Rotational Thromboelastometry (ROTEM®) in Relation to Inflammatory Biomarkers and Clinical Outcome in COVID-19 Patients.

Background: The pathogenesis of hypercoagulability in COVID-19 patients is complex and not fully understood. Rotational thromboelastometry (ROTEM®) is a viscoelastic method that allows the definition of a patient's hemostatic profile. This study aimed to assess the relationship between ROTEM® parameters, the profile of inflammatory cytokines, and clinical outcomes in COVID-19 patients. Methods: A total of 63 participants (n = 29 symptomatic non-ICU COVID-19 patients, and n = 34 healthy controls) were prospectively included in the study. We assessed the relationship between the parameters of three ROTEM® tests (NATEM®, EXTEM®, and FIBTEM®) and levels of CRP, interleukin-8, interleukin-1ß, interleukin-6, interleukin-10, tumor necrosis factor, interleukin 12p70, and clinical outcomes. Results: ROTEM® indicated hypercoagulability in COVID-19 patients in all the tests performed. The levels of all inflammatory cytokines were significantly higher in COVID-19 patients. NATEM more frequently detected hypercoagulability in COVID-19 patients compared to EXTEM. The strongest correlations with inflammatory biomarkers and CT severity score were with FIBTEM parameters. The elevated maximum clot elasticity (MCE) in FIBTEM was the strongest predictor of poor outcomes. Conclusions: Increased FIBTEM MCE may be associated with greater severity of COVID-19. Non-activated ROTEM (NATEM test) seems to be more valuable for detecting hypercoagulability in COVID-19 patients compared to the tissue factor activated test (EXTEM).

Flow-cytometry-based evaluation of peripheral blood lymphocytes in prognostication of newly diagnosed DLBCL patients.

AIMS: We aimed to analyse whether quantitative assessment of peripheral blood lymphocyte CD19(+)CD20(+)CD22(+)CD79a(+) B cells, CD3(+)CD4(+)CD5(+)CD8(+) T cells and CD4(+)CD25(+++)Foxp3high Treg can improve prognostication in DLBCL patients. METHODS: The absolute count of lymphocytes, B-cells, T-cells and Treg-cells as well as the percentage of apoptotic cells were assessed by means of flow cytometry in all studied subjects. RESULTS: Significantly lower level of ALC and the percentage of apoptotic cells have been observed exclusively in DLBCL patients with HR. We also showed, that in comparison with LR, in HR and MR groups, there is a significant decrease in the absolute number of T-cells and Tregs. The applied treatment does no normalize the number of B-cells, Tregs and apoptotic cells only in the case of HR patients. CONCLUSIONS: Lymphopenia, the decreased absolute number of T cells, Tregs, and a percentage of apoptotic cells, correlates with clinical staging in DLBCL patients. The increased number of B cells and the decreased level of Tregs and apoptotic cells after treatment might predict a poor clinical outcome in patients treated with RCHOP. Thereby, flow-cytometry-based evaluation of peripheral blood lymphocytes may be useful in prognostication of newly diagnosed DLBCL patients.

Utility of laboratory tests in B-CLL patients in different clinical stages.

The study objective was to analyse the utility of laboratory tests performed in 30 patients with B-cell chronic lymphocytic leukaemia (B-CLL) at different clinical stages. Laboratory tests included automated and microscopic assessment of peripheral blood and bone marrow counts as well as evaluation of leukaemic cells. Apart from the diagnostic and prognostic value of laboratory abnormalities such as clonal lymphocytosis with CD5+CD19+CD23+ phenotype, reduced erythrocyte parameters, thrombocytopenia or bone marrow infiltration by the neoplastic clone as well as low percentage of Gumprecht's shadows, low apoptotic activity of peripheral blood lymphocytes, and increased percentage of CD38- and ZAP-70 ± cells markedly correlate with the stage of disease progression. These results seem to confirm the diagnostic and prognostic significance of these parameters determined in routine laboratory tests in B-CLL patients.

[Parameters of platelets activation and myeloperoxidase concentration as markers of coronary disease]. / Parametry aktywacji plytek krwi i stezenie mieloperoksydazy, jako markery choroby niedokrwiennej serca.

Ischemic heart disease is mainly caused by atherosclerosis and its complications. Platelets have important role in initiation of atherosclerotic lesions. Increase platelet activation and aggregation within coronary circulation initiate thrombus formation at a ruptured or eroded plaque. Large platelets are enzymatically and metabolically more active and have a higher potential thrombosis ability than smaller one. There is growing evidence that myocardial cell injury not only is related to platelet activation of neutrophils (PMNs). PMNs have been demonstrated to release myeloperoxidase (MPO) into coronary circulation. MPO promotes destabilization and rupture of the atherosclerotic plaque surface, impairing vasodilatory and anti-inflammatory function.