Zinat Yazdani, Iman Baluchi, Behjat Kalantary Khandany, Gholamhosein Hassanshahi,
Volume 15, Issue 2 (3-2021)
Abstract
Background and objectives: Acute myeloid leukemia (AML) is a heterogeneous malignancy caused by various pathological mechanisms. Chemokines are involved in the initiation, progression, migration, survival, treatment and complications of AML. CXCL1 has an indirect effect on the progression of cancer and CXCL10 produced by leukemia cells attracts natural killer cells toward tumor sites to eradicate cancer cells. The present study investigated effects of chemotherapy on serum levels of CXCL1 and CXCL10 in patients with AML.
Methods: Throughout this case-control study, blood samples were collected from AML patients with M4/M5 subtype (n=25) before and after the first stage of a chemotherapy regimen (7+3). Serum levels of the chemokines were determined using commercial ELISA kits. Data were analyzed using two-sample and paired T-test in SPSS 22 software.
Results: The level of CXCL10 was high in patients but decreased following chemotherapy. After the chemotherapy the patients attained partial remission. However, the level of CXCL1 did not change in the patients.
Conclusion: Although chemotherapy could decrease CXCL10 levels and induce partial remission, CXCL1 levels does not change in AML patients with M4/M5 subtype. Based on the results, the employment of CXCL1 and CXCL10 inhibitors in the chemotherapy regimen could prevent relapse in the later stages or even reduce the duration of treatment.
Bahar Yazdani, Hussein Anani, Iman Baluchi, Behjat Kalantary Khandany, Gholamhossein Hassanshahi,
Volume 15, Issue 4 (7-2021)
Abstract
Background and objectives: Acute myeloid leukemia (AML) is a malignancy that involves the bone marrow and peripheral blood. Some chemokines play a role in the progression, migration and tumor initiation and are therefore associated with poor prognosis. CCL2 promotes tumor growth and is associated with poor prognosis in AML patients. We investigated effects of chemotherapy on serum level of CCL2 in AML patients.
Methods: Throughout this case-control study, blood samples were collected from 25 healthy individuals and 25 AML (M4 and M5) patients before and after the first stage of the current chemotherapy regimen (7+3). Serum level of CCL2 was measured using commercial ELISA kits. Data were analyzed in SPSS 22 using the two-sample t-test and paired t-test.
Results: Before chemotherapy, serum level of CCL2 was significantly higher in the patients than in the healthy controls. Following chemotherapy, the serum level of CCL2 reduced significantly to a level comparable to that of the healthy controls.
Conclusion: The current chemotherapy (7+3) can effectively inhibit CCL2 in AML patients.
Aya Chakroun, Hela Baccouche, Sonia Mahjoub, Neila Ben Romdhane,
Volume 15, Issue 6 (11-2021)
Abstract
Background and objectives: Differential diagnosis between clonal lymphocytosis (CL) and reactive lymphocytosis (RL) is often established through blood smear examination but with some limitations. We aimed to evaluate ability of clinical data and extended-cells blood count (CBC) parameters to discriminate CL from RL and to establish a decision-making algorithm for moderate lymphocytosis in adults.
Methods: A total of 85 samples were collected from adults with absolute lymphocytescount of >5G/l. The samples were divided into RL group (n=34) and newly diagnosed CL group (n=51).Demographic data, CBC parameters including high fluorescence lymphocytes cells percentage (HFLC%) and abnormal lymphocytes or blasts (’AbnLym/BL’’) morphological flag were evaluated for each study group. New threshold for discriminating parameters were determined using receiver operating characteristic (ROC) curves and used in an algorithm for moderate lymphocytosis.
Results: Age, high lymphocytes count and the presence of the ’AbnLym/BL’’ flag and low HFLC% were predictor of malignant lymphocytosis. Age threshold of 62.5 years and absolute lymphocytes count of > 10.47 G/l were highly effective in CL detection with area under the ROC curve of 0.9 and 0.99, respectively. In addition, HFLC% showed an area under the ROC curve of 0.71. Considering ALC threshold of 10.47 G/l alone, a sensitivity of 96.7% and a specificity of 100 % were achieved. For moderate lymphocytosis ranging between 5 and 10.47G/l, no false positive or negative result was detected when we considered both the proposed ALC and age cut-offs.
