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Leukemia Research Reports 2023Chronic myeloid leukemia (CML) and chronic myelomonocytic leukemia (CMML) are two common myeloid neoplasms with overlapping morphologic features. We report a patient...
Chronic myeloid leukemia (CML) and chronic myelomonocytic leukemia (CMML) are two common myeloid neoplasms with overlapping morphologic features. We report a patient initially diagnosed with CML and treated with Tyrosine kinase inhibitor (TKI) but who then developed persistent monocytosis and worsening thrombocytopenia one year later. Repeat bone marrow biopsies only showed CML at the molecular level. However, markedly hypercellular bone marrow, megakaryocytic dysplasia, and , and mutations by NextGen sequencing pointed to a diagnosis of CMML. For CML patients with persistent monocytosis and cytopenia, a mutational profile by NGS is helpful to exclude or identify the coexisting CMML.
PubMed: 37415731
DOI: 10.1016/j.lrr.2023.100378 -
Leukemia & Lymphoma Sep 2023Chronic myelomonocytic leukemia (CMML) is a myelodysplastic syndrome/myeloproliferative neoplasm (MDS/MPN) chacaterized by persistent peripheral blood monocytosis,...
Chronic myelomonocytic leukemia (CMML) is a myelodysplastic syndrome/myeloproliferative neoplasm (MDS/MPN) chacaterized by persistent peripheral blood monocytosis, hypercellular bone marrow and dysplasia at least in one myeloid lineage. CMML shares much of its molecular landscape with other myeloid neoplasms, while differs from others such as chronic neutrophilic leukemia (CNL), given the high frequency of CSF3R mutations in the latter. In this article, we report a case of CSF3R-mutated CMML and dissect this rare entity by reviewing the medical literature, with the intent to understand how this rare mutation shapes CMML's clinical and morphological phenotype. CSF3R-mutated CMML emerges as a rare entity meeting the ICC/WHO diagnostic criteria for CMML and simultaneously showing clinical-pathological and molecular traits of CNL and atypical chronic myeloid leukemia, rising an important and difficult diagnostic and therapeutical issue.
Topics: Humans; Leukemia, Myelomonocytic, Chronic; Leukemia, Neutrophilic, Chronic; Mutation; Myeloproliferative Disorders; Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative; Prognosis; Receptors, Colony-Stimulating Factor
PubMed: 37395413
DOI: 10.1080/10428194.2023.2227750 -
Journal of Avian Medicine and Surgery Jun 2023A 1-year-old major Mitchell's cockatoo () was presented for evaluation of weakness, diarrhea with undigested seeds in the droppings, and weight loss. Leukocytosis with...
A 1-year-old major Mitchell's cockatoo () was presented for evaluation of weakness, diarrhea with undigested seeds in the droppings, and weight loss. Leukocytosis with severe heterophilia, monocytosis, and lymphocytosis was noted on the complete blood count. Altered plasma biochemical parameters included a slight increase in creatine kinase and mild hypoproteinemia. Two blood smears before and after 2 days of treatment revealed mild polychromasia and anisocytosis but no blood parasites. Radiographic and computed tomographic imaging of the cockatoo were helpful in identifying airsacculitis, pneumonia, and gastrointestinal motility disorders. The patient died 5 days after treatment for the presenting clinical problems. On the gross postmortem examination, dark red foci in the ventricular muscle layers and 1-3-mm white foci in the myocardium, opaque air sacs, and dark lungs were identified. Histopathologic examination of submitted tissue samples found severe granulomatous ventriculitis and myocarditis with intralesional species megalomeronts. Qualitative polymerase chain reaction testing for the cytochrome (cyt ) gene performed on pooled heart, liver, kidney, and intestinal tissues identified 99.5% homology to . This case report demonstrates the expansion of the geographic range of to France and potentially to Belgium, which may compromise breeding and conservation of Australian parrots living outdoors. Challenging diagnosis, rapid disease progression, and the absence of validated treatment protocols for psittacine patients suggest that the use of preventive measures to reduce the presence of insect vectors such as hippoboscid flies and biting midges () should be considered. should be considered and potentially screened by polymerase chain reaction testing on blood samples, especially in the case of highly susceptible avian species (eg, Australian parrots in Europe) that present with sudden weakness, heterophilic leukocytosis, and monocytosis associated with mild anemia.
Topics: Animals; Cockatoos; Protozoan Infections, Animal; Leukocytosis; Australia; Parrots; Haemosporida; Ceratopogonidae; Bird Diseases; Phylogeny
PubMed: 37358204
DOI: 10.1647/21-00026 -
International Journal of Laboratory... Dec 2023
Review
When dysplasia deceives instrumental results: Pseudo monocytosis on the sysmex XN haematological analyser and DI-60 digital morphology system: Cases report and literature review.
