Novel cell population data from a haematology analyzer can predict timing and efficiency of stem cell transplantation.

Autologous hematopoietic stem cell transplantation (AHSCT) is a necessary component for many oncohematological diseases treatment. For a successful result of AHSCT a sufficient quantity of hematopoietic stem cells (HSCs) is needed. It has been proposed that morphological changes of myeloid cells could reflect the processes of bone marrow stimulation and may provide useful information to predict the stimulation efficiency and expected outcome of CD34(+) stem cells. The Beckman Coulter Cellular Analysis System DxH800 performs Flow Cytometric Digital Morphology analysis of leukocytes. All leukocyte cellular measurements can be reported as numerical values called Cell Population Data (CPD), which are able to detect morphological changes in the cell size and distribution of neutrophils. Our findings suggest that the changes in neutrophil CPD were detectable 2-4days before the observed increase in CD34(+) count in the peripheral blood and can potentially improve the management of patients. There was also a good correlation between MN-V-NE and ImmNeIndex with the CD34(+) count suggesting they can be used as a surrogate for the CD34(+) count (r=0.67 and 0.65 p<0.005 respectively).

Outcomes after chemotherapy with WHO category II regimen in a population with high prevalence of drug resistant tuberculosis.

Standard short course chemotherapy is recommended by the World Health Organization to control tuberculosis worldwide. However, in settings with high drug resistance, first line standard regimens are linked with high treatment failure. We evaluated treatment outcomes after standardized chemotherapy with the WHO recommended category II retreatment regimen in a prison with a high prevalence of drug resistant tuberculosis (TB). A cohort of 233 culture positive TB patients was followed through smear microscopy, culture, drug susceptibility testing and DNA fingerprinting at baseline, after 3 months and at the end of treatment. Overall 172 patients (74%) became culture negative, while 43 (18%) remained positive at the end of treatment. Among those 43 cases, 58% of failures were determined to be due to treatment with an inadequate drug regimen and 42% to either an initial mixed infection or re-infection while under treatment. Overall, drug resistance amplification during treatment occurred in 3.4% of the patient cohort. This study demonstrates that treatment failure is linked to initial drug resistance, that amplification of drug resistance occurs, and that mixed infection and re-infection during standard treatment contribute to treatment failure in confined settings with high prevalence of drug resistance.