ABSTRACT
Introdução: O exame de velocidade de hemossedimentação (VHS) mede a distância em que os eritrócitos caem durante 60 minutos em um tubo vertical. Objetivo: Comparar dois métodos de realização do exame de VHS em um hospital oncológico. Material e métodos: Foram coletados, de 45 pacientes, 5mL a 6mL de sangue que foram transferidos para dois tubos com anticoagulante. O sangue de ambos os tubos foi transferido para uma pipeta de vidro com capacidade de 200mm e 2,5mm de diâmetro interno, que foi adaptada em suporte vertical, aguardando por uma hora. Os resultados foram analisados pelo programa SPSS versão 25. Resultados: O nível de sedimentação em milímetros (mm) do método referência de Westergren modificado utilizando citrato de sódio 3,2% é menor quando comparado com o método alternativo utilizando anticoagulante EDTA, com Z score: -5,29 (p = 0,01) e R = 0,79. Discussão: O International Council for Standardization in Haematology (ICSH) descreveu grandes diferenças entre os métodos de Westergren e os não baseados em Westergren. Conclusão: Sugere-se a utilização do método de Westergren modificado na realização do exame. Além disso, com a padronização do melhor método de realização do exame, gerará resultados mais confiáveis, refletindo de forma positiva na rotina hospitalar.
Introduction: The erythrocyte velocity test (ESR) the distance at which erythrocytes fall within 60 minutes in a vertical tube. Objective: to compare two methods of performing the ESR test in an oncology hospital. Material and methods: 5-6 mL of blood were collected from 45 patients transferred to two tubes with anticoagulant. The blood from both tubes was transferred to a glass pipette with a 200mm capacity and 2.5mm internal diameter, which was adapted on a vertical support, waiting for 1 hour. The results obtained by the SPSS version 25 program. Results: The level of sentiment in mm (mm) of the Westergren reference method modified using sodium citrate 3.2% is lower when compared to the alternative method using EDTA anticoagulant, with Z score: -5.29 (p = 0.01) and R = 0.79. Discussion: The International Council for Standardization in Hematology (ICSH), layouts that greatly differ between Westergren's methods and those not based on Westergren. Conclusion: It is suggested to use the modified Westergren method when performing the exam. In addition, with the standardization of the best method of conducting the exam, it will generate better known results, reflecting positively on the hospital routine.
ABSTRACT
Descrição: Relato de caso de um paciente com um transcrito raro (e1a2) na Leucemia Mieloide Crônica (LMC) e outro com uma translocação rara na Síndrome Mielodisplásica (SMD). Discussão: O transcrito e1a2 possui frequência de 1% entre os casos de LMC, já a translocação t(11,17)(q23;q21) não foi evidenciada em paciente com SMD do tipo Anemia Refratária com Excesso de Blastos (AREB) do tipo 2. Conclusão: Ambos os casos apresentados possuem associação incomum entre fenótipo e genótipo. A correlação da clínica com os achados laboratoriais é importante para a determinação fidedigna do diagnóstico e prognóstico destes pacientes.
Description: Case report of a patient with a rare transcript (e1a2) in Chronic Myeloid Leukemia (CML) and another with a rare translocation in Myelodysplastic Syndrome (SMD). Discussion: The transcript e1a2 has a frequency of 1% in CML cases, whereas t (11,17) (q23; q21) translocation was not observed in a patient with type of Refractory Anemia with Excess Blasts (AREB) type 2. Conclusion: Both cases reported have unusual association between phenotype and genotype. The correlation of the clinic with the laboratory findings is important for the reliable determination of the diagnosis and prognosis of these patients.
Subject(s)
Humans , Female , Middle Aged , Phenotype , Translocation, Genetic , Anemia, Refractory , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Leukemia , Hematologic Neoplasms , GenotypeABSTRACT
Abstract High sensitivity of qPCR assay can be compromised by the presence of PCR inhibitors in samples analyzed. The aim of this study was to analyze the RT-qPCR assay efficiency considering the RNA quality/quantity and the presence of PCR inhibitors in patients with chemotherapy and/or antibiotic therapy. We analyzed 60 samples using RT-qPCR from individuals suspected of leukemia and 44 samples were quantified by fluorimetry and spectrophotometry. The efficiency of the RT-qPCR assay was evaluated comparing the threshold cycle (Ct) from tested samples and the standard curve. The 260/280 and 260/230 ratios, the presence of PCR inhibitors and the amount of sample (ng) used in the RT-qPCR reaction can be associated with 56.8% (R²=0.56, p<0.05) in the Ct obtained. The decrease of the RT-qPCR efficiency can be explained in 42,8% due to the variation of the 260/280 ratio (R²=0.42,p<0.05). The presence of antibiotics in the blood sample can be associated in 11.3% with the variability of 260/280 ratio (R²=0.11,p<0.05). Presence of chemotherapeutic drugs in the blood sample was not correlated with Ct variation (p=0.17). The spectrophotometer determines a RNA quantification with 2.2 times higher than the fluorimeter (t=2.2, p=0,03) and this difference is correlated with the 260/280 ratio (R²=0.36, p<0.05). Samples with low purity had a reduction in the qPCR efficiency, although we did not observe false results.