Comparison of clinical outcomes of several risk stratification tools in newly diagnosed AML patients: A real-world evidence in our current therapeutic era.

BACKGROUND OF THE STUDY: AML classification tools have been developed to stratify the risk at AML diagnosis. There is a need to evaluate these tools in the current therapeutic era. COHORT CHARACTERISTICS: In this retrospective study, we compared five classifiers: ELN 2017, ELN 2022, ALFA classifier, Papaemmanuil et al. classifier, and Lindsley et al. classifier, in a real-life cohort of 281 patients newly diagnosed for AML in Nice University Hospital. In our cohort median age was 68 years old, sex ratio was M/F 56%/44%, performance status was lower than 2 in 73.1% of patients, AML subtype was "De novo" in 71.5%, "secondary" in 22.4%, and "therapy-related" in 6.0% of patients. Intensive chemotherapy was used in 53.0% of patients, and non-intensive chemotherapy in 40.6% of patients. Molecular analysis was available in a large majority of patients and the main mutations found were NPM1 (22.7%), DNMT3A (17.4%), TP53 (13.1%), TET2 (12.4%), and FLT3-ITD (12.4%). RESULTS: In our findings, the comparison of overall survival between the three prognostic groups in the global cohort was statistically significant in all classifiers: ELN 2017 p < 0.0001, ELN 2022 p < 0.0001, ALFA classifier p < 0.0001, Papaemmanuil classifier p < 0.0001, Lindsley classifier p = 0.001. ELN 2017, ELN 2022, ALFA classifier, Papaemmanuil classifier, and Lindsley classifier were calculated respectively in 99%, 99%, 89%, 90%, and 89% of patients. CONCLUSIONS: Using Akaike's information criteria (AIC) to compare all five classifiers, ELN 2022 is the best classifier into younger and older patients and for prognosis.

[Erythrocytic parameters Sysmex in a case of severe haemolysis]. / Utilisation des paramètres érythrocytaires Sysmex dans un cas d'hémolyse sévère.

We are reporting a case of severe haemolytic anemia with cold agglutinins which combines several spurious determinations. It shows the usefulness of the new erythrocytic parameters of the XE 5000 Sysmex, specially: red blood cells with optical count (RBC-O), GR-He (intra-erythocytic hemoglobin) and R-MFV (most frequent volume). Optical red blood cells act as a substitute for red cells count instead of impedance red cells and R-MFV as a substitute for MCV (mean cell volume). The hematocrit (HCT) is corrected thanks to the following formula: HCT=(RBC-O X R- MFV)/1000. Free plasmatic hemoglobin is included in the measure of hemoglobin by the analyzer but is not available for tissue oxygenation. So, hemoglobin (HGB) has to be corrected by the means of GR- He thanks to the following formula: HGB=(GR He x RBC-O)/10.

Evaluation of the Sysmex Xe-2100 hematology analyzer in hospital use.

The Sysmex XE-2100 (Sysmex Corp. Kobe, Japan) is a latest-generation hematology analyzer. Its optical and electrical measuring technology is improved by the addition of flux cytometry, fluorescence, and differential lysis. Its analytical performance in terms of precision, reproducibility, linearity, carryover, and time stability was found to be entirely satisfactory. In addition, the results of 500 complete blood counts and differentials correlated perfectly with those obtained by the Coulter STKS (Beckman Coulter, Villapointe, France). The comparison of 500 leukocyte differential count results analyzed in parallel with optical microscopy and the XE-2100 were surprising, and favorable to the XE-2100. This analyzer provides the user with an undeniable feeling of security concerning its reliability in detecting and identifying anomalies in the automated leukocyte differential count. With a sensitivity of 96%, a negative predictive value (NPV) of 98%, and a false-negative (FN) rate of 4%, the XE-2100 has perhaps reached the technological limits for a machine performing morphological recognition of normal and pathological blood cells.

Coexpression of endothelial markers and CD14 by cytokine mobilized CD34+ cells under angiogenic stimulation.

OBJECTIVE: A subset of adult peripheral blood leukocytes functions as endothelial progenitor cells that incorporate into the vasculature in animal models of neovascularization. The basic mechanisms by which differentiation proceeds are still unclear. This study analyses the in vitro differentiation of cytokine mobilized, human CD34(+) cells. METHODS: Granulocyte-monocyte colony stimulating factor mobilized human CD34(+) cells were isolated and grown in culture in the presence of vascular endothelial growth factor (50 ng/ml) and basic fibroblast growth factor (10 ng/ml). Their differentiation was followed using cytological and immunohistochemical techniques. Fibronectin-coated culture dishes or three-dimensional cultures were used. RESULTS: CD34(+) cells grown on fibronectin-coated dishes differentiated along the granulocytic and monocytic/macrophage lineages with no evidence for an endothelial cell differentiation. CD14(+) macrophages appeared in long-term culture and then acquired endothelial cell markers such as VE-cadherin, the endothelial form of NO synthase and the von Willebrand factor. Yet they were unable to form tubular structures in Matrigel. Only typical macrophages were observed in Matrigel. CONCLUSION: Angiogenic stimulation of CD34(+) precursor cells leads to cells that expressed mixed macrophage and endothelial cell properties. They could represent an intermediate phenotype in the pathway that leads to mature endothelial cells.