Study of peripheral blood thrombocytes in smokers

Total circulating platelet count and thrombocytogram were examined in 60 tobacco smokers and in 30 nonsmoking normal subjects aged 23-32. The smokers were divided into two subgroups, 30 subjects in each: Group 1 included those with a history of smoking under 5 years and Group 2 those smoking for 5 years and Group 2 those smoking for 6-10 years. The platelet count was found increased in Group 1 smokers at the expense of old, atypical, and involutional forms. In Group 2 smokers the total platelet count and the counts of their differentiation forms were reduced. This evidences the effect of tobacco smoking on circulating platelets, this effect depending on the length of tobacco smoke inhalation.     

Characteristics of marrow production and reticulocyte maturation in normal man in response to anemia

Erythropoiesis in normal man was studied during periods of phlebotomy-induced anemia of varying severity. This study permitted a comparison of marrow production measurements over a wide range of marrow production levels. As long as the serum iron remained above 50 mug/100 ml, measurements of plasma iron turnover provided an excellent index of marrow production at all levels of red cell production. In contrast, the absolute reticulocyte count demonstrated a poor correlation with the other measurements. This was shown to be the result of a prolongation of the time required for circulating reticulocytes to lose their reticulum, which correlated with the severity of the anemia. For the clinical application of the reticulocyte count as a measurement of marrow production, an adjustment must be made for this alteration in the circulating reticulocyte maturation time.     

Erythrokinetics: Evaluation of Red Cell Production by Ferrokinetics and Reticulocyte Counts

Abstract. Effective erythroid marrow activity was quantitated by reticulocyte counts and iron kinetics in normal individuals and in 50 patients suffering from various haematological disorders. To allow direct comparison between both measurements normal base line values were established and defined as production index 1. The erythrocyte iron turnovers as calculated from plasma iron turnover and radioiron red cell incorporation were divided by the figure found in normal subjects, 0.49 mg per 100 ml whole blood per day. Reticulocyte percentages were first corrected for changing haematocrit levels considering as normal 1 and 45% respectively. In this form reticulocyte counts overestimated effective red cell production in the majority of anaemic patients. Further correction was needed to account for the well known inverse temporal relationship between the erythropoietin-induced marrow transit acceleration and the prolonged maturation period of circulating reticulocytes. For this purpose the haematocrit-corrected reticulocyte counts were divided by the fraction marrow transit time normal (3.5 days)/marrow transit time patient. This parameter is defined as the time period necessary for 50% appearance of maximum cellular activity. Now production indices derived from the 2 methods agreed almost perfectly. Marrow transit times were related to characteristics of the peripheral blood film, i.e. polychromasia and mean morphological reticulocyte maturation stage. On this basis guidelines were worked out for a meaningful interpretation of reticulocyte counts.     

THE ANEMIA OF SCURVY : EFFECT OF VITAMIN C DIET ON BLOOD FORMATION IN EXPERIMENTAL SCURVY OF GUINEA PIGS

1. Weight loss, progressive anemia, and a moderate increase in reticulated red blood cells occurred in seventeen guinea pigs on a diet deficient in vitamin C. 2. The histological changes of the bone marrow removed from guinea pigs with scurvy showed large numbers of erythrogenic cells, but scant evidence of active maturation to the adult erythrocyte. 3. A reticulocyte response was induced in guinea pigs with scurvy when fed orange juice daily. 4. The histological changes of the bone marrow removed from guinea pigs during the reticulocyte response showed large numbers of mitotic figures and relatively more adult red blood cells than in the bone marrow from guinea pigs with scurvy that had not been treated with orange juice. 5. It is concluded from this study that the anemia of experimentally induced scurvy in the guinea pig is largely dependent upon vitamin C deficiency resulting in retarded maturation of the red blood cell.     

Phase I study of granulocyte colony-stimulating factor in patients with transitional cell carcinoma of the urothelium.

