) negative. HER2 was overexpressed in 18% of cases. The triple-negative subgroup represented 46%, displaying a particularly aggressive pattern (90% grade III; 88% Ki67 >20%). CONCLUSION This study demonstrates the high incidence of aggressive triple-negative tumors in Mali. Apart from a higher prevalence of premenopausal women, no significant difference in risk factors was observed between triple-negative tumors and other tumors. The hormonal therapy systematically prescribed therefore needs to be revised in light of this study.
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Affiliation(s)
- Madani Ly
- Service d'Hématologie et d'Oncologie Médicale, Hôpital du Point G, Bamako, Mali.
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Diallo YL, Diallo DA, Dembélé AK, Cissoko LNS, Ly M, Touré BA. [A case of the association of acute lymphoblastic lymphoma with active tuberculosis in the child: a Malian case]. Mali Med 2010; 25:53-54. [PMID: 21441090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Y L Diallo
- Service d’hematologie oncologie medicale, CHU du Point G, BP, Bamako, Mali.
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