Topics: Humans; Leukocyte Count; Leukocytes; Leukocytosis
PubMed: 37350511
DOI: 10.1111/ijlh.14125 -
Veterinary Immunology and... Jul 2023Lymphocyte immunophenotyping can be useful for evaluating immune competence and predicting the disease prognosis. It is essential to gain knowledge about canine...
Lymphocyte immunophenotyping can be useful for evaluating immune competence and predicting the disease prognosis. It is essential to gain knowledge about canine lymphocyte immunophenotypes in various conditions. The study deals with the characteristics of lymphopenia in dogs, with an emphasis on lymphocyte immunophenotyping by flow cytometry. Blood samples from 44 dogs with lymphopenia were included in the study. All lymphopenias sent from veterinary clinics to the diagnostic laboratory were analyzed. The hematological and biochemical abnormalities were investigated, as well as the effect of the age. Lymphopenias were classified according to the level of C-reactive protein (CRP). The percentage of T cells, B cells, T cells and T cells, and T/B and T/T ratios were determined by flow cytometry. Lymphopenias often occurred in dogs over 7 years of age (79.5 %). The most common were postoperative lymphopenia (31.8 %) and inflammatory diseases (29.5 %), most commonly affecting the gastrointestinal tract. Frequent abnormalities were monocytosis (56.8 %), increased CRP (72.7 %) and decreased albumin/globulin ratio (50.0 %). The percentage of T lymphocytes was significantly lower in the group with elevated CRP than in the group with basal CRP (P = 0.0329). A negative correlation was found between the level of CRP and the percentage of T lymphocytes (r = -0.3278, P = 0.0390). This study provided new insights into the appearance, incidence and classification of canine lymphopenia.
Topics: Dogs; Animals; Immunophenotyping; Lymphocytes; Lymphopenia; T-Lymphocytes; B-Lymphocytes; Flow Cytometry; Dog Diseases
PubMed: 37331238
DOI: 10.1016/j.vetimm.2023.110620 -
Journal of Clinical Immunology Oct 2023
Topics: Humans; Child; Lung Diseases, Interstitial; Leukocyte Disorders; Antigens, Neoplasm
PubMed: 37291413
DOI: 10.1007/s10875-023-01529-0 -
The American Journal of Case Reports Jun 2023BACKGROUND Refractory hypokalemia has been rarely demonstrated in patients with acute monocytic leukemia (AMoL). Hypokalemia develops in these patients owing to renal... (Review)
Review
BACKGROUND Refractory hypokalemia has been rarely demonstrated in patients with acute monocytic leukemia (AMoL). Hypokalemia develops in these patients owing to renal tubular dysfunction, secondary to lysozyme enzymes that are released by monocytes in AMoL. Additionally, renin-like substances are produced from monocytes and can lead to hypokalemia and metabolic alkalosis. There is also an entity called spurious hypokalemia, in which high numbers of metabolically active cells in blood samples increase sodium-potassium ATPase activity, resulting in influx of potassium. Additional research is warranted regarding this specific demographic to create standardized treatment approaches to electrolyte repletion. CASE REPORT In this case report, we demonstrate a rare case of an 82-year-old woman with AMoL, complicated by refractory hypokalemia, who presented with concerns of fatigue. The patient's initial laboratory results were significant for leukocytosis with monocytosis and severe hypokalemia. Refractory hypokalemia was noted, despite administration of aggressive repletions. During her hospitalization, AMoL was diagnosed and an extensive workup was performed to evaluate the underlying cause of hypokalemia. Ultimately, the patient died on day 4 of hospitalization. We describe the correlation between severe refractory hypokalemia and leukocytosis and provide a literature review of multiple etiologies of refractory hypokalemia in patients with AMoL. CONCLUSIONS We evaluated the numerous pathophysiologic mechanisms responsible for refractory hypokalemia in patients with AMoL. Our therapeutic outcomes were limited owing to the patient's early death. It is of high importance to evaluate the underlying cause of hypokalemia in these patients and to treat accordingly with caution.