Recombinant human granulocyte colony-stimulating factor (rhG-CSF) was administered at a dose of 1-60 micrograms/kg of body weight to 22 patients with transitional cell carcinoma before chemotherapy as part of a Phase I/II study. In all patients, a specific dose-dependent increase in the absolute neutrophil count (ANC) of 1.8-12 fold was seen. In addition, this augmentation in the ANC was accompanied by an increase in leukocyte alkaline phosphatase, a marker of secondary granule formation. In six of eight patients analyzed, an increase in bone marrow myeloid to erythroid cell ratio was seen. Day 14 peripheral blood cell derived colony forming unit granulocyte macrophage were also increased by day 6 of rhG-CSF treatment. Circulating levels of eosinophils and basophils were unchanged; however, a 10-fold increase in monocytes was observed in patients treated at the highest doses. There was also a small increase in CD3+ lymphocytes that was not dose dependent. Hemoglobin, hematocrit, and platelet count remained near baseline throughout the period of rhG-CSF administration. These findings demonstrate that rhG-CSF is a potent stimulus for normal neutrophil proliferation and maturation.     

缺氧缺血性脑病患儿血常规结果分析及其临床意义

目的探讨27项血常规参数在新生儿缺氧缺血性脑病（HIE）中的变化及其意义。方法利用全自动血细胞分析仪对29例HIE患儿和30例健康新生儿进行白细胞、红细胞及血小板等参数检测,分析其结果和临床意义。结果H1E组与对照组比较,（1）白细胞参数：淋巴细胞比率、单核细胞比率、中性粒细胞比率差异有统计学意义（P〈0．05）,而白细胞计数、嗜酸性粒细胞比率、嗜碱性粒细胞比率差异无统计学意义（P〉0．05）;（2）红细胞参数：血细胞比容、红细胞平均体积、平均血红蛋白浓度（MCHC）、红细胞分布宽度CV、红细胞分布宽度SD、网织红细胞计数、网织红细胞百分比、未成熟网织红细胞、低荧光网织红细胞比率、高荧光网织红细胞比率、有核红细胞计数、有核红细胞百分比等12项红细胞参数差异有统计学意义（P〈0．05）,而红细胞计数、血红蛋白、平均血红蛋白含量、中荧光强度网织红细胞比率等参数差异无统计学意义（P〉0．05）;（3）血小板参数：血小板计数、血小’板：压积差异有统计学意义（P〈0．05）,而平均血小板体积、血小板分布宽度及大型血小板比率等参数差异无统计学意义（P〉0．05）。结论利用全自动血细胞分析仪对HIE患儿外周血进行常规筛查和动态监测,计数快速、准确,能很好地满足临床应用,协助临床诊断HIE。     

Cell-cycle distribution of different cell compartments in normal versus reactive bone marrow: a frame of reference for the study of dysplastic hematopoiesis

Limited information is currently available about the proliferation activity and cell-cycle distribution of different bone marrow (BM) cell subsets defined according to their lineage and maturation stage in normal versus cytopenia-associated reactive BM samples. Here, we report a three-color flow cytometry approach to investigate the cell-cycle distribution of different BM cell compartments-CD34(+) hematopoietic progenitor and precursor cells (HPC), maturing neutrophils and monocytic cells, mature lymphocytes, eosinophils, and nucleated red blood cell precursors (NRBC)-from normal (n = 47) versus cytopenia-associated reactive (n = 47) BM samples. Highly similar proliferation profiles were detected in normal versus reactive BM, with a higher proliferation index (PI) for the more immature CD34(+) HPC, CD11b(-) maturing neutrophils and NRBC versus other BM cell compartments. The only differences observed between normal and reactive BM were restricted to the more mature (CD13(hi) /CD11b(+) ) bands/neutrophils and to monocytic cells, which showed an increased PI (0.9% ± 0.8% vs. 0.6% ± 0.5% and 6 ± 3.6 vs. 4.6 ± 4.5, respectively) at the expense of a lower PI of CD34(+) HPC in reactive conditions. Of note, bands/mature neutrophils and mature lymphocytes showed either residual numbers or absence of S + G? /M-phase cells in both normal and reactive BM. Our results suggest that a slight shift of proliferation from the early precursors to the more mature granulomonocytic compartment occurs in reactive BM, which could reflect an attempt of the hematopoietic system to rapidly produce functional neutrophils and monocytes, at the expense of a lower expansion of the minor compartments of CD34(+) HPC.     

