The prognostic impact of lymphocyte subsets in newly diagnosed acute myeloid leukemia

BACKGROUND: Tumor-infiltrating lymphocytes, which form a part of the host immune system, affect the development and progression of cancer. This study investigated whether subsets of lymphocytes reflecting host-tumor immunologic interactions are related to the prognosis of patients with acute myeloid leukemia (AML). METHODS: Lymphocyte subsets in the peripheral blood of 88 patients who were newly diagnosed with AML were analyzed by quantitative flow cytometry. The relationships of lymphocyte subsets with AML subtypes, genetic risk, and clinical courses were analyzed. RESULTS: The percentages of T and NK cells differed between patients with acute promyelocytic leukemia (APL) and those with AML with myelodysplasia-related changes. In non-APL, a high proportion of NK cells (>16.6%) was associated with a higher rate of death before remission (P=0.0438), whereas a low proportion of NK cells (≤9.4%) was associated with higher rates of adverse genetic abnormalities (P=0.0244) and relapse (P=0.0567). A multivariate analysis showed that the lymphocyte subsets were not independent predictors of survival. CONCLUSION: Lymphocyte subsets at diagnosis differ between patients with different specific subtypes of AML. A low proportion of NK cells is associated with adverse genetic abnormalities, whereas a high proportion is related to death before remission. However, the proportion of NK cells may not show independent correlations with survival.

Platelet Activation Markers (beta-thromboglobulin and platelet factor 4) and Clopidogrel Drug Response in Patients with Myocardiac Infarction

BACKGROUND: Dual antiplatelet therapy (aspirin and clopidogrel) is used to prevent adverse cardiac events in patients undergoing percutaneous coronary intervention (PCI). Some patients do not respond adequately to clopidogrel. Beta-thromboglobulin (beta-TG) and platelet factor 4 (PF-4) can act as markers to detect platelet activation. We investigated the relationship between clopidogrel response and the dynamics of beta-TG and PF4 concentrations. METHODS: This study included 36 myocardial infarction (MI) patients, who underwent PCI and was indicated for dual antiplatelet therapy. Platelet reactivity, using the VerifyNow P2Y12 assay, was measured on the 3rd day of PCI. At the time of admission, and on the 3rd and 10th day of PCI, the plasma beta-TG and PF4 concentrations were quantified. RESULTS: Ten patients (27.8%) were clopidogrel non-responders displaying >208 P2Y12 reaction units. At the time of admission, levels of beta-TG in patients were elevated than that in the healthy controls (P<0.001). A similar trend was observed on the 3rd and 10th day of PCI (P<0.001). The beta-TG levels on the 10th day were reduced than those at the time of admission and on the 3rd day of PCI. PF4 levels were not different between patients and controls, and were not significantly reduced after PCI. Higher beta-TG levels were observed in clopidogrel non-responders on the 10th day, but not significant. CONCLUSIONS: Clopidogrel therapy in MI reduce beta-TG concentration, but the beta-TG and PF4 levels before and after therapy are not associated with the response to clopidogrel. Platelet-derived markers may not be suitable for distinguishing clopidogrel non-responders.

Quantitation of T-lymphocyte Subsets Using the CELL-DYN Sapphire Automated Haematology Analyser / 임상검사와정도관리