Conclusion: A combination threshold for ALC and age appears to be helpful for screening CL, especially in moderate lymphocytosis for both laboratory and clinical routine practice.
Harsha Jaykar, Mangala Nagare, Gauri Bhat,
Volume 16, Issue 6 (11-2022)
Abstract
Background and objectives: Coronavirus disease 2019 (COVID-19) is a communicable disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The clinical manifestations of COVID-19 vary from asymptomatic to acute respiratory distress syndrome. In severely-ill patients, neutrophil count is significantly increased. This study aimed to evaluate absolute neutrophil count (ANC) in patients with COVID-19 and healthy individuals.
Methods: This retrospective, cross-sectional study was carried out on patients admitted to the outpatient department of OBGY Rural Hospital (Maharashtra, India) from April 2021 to June 2021. A peripheral venous blood sample (3 ml) was taken from 143 patients with COVID-19 and 143 healthy controls. The blood samples were analyzed using a fully automated blood cell counter for the estimation of complete blood count. A peripheral blood smear was prepared and stained with Leishman stain for evaluation of morphological changes.
Results: The ANC of COVID-19 patients was significantly higher than that of healthy control subjects (p=0.00001). Toxic granules (48.9%) were the most common morphological neutrophil abnormality, followed by hypolobation, hypogranulation, Pseudo-Pelger-Huet anomaly (20.9%), and shift to left with the presence of immature myeloid series cells.
Conclusion: High ANC along with morphological changes in neutrophils could be used as a simple and inexpensive surrogate marker of COVID-19 and its severity.
Sepideh Shakeri, Narjes Soltani, Mohammad Reza Javan, Mehrnaz Abdolalian, Hossein Ayatollahi, Seyyede Fatemeh Shams,
Volume 17, Issue 1 (1-2023)
Abstract
Background and objectives: Fanconi anemia (FA) is an autosomal recessive disorder that usually manifest in forms of pancytopenia, hyperpigmentation, and skeletal complications. Mutation in the DNA repair regulatory genes is associated with the development of FA. Examination of chromosomal breakages when chromosomes are exposed to cross-linking agents is a common method of FA diagnosis. This study aimed to evaluate the prevalence and characteristics of patients with FA in Mashhad, northeast of Iran.
Methods: In this study, we evaluated 312 suspected FA patients who had been referred to the laboratory of Ghaem Hospital during 2014-2020. The mitomycin C method was used to identify FA-positive subjects.
Results: After the examinations, 84 patients (26.9%) were cytogenetically positive for FA. Of 84 patients, 48 (57.1%) were male and 36 (42.9%) were female. Thumb abnormality was the most common congenital anomaly (43.2%).
Conclusion: Based on the findings, males are more susceptible to FA, and thumb abnormality is the most common congenital anomaly associated with FA. Combination of clinical manifestations and genetic susceptibility in patients may contribute to a more accurate diagnosis.
Alireza Sobhani, Hakimeh S. Sajjadi, Touba Abbasi,
Volume 17, Issue 4 (7-2023)
Abstract
Alireza Sobhani1 
,
Hakimeh S. Sajjadi 2,
Touba Abbasi1
Lymphangioma circumscriptum is a rare congenital proliferation of lymphatic vessels that may occur anywhere on the skin and mucous membranes. Based on the depth and the size of abnormal lymph vessels, these lesions are divided into two groups: the superficial vesicles are called lymphangioma circumscriptum and the more deep-seated group includes cavernous lymphangioma, cystic hygroma, and benign lymphangioendothelioma. The differential diagnosis of lymphangioma includes herpes zoster, herpes simplex, molluscum contagiosum, cutaneous melanoma, dermatitis herpetiformis, and viral warts. Herein, we report a rare case of giant cutaneous lymphangioma circumscriptum with emphasis on histopathology and differential diagnosis. Our case was a 14-year-old boy with a history of multiple, clear, pink, red, and brown vesicles protruded as a patch of wart-like growths on the flank’s skin since the 6 months of age. Histopathologic examination indicated presence of multiple thin-walled dilated lymphatic spaces in the papillary dermis lined with a single layer of endothelial cells filled with finely granular hyaline material.
Ebrahim Mohammed Abed Ahamid Ahmed, Babker Ahmed Mohamed , Bakri Yousf Mohamed Nour, Babiker Saad Almugadam ,
Volume 18, Issue 4 (7-2024)
Abstract
Background: Acute ischemic stroke occurs when blood clots obstruct blood vessels within the brain. Platelets (Plts) are integral to the pathophysiology of stroke. This research aimed to explore the relationship between Plt quality and Plt indices in the context of acute ischemic stroke.