Topics: Aged, 80 and over; Female; Humans; Hypokalemia; Leukemia, Monocytic, Acute; Leukocytosis; Potassium
PubMed: 37285330
DOI: 10.12659/AJCR.938775 -
Archives of Razi Institute Dec 2022is a pathogen considered a disease in both dogs and breeders, a tropical and non-tropical disease caused by an intracellular pathogen. For the first time, the study...
is a pathogen considered a disease in both dogs and breeders, a tropical and non-tropical disease caused by an intracellular pathogen. For the first time, the study aimed at hematological and molecular detection and phylogenetic analysis of in dogs in Baghdad, Iraq. Two hundred dogs were clinically examined from April to September 2019 at the Veterinary Hospital in Baghdad. Blood samples with EDTA tubes were used for microscopic examination, complete blood count (CBC) and polymerase chain reaction (PCR). The study's results revealed that the infection rate was 3.5% when analyzed using microscopic or molecular methods. Ataxia, posterior recumbency, and occasionally vision problems were identified as the clinical characteristics that were distinguished in this study. The hematological values showed no significant differences between infected and uninfected dogs (>0.05). However, the study did show that infected dogs had neutrophilia and monocytosis. Four samples were sent to the sequencers, and NCBI accession numbers were assigned to two isolates of the 16s rRNA gene (MN227483.1 and MN227484.1). This study showed that 99% of the isolates matched those found in other countries. The study concluded that microscopic examination is not the best method for diagnosing in dogs because it requires the ability to differentiate microscopically between intracellular inclusion bodies and the included morula of and may produce incorrect results. Instead, molecular tests are used to confirm an diagnosis.
Topics: Dogs; Animals; Ehrlichia canis; Ehrlichiosis; Phylogeny; RNA, Ribosomal, 16S; Iraq; Dog Diseases; Ehrlichia
PubMed: 37274905
DOI: 10.22092/ARI.2022.358868.2321 -
Transfusion and Apheresis Science :... Oct 2023Autoimmune hemolytic anemia (AIHA) is characterized by hemolysis caused by autoantibodies. However, many patients do not respond to therapies and may have an unfavorable... (Observational Study)
Observational Study
Autoimmune hemolytic anemia (AIHA) is characterized by hemolysis caused by autoantibodies. However, many patients do not respond to therapies and may have an unfavorable outcome. It has been hypothesized that patients with AIHA and alloantibodies have a lower survival compared to patients with this disease and without alloimmunization. To this end, the clinical and laboratory profile was described and sought to identify features associated with survival in patients with AIHA. This is a single-site retrospective observational study that included patients (children, adolescents, adults and elderly) diagnosed with AIHA from January 2000 to June 2019. Epidemiological data, laboratory tests, treatment response, alloantibody and autoantibody profile, red cell transfusion and clinical course were analyzed. Survival analysis was performed using Kaplan-Meier curves and Cox proportional hazards regression. The study included 138 patients, mostly caucasians and female. The median age at diagnosis was 48.5 years (0.16-88) and 82 (59.4 %) patients had secondary AIHA. In addition, 33 % (25/75) of subjects had alloantibodies at the time of AIHA diagnosis and 40 % (16/40) detected alloantibody emergence later. The overall 10-year survival rate was 51 % (median follow-up was 39 months). Monocytosis, IgM class autoantibody and Direct Antiglobulin Test (DAT) intensity had a significant impact on predicting mortality in this population. On the other hand, alloimmunization at diagnosis and after did not affect survival in this population.
Topics: Adolescent; Adult; Aged; Child; Female; Humans; Male; Anemia, Hemolytic, Autoimmune; Autoantibodies; Erythrocyte Transfusion; Isoantibodies; Retrospective Studies; Middle Aged
PubMed: 37271665
DOI: 10.1016/j.transci.2023.103741 -
Clinical Case Reports Jun 2023Chronic neutrophilic leukemia is a rare disease with a poor prognosis. Its diagnosis is challenging in the lack of genetic tools. It can infrequently be associated with...
KEY CLINICAL MESSAGE
Chronic neutrophilic leukemia is a rare disease with a poor prognosis. Its diagnosis is challenging in the lack of genetic tools. It can infrequently be associated with autoimmune hemolytic anemia.
ABSTRACT
Chronic neutrophilic leukemia is a rare disease with poor prognosis, characterized by a sustained mature neutrophilic leukocytosis in the absence of monocytosis or basophilia with few or no circulating immature granulocytes, hepatosplenomegaly, and granulocytic hyperplasia of the bone marrow. In addition, no molecular markers for other myeloproliferative neoplasms are detected. The 2016 WHO classification included the presence of the CSF3R mutation as a key diagnostic criterion for this disease. Although anemia may be present at diagnosis, hemolytic one rarely complicates myeloproliferative neoplasms. Treatment is largely based on cytoreductive agents, but bone marrow allograft remains the only curative option. We report the case of a patient with chronic neutrophilic leukemia associated with autoimmune hemolytic anemia. We describe the epidemiological, clinical, prognostic, and therapeutic features of this disease in addition to the difficulties of its diagnosis and management in Tunisia.
PubMed: 37251749
DOI: 10.1002/ccr3.7432