A proliferation-inducing ligand (APRIL) serum levels predict time to first treatment in patients affected by B-cell chronic lymphocytic leukemia

Purpose: A proliferation-inducing ligand (APRIL), a tumor necrosis factor superfamily member involved inB-lymphocytes differentiation and survival, plays a role in protecting B-Cell Chronic lymphocytic leukemia(B-CLL) cells from apoptosis. Having observed that APRIL serum (sAPRIL) levels were higher in B-CLLpatients with CLL at diagnosis as compared to healthy donors (14.61 \ub1 32.65 vs. 4.19 \ub1 3.42 ng \u2044 mL;P < 0.001), we tested the correlation existing in these patients between sAPRIL, clinical\u2013biological parametersand disease progression. Experimental design: sAPRIL levels were measured by ELISA in 130patients with B-CLL at diagnosis and in 25 healthy donors. Results: sAPRIL levels did not correlate withgender, age, clinical stage, blood cell counts, b2-microglobulin (b2M) levels, ZAP-70 and CD38 expression.Using median sAPRIL natural logarithm (ln) as cutoff, we distinguished two groups of patients (APRILLOWand APRILHIGH) who were comparable with regard to clinical\u2013biological parameters and overall survival, butdifferent with regard to time to the first treatment (TTFT; P = 0.035). According to univariate analysis, highlymphocyte count, high b2M, Binet stage B\u2013C, ZAP-70 expression and ln(sAPRIL) above median wereassociated with earlier TTFT. Advanced clinical stage, high b2M, ZAP-70 expression and ln(sAPRIL) abovemedian remained independently predictive of shorter TTFT at multivariate analysis. Moreover, sAPRILincreased its prognostic significance when patients were stratified according to independent favorable clinical\u2013biological characteristics (low b2M, stage A and lack of ZAP-70 expression). Conclusions: sAPRIL is anovel indicator of shorter TTFT in B-CLL and a predictor of progression especially in patients otherwiseconsidered at low risk according to validated prognostic factors

Dirasat Al Turats Al Jighrafi Al Arabi Al Islami

148 hal.; 24 c

A case of warm autoimmune hemolytic anemia with a direct antiglobulin test positive for C3 in rheumatoid arthritis patient successfully treated with low-dose rituximab

A Case of Warm Autoimmune Hemolytic Anemia With a Direct Antiglobulin Test Positive for C3 in Rheumatoid Arthritis Patient Successfully Treated With Low-Dose Rituximab

Validity and reliability of serologic immunophenotyping of multiple blood group systems by ORTHO Sera with fully automated procedure

The increase of immunization against blood group antigens has reinforced the need for automated extensive blood typing. The aim of this study was to assess both the validity and reliability of red blood cell (RBC) automated agglutination technology in testing for antigens of Kidd (Jk), Duffy (Fy), and MNS (Ss) blood systems. ORTHO Sera (Ortho Clinical Diagnostics, Raritan, NJ) anti-Jka, anti-Jkb, Anti-Fya, anti-Fyb, anti-S, and anti-s reagents were each tested on RBC samples previously typed. Replicates were performed on three separate testing sessions with three consecutive repetitions within each session, thus obtaining 486 test results. Accuracy was assessed by aggregate analysis of sensitivity, specificity, and area under the receiver operating characteristics curve (AUC). Reliability was estimated by a cross-classified mixed-effect logistic model. All reagents tested yielded optimal accuracy (100% for sensitivity and specificity, and 1.00 for AUC), except for anti-S, for which performance was slightly lower (98%, 100%, and 0.99, respectively), owing to misclassification of one sample in a single replicate. Anomalous automated measurements were recorded in 38 of 486 tests (7.8%), which then needed additional manual interpretation. Different sessions and samples were the major contributors to measurement failures (38% and 18%, separately). Order of repetitions and antigen specificity across replicates did not contribute to the risk of failures, although weak evidence of enhanced risk was observed with Jk testing. Automated RBC typing with ORTHO Sera reagents against antigens in the Kidd, Duffy, and MNS blood group systems displayed nearly 100 percent accuracy. However, a sizable number of replicates needed additional ad hoc interpretation, thus suggesting that the reliability could still be improved. Automated agglutination technology represents a viable option for phenotyping large volumes of samples