BACKGROUND: Quantitative analysis of T-lymphocyte subsets is used to assess immune competency. Traditionally, T-lymphocyte subset analysis has been performed using flow cytometry, which requires complex instrumentation and relatively skilled manual operation. We evaluated the performance of an automated haematology analyser, the CELL-DYN Sapphire (CD Sapphire; Abbott Laboratories, USA) for T-lymphocyte subset analysis. METHODS: The precision and linearity obtained using the CD Sapphire was evaluated. T-lymphocyte subsets in blood samples from 120 patients were quantified using CD Sapphire and flow cytometry (Cytomics FC 500; Beckman-Coulter, France). The time required for complete T cell subset analysis using both methods was also evaluated. RESULTS: Results of CD Sapphire-based quantitation of CD3+, CD3+CD4+, and CD3+CD8+ cells showed intra-assay CV of less than 5% for precision and displayed linearity in the ranges of 84 to 5364, 41 to 2615, and 44 to 2800 cells/microL, respectively. There was good correlation among the CD3+, CD3+CD4+, and CD3+CD8+ cell counts as well as in the CD4/CD8 ratio (r=0.987, 0.982, 0.982, and 0.980, respectively) using CD Sapphire and flow cytometry. The mean turnaround time for the CD Sapphire (10.0+/-0.5 minutes) was significantly less than that for flow cytometry (111.8+/-8.4 minutes, P<0.001). CONCLUSIONS: T cell subset analysis using the CD Sapphire gives excellent performance and consistent results that correlate well with those obtained by flow cytometry. We conclude that this time-efficient method can replace conventional flow cytometric methods used for measuring T cell subsets.

Elevated Levels of T Helper 17 Cells Are Associated with Disease Activity in Patients with Rheumatoid Arthritis

BACKGROUND: Interleukin-17 (IL-17)-producing T helper (Th) 17 cells are considered as a new subset of cells critical to the development of rheumatoid arthritis (RA). We aimed to investigate the distribution of Th1 and Th17 cells and their association with disease activity, and determine the Th17-related cytokine levels in the peripheral blood of RA patients. METHODS: Peripheral blood mononuclear cells from 55 RA and 20 osteoarthritis (OA) patients were stimulated with mitogen, and the distributions of CD4+Interferon (INF)+IL-17- (Th1 cells) and CD4+INF-IL-17+ (Th17 cells) were examined by flow cytometry. Serum levels of IL-6, IL-17, IL-21, IL-23, and tumor necrosis factor (TNF)-alpha were measured by ELISA. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were recorded. The 28-joint disease activity score (DAS28) was also assessed. RESULTS: The median percentage of Th17 cells was higher in RA patients than in OA patients (P=0.04), and in active than in inactive RA (P=0.03), whereas that of Th1 cells was similar in both groups. Similarly, the levels of IL-17, IL-21, and IL-23 were detected in a significantly higher proportion of RA patients than OA patients and the frequencies of detectable IL-6, IL-17, and IL-21 were higher in active RA than in inactive RA group. The percentage of Th17 cells positively correlated with the DAS28, ESR, and CRP levels. CONCLUSIONS: These observations suggest that Th17 cells and Th17-related cytokines play an important role in RA pathogenesis and that the level of Th17 cells in peripheral blood is associated with disease activity in RA.

Evaluation of IH-1000 for Automated ABO-Rh Typing and Irregular Antibody Screening / 대한수혈학회지

BACKGROUND: Despite modern advances in laboratory automated medicine, work-process in the blood bank is still handled manually. Several automated immunohematological instruments have been developed and are available in the market. The IH-1000 (Bio-Rad Laboratories, Hercules, CA, USA), a fully automated instrument for immunohematology, was recently introduced. In this study, we evaluated the performance of the IH-1000 for ABO/Rh typing and irregular antibody screening. METHODS: In October 2011, a total of 373 blood samples for ABO/Rh typing and 303 cases for unexpected antibody screening were collected. The IH-1000 was compared to the manual tube and slide methods for ABO/Rh typing and to the microcolumn agglutination method (DiaMed-ID system) for antibody screening. RESULTS: For ABO/Rh typing, concordance rate was 100%. For unexpected antibody screening, positive results for both column agglutination and IH-1000 were observed in 10 cases (four cases of anti-E and c, three of anti-E, one of anti-D, one of anti-M, and one of anti-Xg) and negative results for both were observed in 289 cases. The concordance rate between IH-1000 and column agglutination was 98.7%. Sensitivity and specificity were 90.9% and 99.3%, respectively. CONCLUSION: The automated IH-1000 showed good correlation with the manual tube and slide methods and the microcolumn agglutination method for ABO-RhD typing and irregular antibody screening. The IH-1000 can be used for routine pre-transfusion testing in the blood bank.

Leukemic conversion from bone marrow necrosis / 대한혈액학회지

No abstract available.