Methods: This cross-sectional investigation involved 100 patients diagnosed with acute ischemic stroke at Kosti Teaching Hospital and Alyammama Hospitals. The diagnosis was confirmed using brain CT imaging and electrocardiography (ECG). Blood samples were collected in EDTA-containing tubes within 24 hours following the commencement of treatment and were subsequently analyzed for Plt count, mean Plt volume (MPV), Plt distribution width (PDW), and plateletcrit (PCT) utilizing a hematological analyzer. Data were analyzed using GraphPad Prism software.
Results: Platelet counts negatively correlated with PDW [r=-0.074, P=0.459; R=-0.023, P=0.815], MPV [r=-0.130, P=0.194; R=-0.081, P=0.417], and diastolic blood pressure [r= -0.023, P=0.818; R= -0.024, P=0.805]; and positively correlated with PCT [r= 0.103, P=0.308; R=0.143, P=0.155] and diastolic blood pressure [r=0.022, P=0.823; R= 0.008, P=0.932]. Moreover, PDW positively correlated with systolic blood pressure [r=0.105, P=0.298; R= 0.147, P=0.148] and diastolic blood pressure [r=0.146, P=0.145; R=0.173, P=0.084]. Based on Spearman but not Pearson correlation, PDW showed a negative correlation with PCT [r=-0.005, P=0.959; R=0.010, P=0.929].
Conclusion: The study shows a correlation between Plt count and indices in ischemic stroke patients. The research also presented evidence concerning the relationship between diastolic and systolic blood pressure and Plt counts and indices.
Abazar Yari , Morteza Ahmadi , Mahdieh Mehrpouri ,
Volume 18, Issue 5 (9-2024)
Abstract
Background: Thyroid hormones play a critical role in hematopoiesis, and thyroid disorders such as hypothyroidism and hyperthyroidism can affect blood parameters. Therefore, this study aimed to evaluate the effect of thyroid dysfunction on various blood parameters.
Methods: This case-control study included 194 subjects who were classified into three groups based on TSH levels: hypothyroid (n=70), hyperthyroid (n=56), and control (n=68). Conditions that affect blood parameters, including pregnancy, inherited or acquired red blood cell abnormalities, chronic inflammatory diseases, evidence of nutritional deficiencies, and underlying diseases such as cancer, as well as patients unwilling to participate in the study, were excluded. Hematological parameters were measured using a cell counter, and the results were analyzed using SPSS software.
Results: The results showed that 78% of the participants were female and 22% were male, aged 4 to 89 years. The analyses revealed that RBC, Hb, HCT, WBC count, and WBC differential count were significantly different between the three groups (P-value <0.05), but the differences were not significant for MCV, MCH, MCHC, RDW, PLT, and MPV (P-value >0.05). Correlation analysis indicated a significant correlation between TSH and Hb, HCT, WBC, PLT, neutrophils, lymphocytes, monocytes, and eosinophils (P<0.05).
Conclusion: Since thyroid hormones play a critical role in hematopoiesis, thyroid dysfunction can affect many hematological parameters. Therefore, the management of patients with thyroid disease should include the CBC test. In addition, patients with poor responses to anemia treatment may have an underlying thyroid disorder.
Aradhana Harrison , Aswathy Prabha , Karishma Krishna , Vejay Viknesh Marudhadurai , Jahnavi Chikkegowda, Rajshree Choudhary ,
Volume 18, Issue 5 (9-2024)
Abstract
Background: β-thalassemia trait (BTT) can be screened by several discriminator indices (DIs) using complete blood counts (CBC). These DIs can help differentiate BTT from other causes of anaemia, thus reducing the financial burden of laboratory testing. At standard cut-off values, statistical analyses traditionally used to compare the diagnostic competence of these DIs give variable results. This study establishes new optimal cut-off values to improve the applicability of these DIs for BTT screening.
