Caractérisation des plasmocytes médullaires par cytométrie de flux 8 couleurs dans les gammapathies monoclonales

CHATENAY M.-PARIS 11-BU Pharma. (920192101) / SudocSudocFranceF

Carboxyhemoglobin, a reliable diagnosis biomarker for hemolysis in intensive care unit: a retrospective study

International audienceHemolytic anemia (HA) is a common condition in intensive care units (ICU) responsible for life-threatening organ failure in severe cases [1]. HA needs urgent treatment initiation, but its diagnosis remains challenging as none of the biological diagnostic parameters, including bilirubin, LDH and haptoglobin, are specific. During hemolysis, free hemoglobin released by red blood cells is catabolized by heme-oxygenase 1, leading to formation of iron, biliverdin and carbon monoxide [2]. Next, carbon monoxide binds to free hemoglobin to form carboxyhemoglobin. Carboxyhemoglobin is routinely measured in ICU and available within a few minutes by CO-oximetry, a point of care testing (GEM® Premier™ 4000, Werfen, Le Pré-Saint-Gervais, France) [3]. Our objective was to evaluate carboxyhemoglobin as a diagnostic tool for HA in adult patients admitted in ICU

Dominance of an UBA1 mutant clone over a CALR mutant clone: from essential thrombocytemia to VEXAS.

International audienc

Clinical and biological impact of ATP-binding cassette transporter activity in adult acute myeloid leukemia

International audienceChemotherapy resistance is the main cause of treatment failure in acute myeloid leukemia (AML) and has been related to ATP-binding cassette (ABC) transporter activity. However, the links between ABC activity, immunophenotype, and molecular AML parameters have been poorly evaluated. Moreover, the prognostic value of ABC activity, when compared to new molecular markers, is unknown. Here we investigated the links between ABC activity, as evaluated by JC-1 +/- cyclosporine A assay, and immunophenotypic, cytogenetic, molecular, and targeted next-generation sequencing features in 361 AML patients. High ABC activity was found in 164 patients and was significantly associated with less proliferating disease, an immature immunophenotype (expression of CD34, HLA-DR, CD117, CD13), and gene mutations defining AML as belonging to secondary-type ontogenic groups. Low ABC activity was associated with more mature myeloid differentiation (CD34-, cyMPO+, CD15+, CD33+) or monocytic commitment (CD64+, CD4+weak, CD14+), with NPM1 mutations, KMT2A rearrangements, and core-binding factor gene fusions, hallmarks of the de novo-type AML ontogeny. ABC activity was one of the major factors we identified using a random forest model for early prediction of AML ontogeny. In the 230 patients evaluated at diagnosis and intensively treated, high ABC activity was a predictive factor for primary resistance, and in multivariate analysis including full molecular data, an independent factor for event-free survival (P=0.0370). JC-1 +/- cyclosporine A assay could be used at diagnosis to predict AML ontogeny and to complete prognosis evaluation in addition to new molecular markers