Automated measurement of schistocytes after bone marrow transplantation

Bone Marrow Transplantation
J F LesesvePierre Bordigoni

Abstract

Bone marrow transplantation-related thrombotic microangiopathy (BMT-TMA) is a severe complication partly suspected on the evidence of a microangiopathic haemolysis. Microscopic schistocyte observation confirms the mechanical origin of the haemolysis, but remains a tedious procedure that lacks standardization. Direct measurement of abnormal red blood cell (RBC) fragments is now available on some automated haematology systems. We compared in 131 patients (69 BMT with five BMT-TMA, 38 thrombotic thrombocytopenic syndromes, 11 macroangiopathies, 13 dyserythropoiesis) percentages of microscopic schistocytes and automated RBC fragments (Bayer ADVIA 120) to evaluate the clinical relevance of the automated measurements for BMT-TMA detection. The analyser correlated well with the microscope (intraclass correlation coefficient: 0.82) and quantified RBC fragments with a moderate overestimation (+0.4%) as compared to microscopic counts. BMT patients had higher RBC fragments when they had TMA (1.1 vs 0.4% without TMA). Automated counting was useful to flag BMT-related TMA, particularly when RBC fragments were above 1%. As RBC fragments were frequently detected in BMT patients even without TMA, a threshold of less 1% that ruled out TMA was d...Continue Reading

References

Nov 25, 1998·Bone Marrow Transplantation·A ZomasJ Mehta
Jan 14, 1999·British Journal of Haematology·G RockW B Benny
Aug 15, 2000·American Journal of Clinical Pathology·J E KunickaD Zelmanovic
Aug 23, 2002·The New England Journal of Medicine·Joel L Moake

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Citations

Jun 15, 2012·International Journal of Laboratory Hematology·J-F LesesveG Zini
Nov 9, 2012·International Journal of Laboratory Hematology·K ChalvatziE Diza
Nov 23, 2013·International Journal of Laboratory Hematology·J-F LesesveT Lecompte
Apr 23, 2013·International Journal of Laboratory Hematology·J-F LesesveF Régnier
Jun 29, 2005·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Corey CutlerJoseph H Antin
Feb 14, 2015·Clinics in Laboratory Medicine·Thomas Pierre Lecompte, Michael Pierre Bernimoulin
May 4, 2007·International Journal of Laboratory Hematology·J-F LesesveT Lecompte
Feb 3, 2011·International Journal of Laboratory Hematology·J-F LesesveP Bordigoni
Aug 30, 2019·Journal of Perinatology : Official Journal of the California Perinatal Association·Timothy M BahrSterling T Bennett
Apr 24, 2019·Research and Practice in Thrombosis and Haemostasis·Anoop K EnjetiGeoffrey K Isbister
Nov 16, 2011·International Journal of Laboratory Hematology·G ZiniUNKNOWN International Council for Standardization in Haematology (ICSH)

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