Methods: This was a retrospective study conducted on anaemic adults whose high-performance liquid chromatography (HPLC) and CBC results achieved over the past 6 months were reviewed. Based on HPLC reports, patients were categorised into BTT and non-BTT groups, with each group comprising 25 age- and sex-matched patients. Discriminator indices, including Mentzer’s Index (MI), Green and King Index (GKI), Sehgal Index (SI), Shine and Lal Index (SLI), Srivastava Index (SrI), and England and Fraser Index (EFI), were calculated for both groups. Statistical analysis was performed respective to standard cut-off values to establish new optimal cut-off values with the highest sensitivity and specificity.
Results: According to the results, SrI emerged as the best index, offering high sensitivity, specificity, Youden’s Index, accuracy, and odds ratio. On the other side, SLI and GKI were observed to be poor indices with low sensitivity and specificity. The new optimal cut-off values for the best performance of each DI for BTT screening were as follows: SrI ≤3.5, MI ≤11.4, GKI ≤59.7, SI ≤709.4, SLI ≤941.1, and EFI ≤1.91.
Conclusion: The performance of DIs at standard cut-off values was poor to screen BTT. New optimal cut-off values provided maximal sensitivity and specificity thereby enhancing their performance as screening parameters for BTT in regions with a high-prevalence of the condition. Further studies are warranted to substantiate the new cut-off values for BTT screening.
Joseph Ki , Mohan Kumar , Kanagasabapathy Sivagami , Jeevithan Shanmugam , Periasamy Aparnavi ,
Volume 18, Issue 6 (11-2024)
Abstract
Background: The ABO and Rh blood group systems have been associated with variations in disease susceptibility. This study aimed to assess the variability in blood parameters, including red cell parameters and metabolic parameters (Renal function, hepatic function, blood glucose, lipid profile, and thyroid function), by ABO and Rh blood grouping systems.
Methods: A secondary data analysis was conducted among patients who underwent a preventive health check-up at a private tertiary care hospital in Coimbatore, India. The laboratory database contained records of 62,808 adult participants who reported for master health check-ups between January 2017 and February 2024. Among these patients, those who reported for the first time were included.
Results: Blood grouping and typing data were available for 50,368 and 56,155 participants, respectively, with a mean age range of 52.6 to 53.0 years across all blood groups. The most prevalent blood group was O, followed by B, A, and AB, with a similar distribution across genders. The mean hemoglobin level was highest in the B group (13.7 ± 13.9 g/dl). MCH and MCV values were elevated in the A and O groups, while MCHC and ESR were higher in the B and AB groups. Renal and liver parameters mostly did not vary by blood group or Rh type, except for elevated urea levels in the A group and higher ALP levels in the O and Rh-positive groups. LDL and total cholesterol were highest in the A group, while HDL was highest in the AB group.
Conclusion: The results underscore the importance of considering blood group variations when interpreting blood parameters in clinical practice.
Zahra Eslami , Shayan Marhamaty, Seyyed Mehdi Jafari , Mohadese Khorasani , Mehdi Sheikh Arabi , Hamidreza Joshaghani ,
Volume 19, Issue 1 (1-2025)
Abstract
Background: Bivalent minerals function as crucial cofactors that participate in a multitude of metabolic pathways within the organism. Specifically, zinc (Zn) assumes catalytic, structural, and regulatory roles in numerous biological processes. A severe deficiency in Zn can lead to disruptions in nucleic acid and protein synthesis, impaired cellular proliferation, increased apoptosis, and heightened lipid peroxidation of cellular membranes, a phenomenon associated with a reduced lifespan of red blood cells (RBCs). The objective of this study was to investigate the correlations between Zn status and various erythrocyte indices in a cohort of anemic patients, in comparison to a control group.
Methods: A cohort of 563 participants was enrolled in this investigation. Serum Zn concentration was quantified using a BT-3500 autoanalyzer, while hematological indices were determined via a Sysmex KX21N cell counter. Following confirmation of data normality, Spearman's rank correlation coefficient was employed to analyze the relationship between serum Zn levels and RBC indices.
Results: The mean serum Zn concentration was 102.8 ± 17.6 mg/dL. Serum Zn levels exhibited a weak correlation with RBC and hemoglobin (Hb) concentrations in healthy women, as well as a weak correlation with mean corpuscular hemoglobin concentration (MCHC) in anemic men (p < 0.05). Furthermore, the results indicated significantly higher serum Zn levels, RBC, Hb, hematocrite (HCT), and MCHC in men (p < 0.01), while mean corpuscular volume (MCV) was significantly higher in women (p < 0.01). Notably, in individuals with serum Zn levels < 30 mg/dL, MCHC (p < 0.01) and RBC (p < 0.05) were elevated, whereas Hb (p < 0.05), HCT, MCV, and MCH (p < 0.01) were higher than 30.
