Phenotypic Markers and Functional Regulators of Myelomonocytic Cells

In this chapter, there is a description of hematopoietic stem cells, maturation curve and their differentiation into myeloid cells, including phenotypes and transcription factors involved in this process. Further, we discuss myeloid maturation curve from myeloid precursor, monoblast, premonocyte to monocytes, and also monocytes subsets regarding their CD14 and CD16 expressions and related functions in health and disease. In addition, we reason about the differentiation from monocytes either in dendritic cells or in macrophages in vitro using differential growth factors; these cells are differentiated from those found in vivo being named as monocyte-derived cells. Furthermore, we explore distinguished phenotype of monocytes, macrophages, and dendritic cells monocyte-derived in vitro, using confocal microscopy and flow cytometry, in order to display morphological and phenotypic differences among them

Factor XI deficiency

We describe a patient with a prolonged aPTT who was diagnosedas having factor XI deficiency after a rather large hematoma wasformed after angiography. Factor XI deficiency affects 1 in 1 millionpeople, but it is more common in Ashkenazim with a gene frequencyof 5% to 11%, being 0.3% homozygotes. These individuals usuallydo not present hemorrhagic events, except in cases of trauma orsurgery. These patients should be identified by routine coagulationscreening; bleeding could be prevented by use of fresh humanplasma or plasma concentrates

Lymphoid Hematopoiesis and Lymphocytes Differentiation and Maturation

Lymphocytes belong to the lymphoid lineage and are considered as divergent from other blood cells lineages as those from the myeloid or erythroid lineage. Lymphoid hematopoiesis is not trivial, because although lymphocytes are found in the bloodstream and their precursor originates in the bone marrow, they mainly belong to the separate lymphatic system, which interacts with the blood circulation. We will discuss B cell differentiation in the bone marrow and the later stages of maturation in secondary lymphoid tissues, besides the B cell profiles in interfollicular, perifollicular, and follicular areas. In addition, we will also discuss T-cell precursor and natural killer cells derivation in the marrow. Furthermore, we will also discuss T-cell precursor migration to thymus, differentiation, rearrangement, thymic selection, involved transcription factors, and, finally, T-cell profiles and subsets in secondary lymphoid organs. We will provide flow cytometry plots showing strategies to identify and characterize NK, T and B lymphocytes and their subsets in circulation. Furthermore, we will provide illustrations to help the reader to understand and visualize the information provide over the chapter. Furthermore, the comprehension about lymphocytes and their contribution to the immune response will favor their application in developmental hematology and immunology. These topics are very important for the continuous development of knowledge

Hiperplasia angiolinfoide como causa de eosinofilia

A hiperplasia angiolinfoide (Hale e doença de Kimura são duas entidades que podem se manifestar como nódulos, placas ou pápulas, de localização predominante em face, região retroauricular e cervical. São causas raras de eosinofilia e ainda há muita discussão em torno de suas etiopatogenias. Para alguns autores trata-se de duas patologias distintas enquanto para outros são manifestações diferentes da mesma doença. O presente artigo relata o caso de um paciente asiático que apresentava história de prurido generalizado há um ano, acompanhado de pápulas em membros e nódulo de aproximadamente 5 cm de diâmetro em região retroauricular direita com aumento progressivo. O hemograma apresentava leucocitose às custas de eosinofilia. Os achados sugerem uma superposição entre as duas patologias, pois clinicamente são sugestivos de doença de Kimura, mas a histopatologia e imuno-histoquímica confirmaram a origem endotelial da lesão, sendo compatível com Hale. Os autores destacam a raridade do caso como causa de eosinofilia, assim como alertam para a dificuldade do diagnóstico e da diferenciação entre as duas patologias

Intervalos de referência de hemograma da população adulta brasileira: Pesquisa Nacional de Saúde