Reticulocyte count with maturation fractions in pancytopenic evaluation by a fully automated counter

Using a fully automated reticulocyte counter, the roles of the reticulocyte count with maturation in pancytopenia were evaluated. Different groups of pancytopenia including aplastic anemia, infiltrative marrow disorder, hypersplenism, and megaloblastic anemia were recruited. All patients had bone marrow examinations for morphological diagnosis and reticulocyte evaluation using an automated counter. The roles of these parameters were then analyzed statistically in the differential evaluation among these conditions. The following subjects were studied: 292 normal subjects, 67 cases of aplastic anemia, 69 cases of marrow infiltration by different malignancies, 35 cases of hypersplenism, and 13 cases of megaloblastic anemia. The results showed that the absolute retlculocyte counts were lowest in the groups of aplastic anemia and megaloblastic anemia and highest in hypersplenism. Both showed significant differences from the infiltrative groups. The maturation fractions were most immature in the group of marrow infiltration and are significantly different from the other groups. It was concluded that the highest absolute reticulocyte count (>0.09 10¹²/L) obtained in pancytopenic patients suggests it to be a case of hypersplenism. The lowest counts ( < 0.03 10¹²/L) with lowest immature fractions ( < 10%) suggest the groups of aplastic or megaloblastic anemias. The highest immature fractions ( >30%) with a nearly normal reticulocyte count favor the group of marrow infiltration. © 1993 Wiley-Liss, Inc.     

Anemia in the elderly. Symptoms, causes, and therapies

Anemia is common in the elderly, but it is not a normal manifestation of aging and should be evaluated as it would be in a younger person. History taking, physical examination, assessment of red cell morphology, and simple laboratory evaluations (ie, reticulocyte count, iron studies, vitamin levels, sometimes bone marrow examination) usually elucidate the cause. Hypoproliferation of red cells is the most common form of anemia in the elderly, caused more often by chronic disease or iron deficiency and less often by vitamin deficiencies or bone marrow infiltration. Anemia with an elevated reticulocyte count, seen less often in the elderly, suggests acute blood loss or hemolysis. In some patients, the cause is not obvious, and anemia is likely due to increased sensitivity of the hematopoietic system to multiple insults and decreased homeostatic reserve. Transfusions should be used judiciously in patients with symptomatic anemia who are likely to benefit from increased oxygen delivery after transfusion.     

Impact of allogenic blood transfusions on temperature,platelet count and differential leukocyte count of patients after coronary artery bypass grafting

We compared the median values of temperature, platelet count, white blood cell count and differential leukocyte count (neutrophils, eosinophils, basophils, lymphocytes and monocytes) just before and after coronary artery bypass grafting of patients transfused with packed red cell units (n = 119), and not transfused with packed red cell units (n = 98). Just before surgery and at 7 h, 13 h, 22 h, 46 h and 142 h after surgery, blood samples were taken. In the patient group undergoing transfusion lower median values at a significance level of alpha = 0.025 were found of their temperature postoperatively at 7 h, platelets at 22 h, 46 h and 142 h, white blood cell count at 13 h and 22 h, neutrophils at 7 h, 13 h and 22 h, lymphocytes at 46 h and 142 h, compared to the patients not transfused.     

Measures in the campaign against smoking and their efficacy according to the results of a 3-year observation under the conditions of a district polyclinic

Examination of 4185 men aged 30 to 59 years, carried out within the framework of investigations into multifactorial prevention of coronary heart disease enabled one to establish that the number of tobacco-smokers among that group men amounts to 45.1%. The percentage of tobacco-smokers appreciably decreases with age. Every second tobacco-smoker starts smoking at the age of 15 to 25 years and smokers out up to 20 and over cigarettes a day. It has been established that 86% of the tobacco-smokers have been smoking for more than 20 years, which allows attributing them to a group of persons suffering from stage III-IV tobacco-smoking, needing therapeutic care. Tobacco-smoking control consisting in group and individual interviews made it possible to lower the populational level of tobacco-smoking by 8.4% for 2 years. In the reference group, that indicator decreased by 1.4%. A new narcologic method of the treatment of tobacco-smoking has been elaborated, the efficacy of which amounted to 85.3% for a year. The use of the method led to the lowering of the populational level of tobacco-smoking by 15.1% during 3 years. In the reference group, the number of tobacco-smokers dropped by 4.7%.     

The erythrokaryocyte, the reticulocyte, the normocyte: their place in the scheme of erythropoiesis]

Estimation of reticulocyte and polychromatophil counts has shown that only 28.7-44.9 percent of blood reticulocytes and 61.7 percent of bone marrow reticulocytes are polychromatophilic. Polychromatophil count is approximately equal to the sum of classes I and II reticulocytes. Bone marrow smears staining to detect reticulocytes, followed by staining according to Romanovsky-Giemsa has shown that only solitary erythrokaryocytes did not contain granular or filament reticular substance. The authors analyze the following suppositions: eliminate reticulocytes from the erythropoiesis scheme, denote the former normoblasts erythrokaryocytes but not normocytes, demonstrate the possibility of mature red cell production from oxyphilic erythrokaryocytes and from polychromophilic erythrokaryocytes via polychromatophilic red cells in the scheme.     