Conclusion: Considering the potential impact of varying Zn concentrations on erythrocyte indices, including Hb and MCHC, in both healthy and anemic individuals, careful regulation of its dosage is warranted.
Saeid Anvari , Setare Kheyrandish , Fatemeh Sotudeh , Hossein Mirpour Hasankiadeh , Korosh Khanaki , Esmaeil Shahabi Satlsar,
Volume 19, Issue 2 (3-2025)
Abstract
Chronic basophilic leukemia (CBL) is a rare disorder and according to the published data, few cases have been reported as primary CBL. Morphologic findings in CBL mostly mimic chronic eosinophilic leukemia and basophils have unusual and dysplastic morphology. A 47-year-old patient was referred to the hospital with gastrointestinal symptoms and bloating. Complete blood count (CBC) showed leukocytosis and marked eosinophilia. After evaluating the peripheral blood smear (PBS), abnormal leukocytes with hypersegmented nuclei along with an increase in eosinophils were observed. For further investigation, the patient was referred to the hematology clinic and underwent bone marrow aspiration and biopsy. After the morphological examination, flow cytometry was performed on the aspiration sample to accurately diagnose the disease. Flow cytometric findings were in favor of CBL. Since morphological findings are unreliable for basophil detection and definite diagnosis, flow cytometry is a reliable method for the precise detection of basophils, especially in CBL.
Dr. Eliz Thomas, Dr. Nidhya Ganesan, Dr. Lawanya Gunaseelan, Dr. Subbarao Tadury,
Volume 19, Issue 2 (3-2025)
Abstract
Objective: To analyse the haematological parameters in pregnant women who are COVID-positive in a tertiary care hospital and to observe if there is an association between the findings and disease severity.
Methods: This was a retrospective study which included 64 COVID-positive pregnant patients who were admitted in our hospital, under obstetrics department, in the study period. The haematological parameters of these women during the third trimester were assessed and the outcome of the pregnancy was recorded.
Results: Among 64 COVID-positive pregnant women, 14 complained of the usual symptoms like fever, cough or headache. 1 complained of increased breathlessness. After haematological work-up, 46 (72%) patients were recorded to have anemia and 38 (59%) showed leukocytosis. Neutrophilia was seen in 34 patients. The platelet count was within normal limits for all. 49 of them underwent caesarean section for various reasons; most common reason being previous caesarean section. 62 deliveries were done at term. Only one of the babies delivered had anemia at birth. The 1 and 5 minutes APGAR scores recorded for all the babies were 7 to 9. 15 babies delivered underwent RT-PCR testing and were found to be negative.
Conclusion: The laboratory parameters most commonly seen amongst the COVID-19 pregnant women were anemia, leukocytosis and neutrophilia, which is comparable to the physiologic changes in pregnancy. There was no adverse outcome observed in any of the pregnancies and all the fetuses were normal. There was no incidence of vertical transmission of the virus amongst the tested neonates.
Zeinab Siahmargoie , Mohammad Taher Hojjati , Hadi Bazzazi , Khodaberdi Kalavi , Mana Zakeri , Hadi Joshaghani ,
Volume 19, Issue 2 (3-2025)
Abstract
Background: Polycythemia Vera (PV) is a myeloproliferative neoplasm (MPN) characterized by the overactivity of erythroid progenitors, leading to excessive red blood cell (RBC) production. More than 90% of PV cases harbor a Janus kinase 2 (JAK2) gene mutation. This study aimed to assess the prevalence of JAK2 mutations in individuals with elevated hemoglobin (Hb) levels referred to the laboratory by physicians.
Methods: In this descriptive cross-sectional study, genomic DNA from 72 patients was analyzed for JAK2 mutations using a TaqMan-specific probe.
Results: Of the 72 patients, 24 (33.3%) were women and 48 (66.6%) were men. JAK2 mutations were detected in 33 cases (45.5%), while 39 (54.2%) were negative. Notably, 15 of 24 female patients (62.5%) tested positive for the JAK2 mutation, compared to 18 of 48 male patients (37.5%).
Conclusion: Our findings suggest that screening for JAK2 mutations is particularly important in women with above-normal Hb levels.