Objective: to estimate the reference intervals (RIs) of complete blood count parameters in the Brazilian adult population. Methods: Cross-sectional study, with data from the National Health Survey (PNS), between 2014-2015. The final sample consisted of 2,803 adults. The final sample consisted of 2,803 adults. To establish the RI, exclusion criteria were applied, outliers were removed and partitions were made by sex, age and race/skin color. The non-parametric method was adopted. Differences were assessed using the Mann Withney and Kruskal Wallis tests (p≤0.05). Results: There were statistically significant differences for the following hematological parameters based on sex, red blood cells, hemoglobin, hematocrit, MCH, MCHC, eosinophils and absolute monocytes, neutrophils and platelets (p≤0.05). When analyzed by age, the RIs were statistically different in females for hematocrit, MCV, white blood cells and RDW and in males for red blood cells, white blood cells, eosinophils, mean platelet volume, MCV, RDW and MCH(p≤0.05). For race/color there were differences in the RIs for parameters of hemoglobin, MCH, MCHC, white blood cells and mean platelet volume, neutrophils and absolute eosinophils (p ≤ 0.05). Conclusion: The differences found in the RIs of some in blood count parameters in Brazilian adults reaffirm the importance of having their own laboratory reference standards. The results can support a more accurate interpretation of tests, adequate identification and disease prevention in Brazil.Objetivo: estimar os intervalos de referência (IR) de parâmetros de hemograma completo na população adulta brasileira. Métodos: Estudo transversal, com dados da Pesquisa Nacional de Saúde (PNS), entre 2014-2015. A amostra final constitui-se de 2.803 adultos. Para estabelecer os IR, aplicou-se critérios de exclusão, removeram-se outliers e feito particionamentos por sexo, idade e raça/cor da pele. Adotou-se o método não paramétrico.  As diferenças foram avaliadas pelos testes Mann Withney e Kruskal Wallis (p≤0,05). Resultados: houve diferenças estatisticamente significativas nos IR segundo sexo para glóbulos vermelhos, hemoglobina, hematócrito, HCM, CHCM, eosinófilos, monócitos, neutrófilos absolutos e plaquetas (p≤0,05). Quando analisados por idade,  houve diferenças nos IR de mulheres para hematócrito, VCM, glóbulos brancos e RDW e nos homens de glóbulos vermelhos, glóbulos brancos, eosinófilos, volume plaquetário médios, VCM, RDW e HCM (p≤0,05). Para raça/cor houve diferenças nos IR de hemoglobina, HCM, CHMC, glóbulos brancos e volume plaquetário médio, neutrófilos e eosinófilos absolutos (p ≤ 0,05). Conclusão: As diferenças encontradas nos IR de alguns em parâmetros de hemograma em adultos brasileiros  reafirmam a importância de se ter padrões de referência laborarias próprios. Os resultados podem subsidiar a interpretação mais precisa dos exames, identificação adequada e a prevenção de doenças no Brasil

Identification Of Anln As Etv6 Partner Gene In Recurrent T(7;12)(p15;p13): A Possible Role Of Deregulated Anln Expression In Leukemogenesis.

The ETV6 gene encodes an ETS family transcription factor that is involved in a myriad of chromosomal rearrangements found in hematological malignancies and other neoplasms. A recurrent ETV6 translocation, previously described in patients with acute myeloid leukemia (AML) (Genes Chromosomes Cancer 51:328-337,2012, Leuk Res 35:e212-214, 2011), whose partner has not been identified is t(7;12)(p15;p13). We herein report that the t(7;12)(p15;p13) fuses ETV6 to ANLN, a gene not previously implicated in the pathogenesis of hematological malignancies, and we demonstrate that this translocation leads to high expression of the fusion transcript in the myeloid and lymphoid lineages.1419

A Novel Assay for the Identification of NOTCH1 PEST Domain Mutations in Chronic Lymphocytic Leukemia

Aims. To develop a fast and robust DNA-based assay to detect insertions and deletions mutations in exon 34 that encodes the PEST domain of NOTCH1 in order to evaluate patients with chronic lymphocytic leukemia (CLL). Methods. We designed a multiplexed allele-specific polymerase chain reaction (PCR) combined with a fragment analysis assay to detect specifically the mutation c.7544 7545delCT and possibly other insertions and deletions in exon 34 of NOTCH1. Results. We evaluated our assay in peripheral blood samples from two cohorts of patients with CLL. The frequency of NOTCH1 mutations was 8.4% in the first cohort of 71 unselected CLL patients. We then evaluated a second cohort of 26 CLL patients with known cytogenetic abnormalities that were enriched for patients with trisomy 12. NOTCH1 mutations were detected in 43.7% of the patients with trisomy 12. Conclusions. We have developed a fast and robust assay combining allele-specific PCR and fragment analysis able to detect NOTCH1 PEST domain insertions and deletions