Pancytopénie sévère secondaire à un déficit en folates en dépit d’un dosage de folatesérythrocytaires normal

International audienceWe report the case of an alcoholic patient with severe pancytopenia with lowplasma folate level but normal erythrocyte folates and cobalamin levels. The bone marrow smear concluded to a pancytopenia due to folates and/or cobalamin deficiency. Severe pancytopenia due to acute plasma folate deficiency can be observed despite normal erythrocyte folates level which reflects the organism’s folates store.Nous rapportons un cas de pancytopénie sévère avec dosage en folates sériques isolément bas contrastant avec des folates érythrocytaires et vitamine B12 normaux, chez un patient alcoolique. Le myélogramme montrait un aspect de moelle carentielle en ces vitamines. Ce cas met en lumière la possibilité de survenue d’une pancytopénie sévère secondaire à une carence en folates, en dépit d’un dosage normal de folates érythrocytaires, qui est un indicateur des apports en folates des 3 derniers mois (durée de vie du globule rouge) et donc des réserves de l’organisme

Spontaneous remission in three cases of AML M5 with NPM1 mutation

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Hypoalbuminemia and hypergammaglobulinemia are associated with an increased infection risk in patients with myeloid malignancies treated with azacitidine. A 3-year monocentric retrospective study

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Clinical value of the quantitative expression of the three epitopes of CD34 in 300 cases of acute myeloid leukemia.

BACKGROUND AND OBJECTIVES: The various epitopes of the CD34 molecule have been classified according to their different sensitivities to enzymatic cleavage by neuraminidase, chymopapain and a glycoprotease from Pasteurella haemolytica. Although monoclonal antibodies have been developed that specifically identify these epitopes, few studies have evaluated the distribution and quantitative expression of such epitopes on leukemic blasts. DESIGN AND METHODS: We report here a prospective multicenter study in which we examined and quantified the expression of the 3 classes of CD34 on fresh leukemic blast cells from 300 cases of acute myeloid leukemia (AML). The binding of monoclonal antibodies was studied by flow cytometry, allowing evaluation of blast cell positivity as well as their mean fluorescence intensity. These quantitative data were made comparable between centers by means of a calibration curve established with the same reagents in all laboratories. RESULTS: Quantitative expression of class I epitope was significantly higher than that of class II and class III epitopes (p<0.0001). The three classes were more frequently expressed in M0 and M1 and less in M3 and M5. The highest levels of CD34 expression were observed in M2, M0 and M1 and the lowest in M3, M5 and BAL for class II and III. CD34 expression was lower for all classes in cases with a normal karyotype, compared to in cases with structural or numerical abnormalities. INTERPRETATION AND CONCLUSIONS: In cases with a t(9;22) the expression of class I was significantly higher than that of class II and III and the opposite was observed in AML with t(15;17). Moreover, as a whole, a high intensity of class III CD34 appeared to be a marker of good prognosis

A GEIL flow cytometry consensus proposal for quantification of plasma cells: application to differential diagnosis between MGUS and myeloma.

This standardized multiparameter flow cytometric approach allows for the detection and quantification of bone marrow tumor plasma-cell infiltration in nearly all cases of MGUS and myeloma, independently of debris and hemodilution. This approach may also prove useful for the detection of minimal residual disease

La biophotonique au service de l'identification de marqueurs pronostiques intracellulaires

International audienceUsing biophotonics techniques to retrieve prognostic intracellular signatures : IHMO project aims at developing a multimodal microscopy platform that includes in a single machine Raman micro spectroscopy and multispectral imaging used for tumor diagnosis and prognosis. Lymphocytes from 24 leukaemic patients suffering from hyper leukocytosis Chronic Lymphoid Leukemia and from 11 healthy individual have been studied, using around 90 cells per blood sample. Blood smears were prepared on microscopy slides; cells were localized by optical microscopy, and Raman microspectroscopy spectra were acquired on cell nuclei. Afterward multi-Z stacks images of each cell were acquired for eight bands distributed in the visible spectrum. Raman data's were classified using a Support Vector Machine algorithm that provided a molecular signature that allowed for distinguishing lymphocytes from other nucleated blood components with 99.6% sensibility and 98.8% specificity. Then the algorithm was used for developing a classification model splitting leukaemic and healthy smears; sensibility was 95% and specificity was 87.5% among the spectra used for evaluation: 1540 from 11 leukaemic patients and 516 from seven healthy individual. IHMO project has demonstrated the power of Raman microspectroscopy for cell classification. Morphological descriptors obtained from multi-Z and multispectral images provide another independent classification that still needs to be assessed. The microscopy platform can be used more generally in the field of cytohaematology, however application to cytological and histological pathology would need further developments