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"Hematology methods."
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Effects of probiotic supplementation over 5 months on routine haematology and clinical chemistry measures in healthy active adults
Use of probiotic-containing foods and probiotic supplements is increasing; however, few studies document safety and tolerability in conjunction with defined clinical end points. This paper reports the effects of 150 days of supplementation with either a single- (
Bifidobacterium animalis
subsp. lactis Bl-04) or a double-strain (
Lactobacillus acidophilus
NCFM and
Bifidobacterium animalis
subsp. lactis Bi-07) probiotic on routine haematology and clinical chemistry measures in healthy active adults. Pre- to post-intervention changes in laboratory measures were determined and compared between supplement and placebo groups. Overall there were few differences in routine haematology and clinical chemistry measures between supplement and placebo groups post-intervention. Exceptions included plasma calcium (
P
=0.03) and urea (
P
=0.015); however, observed changes were small and within assay-specific laboratory reference ranges. These data provide evidence supporting the use of these probiotic supplements over a period of 5 months in healthy active adults without obvious safety or tolerability issues.
Journal Article
Practical flow cytometry in haematology diagnosis
\"This book acts as a clinical manual for the diagnostician who cannot turn to reference books when the morphology or immunophenotype are atypical. This volume presents a logical practical approach to the diagnosis of blood disorders, both neoplastic and reactive, and other diagnostic applications of flow cytometry in non-neoplastic haematology diagnosis. Illustrations are provided throughout with worked examples\"--Provided by publisher.
eBook
Virtual-freezing fluorescence imaging flow cytometry
By virtue of the combined merits of flow cytometry and fluorescence microscopy, imaging flow cytometry (IFC) has become an established tool for cell analysis in diverse biomedical fields such as cancer biology, microbiology, immunology, hematology, and stem cell biology. However, the performance and utility of IFC are severely limited by the fundamental trade-off between throughput, sensitivity, and spatial resolution. Here we present an optomechanical imaging method that overcomes the trade-off by virtually freezing the motion of flowing cells on the image sensor to effectively achieve 1000 times longer exposure time for microscopy-grade fluorescence image acquisition. Consequently, it enables high-throughput IFC of single cells at >10,000 cells s
−1
without sacrificing sensitivity and spatial resolution. The availability of numerous information-rich fluorescence cell images allows high-dimensional statistical analysis and accurate classification with deep learning, as evidenced by our demonstration of unique applications in hematology and microbiology.
High throughput imaging flow cytometry suffers from trade-offs between throughput, sensitivity and spatial resolution. Here the authors introduce a method to virtually freeze cells in the image acquisition window to enable 1000 times longer signal integration time and improve signal-to-noise ratio.
Journal Article
Intensive consolidation therapy compared with standard consolidation and maintenance therapy for adults with acute myeloid leukaemia aged between 46 and 60 years: final results of the randomized phase III study (AML 8B) of the European Organization for Research and Treatment of Cancer (EORTC) and the Gruppo Italiano Malattie Ematologiche Maligne dell’Adulto (GIMEMA) Leukemia Cooperative Groups
Summary
The most effective post-remission treatment to maintain complete remission (CR) in adults aged between 46 and 60 years with acute myeloid leukaemia (AML) is uncertain. Previously untreated patients with AML in CR after induction chemotherapy with daunorubicin and cytarabine were randomized between two intensive courses of consolidation therapy containing high-dose cytarabine, combined with amsacrine or daunorubicin and a standard consolidation and maintenance therapy containing standard dose cytarabine and daunorubicin. One hundred fifty-eight CR patients were assigned to the intensive group and 157 patients to the standard group. After a median follow-up of 7.5 years, the 4-year survival rate was 32 % in the intensive group versus 34 % in the standard group (
P
= 0.29). In the intensive group, the 4-year relapse incidence was lower than in the standard group: 55 and 75 %, respectively (
P
= 0.0003), whereas treatment-related mortality incidence was higher: 22 versus 3 % (
P
< 0.0001). Two intensive consolidation courses containing high-dose cytarabine as post-remission treatment in patients with AML aged between 46 and 60 years old did not translate in better long-term outcome despite a 20 % lower relapse incidence. Better supportive care and prevention of treatment-related complications may improve the overall survival after intensified post-remission therapy in this age group.
Journal Article
How artificial intelligence might disrupt diagnostics in hematology in the near future
Artificial intelligence (AI) is about to make itself indispensable in the health care sector. Examples of successful applications or promising approaches range from the application of pattern recognition software to pre-process and analyze digital medical images, to deep learning algorithms for subtype or disease classification, and digital twin technology and in silico clinical trials. Moreover, machine-learning techniques are used to identify patterns and anomalies in electronic health records and to perform ad-hoc evaluations of gathered data from wearable health tracking devices for deep longitudinal phenotyping. In the last years, substantial progress has been made in automated image classification, reaching even superhuman level in some instances. Despite the increasing awareness of the importance of the genetic context, the diagnosis in hematology is still mainly based on the evaluation of the phenotype. Either by the analysis of microscopic images of cells in cytomorphology or by the analysis of cell populations in bidimensional plots obtained by flow cytometry. Here, AI algorithms not only spot details that might escape the human eye, but might also identify entirely new ways of interpreting these images. With the introduction of high-throughput next-generation sequencing in molecular genetics, the amount of available information is increasing exponentially, priming the field for the application of machine learning approaches. The goal of all the approaches is to allow personalized and informed interventions, to enhance treatment success, to improve the timeliness and accuracy of diagnoses, and to minimize technically induced misclassifications. The potential of AI-based applications is virtually endless but where do we stand in hematology and how far can we go?
Journal Article
Diagnosis and empirical treatment of fever of unknown origin (FUO) in adult neutropenic patients: guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO)
Fever may be the only clinical symptom at the onset of infection in neutropenic cancer patients undergoing myelosuppressive chemotherapy. A prompt and evidence-based diagnostic and therapeutic approach is mandatory. A systematic search of current literature was conducted, including only full papers and excluding allogeneic hematopoietic stem cell transplant recipients. Recommendations for diagnosis and therapy were developed by an expert panel and approved after plenary discussion by the AGIHO. Randomized clinical trials were mainly available for therapeutic decisions, and new diagnostic procedures have been introduced into clinical practice in the past decade. Stratification into a high-risk versus low-risk patient population is recommended. In high-risk patients, initial empirical antimicrobial therapy should be active against pathogens most commonly involved in microbiologically documented and most threatening infections, including
Pseudomonas aeruginosa
, but excluding coagulase-negative staphylococci. In patients whose expected duration of neutropenia is more than 7 days and who do not respond to first-line antibacterial treatment, specifically in the absence of mold-active antifungal prophylaxis, further therapy should be directed also against fungi, in particular
Aspergillus
species. With regard to antimicrobial stewardship, treatment duration after defervescence in persistently neutropenic patients must be critically reconsidered and the choice of anti-infective agents adjusted to local epidemiology. This guideline updates recommendations for diagnosis and empirical therapy of fever of unknown origin in adult neutropenic cancer patients in light of the challenges of antimicrobial stewardship.
Journal Article
Drone Transport of Chemistry and Hematology Samples Over Long Distances
Abstract
Objectives
We addressed the stability of biological samples in prolonged drone flights by obtaining paired chemistry and hematology samples from 21 adult volunteers in a single phlebotomy event—84 samples total.
Methods
Half of the samples were held stationary, while the other samples were flown for 3 hours (258 km) in a custom active cooling box mounted on the drone. After the flight, 19 chemistry and hematology tests were performed.
Results
Seventeen analytes had small or no bias, but glucose and potassium in flown samples showed an 8% and 6.2% bias, respectively. The flown samples (mean, 24.8°C) were a mean of 2.5°C cooler than the stationary samples (mean, 27.3°C) during transportation to the flight field as well as during the flight.
Conclusions
The changes in glucose and potassium are consistent with the magnitude and duration of the temperature difference between the flown and stationary samples. Long drone flights of biological samples are feasible but require stringent environmental controls to ensure consistent results.
Journal Article
Performance evaluation of Rayto RT-7600Vet hematology analyzer in side-by-side comparison with manual hematological methods for apparently healthy Cholistani cattle blood
The present study is the first from Pakistan being reported with an objective to assess performance of Rayto RT-7600Vet hematology analyzer (HA) for Cholistani cattle blood (n = 134), in comparison to the manual hematological methods. The four hematological attributes viz . total erythrocyte count (TEC), hemoglobin (Hb), packed cell volume (PCV) and platelet count (PLT) were deduced through HA (A) and manual (M) methods. Various statistical tests were implied to ascertain level of interrelationship, accuracy and level of agreement between the two methods. All attributes attained through manual methods had high positive, leptokurtic distribution (having many outliers) except for PLT-M and PCV-M. The coefficient of variation for attributes attained through HA and manual methods ranged from 16–24% and from 16–59%, respectively. Comparison between the overall results revealed that all the studied attributes, except TEC, were significantly (P≤0.05) different for both methods. A weak relationship was noticed between the attributes attained through two methods as indicated by weak r-values and adjusted r-square values. The reliability level of estimating Hb and PCV had highest intraclass correlation coefficient value of 0.722 and 0.555 for average measures, respectively. However, accuracy level, as determined through Lin’s concordance correlation coefficient was highest for TEC (0.9504) for both analytical methods. Poor level of agreement, in general, was shown for the two methods of analysis regarding all four hematological attributes through Bland and Altman test. In conclusion, the Rayto RT-7600Vet) may present data having higher skewness, kurtosis, and CV%, however, they are valid for multi-species hematological analysis. Caution must however, be taken in interpreting their results with corrected reference intervals and CV% for each machine and for each tested attribute.
Journal Article
Enhanced stability of simulated leukocytes for hematology internal quality control samples: A material improvement
This study aimed to develop and evaluate simulated leukocytes derived from porcine leukocytes as a stable alternative for internal quality control (IQC) in hematology laboratories. Addressing challenges related to material stability and availability, the research contributes to improving laboratory quality assurance in Vietnam.
Statistical methods including Shapiro-Wilk test, Levene's test, t-tests, ANOVA, and the IQR method were applied to assess post-production quality and establish target values. Target values were established from data collected across 90 laboratories. The Interquartile Range (IQR) method was used to eliminate outliers, and target values were set for three analyzers (Sysmex XN-1000, Sysmex XN-550, and Horiba ABX Micros 60) per batch at three concentration levels. Sample stability was evaluated over a two-month shelf life using t-tests and monitored for 20 days post-opening with repeated measures ANOVA.
Simulated leukocytes derived from goose erythrocytes exhibited instability at high concentration levels, whereas those derived from porcine leukocytes maintained stability over two months and demonstrated acceptable performance for up to 10 days post-opening.
The findings highlight the potential of porcine leukocytes as a reliable IQC material for hematology, meeting the stability and performance requirements of clinical laboratories.
Journal Article