Exacerbation of autoimmune hemolytic anemia associated with pure red cell aplasia after COVID-19: A case report

Autoimmune hemolytic anemia (AIHA) and pure red cell aplasia (PRCA) are rare complications of coronavirus disease 2019 (COVID-19). Herein, we report the case of a 28-year-old Japanese man who showed severe AIHA exacerbation associated with PRCA after COVID-19. AIHA was diagnosed and maintained for 5 years. Approximately 4 weeks after COVID-19, the patient developed severe anemia (hemoglobin level, 3.4 g/dL). Laboratory test results confirmed hemolytic exacerbation of IgG-mediated warm-type AIHA. Despite the hemolysis phase, the bone marrow revealed extreme hypoplasia of erythroblasts with a decreased reticulocyte count, similar to that observed in patients with PRCA. During oral prednisolone treatment, the patient recovered from anemia and showed increased reticulocyte count and reduced hypoplasia of marrow erythroblasts. Exacerbation of AIHA and PRCA was triggered by COVID-19 because other causes were ruled out. Although this case report highlights that COVID-19 could lead to hematological complications such as AIHA and PRCA, the exact mechanisms remain unclear.     

THE ERYTHROPOIETIC ACTION OF GERMANIUM DIOXIDE : II. THE SOURCE OF THE ERYTHROCYTHEMIA PRODUCED BY GERMANIUM DIOXIDE IN THE ALBINO RAT.

A histological comparison of the liver, spleen, bone marrow, circulating young erythrocytes, and differential count in mature male and female albino rats receiving germanium dioxide with their litter controls not receiving this compound was made. It was found that the livers of the test animals in most cases showed a condition of capillary dilatation and that more erythrocytes were in these capillaries than were in those of the controls. There was no evidence of any red cell formation by the liver. The spleens of the test rats gave the impression of being slightly more congested and of having a slightly more dense concentration of cells in the Malpighian corpuscles than those of the controls. There was no evidence of an increased red cell destruction nor was there any evidence of splenic erythropoiesis. In the bone marrow of the rats which had received the germanium dioxide injections there was evidence of a marked stimulation in formation of nucleated erythrocytes, in that many more of these cells were found here than in the marrow sections of the controls. The circulating blood of the test rats contained more young red cells as demonstrated by the increased number of erythrocytes taking the polychromatic stain than did the blood of the controls. No noteworthy differences in the values for the various types of white cells in the circulation determined by the differential count could be found between the two groups. Using, then, as an acceptable criterion of erythropoiesis an increase in the number of erythrocytes in the circulation which is accompanied by an increase in the number of young red cells, and an increased number of nucleated erythrocytes in the bone marrow, we consider ourselves justified in concluding that germanium dioxide is a potent erythropoietic agent and the source of the erythrocythemia produced by this compound is the increased production of red cell precursors by the bone marrow stimulated to increased activity by the compound used.     

A novel antagonist of prostaglandin D2 blocks the locomotion of eosinophils and basophils

Background  Chemoattractant receptor homologous molecule of Th2 cells (CRTH2) has been shown to mediate the chemotaxis of eosinophils, basophils and Th2-type T lymphocytes. The major mast cell product prostaglandin (PG) D₂ is considered to be the principal ligand of CRTH2.
Materials and methods  We developed a novel CRTH2 antagonist, AZ11665362 [2,5-dimethyl-3-(8-methylquinolin-4-yl)-1H-indole-1-yl]acetic acid, and characterized its efficacy in binding assay in HEK293 cells, eosinophil and basophil shape change assay and migration assay, platelet aggregation and eosinophil release from guinea pig bone marrow. The effects were compared with ramatroban, the sole CRTH2 antagonist clinically available to date.
Results  AZ11665362 bound with high affinity to human and guinea pig CRTH2 expressed in HEK293 cells and antagonized eosinophil and basophil shape change responses to PGD₂. AZ11665362 was without effect on the PGD₂-induced inhibition of platelet aggregation. In contrast, AZ11665362 effectively inhibited the in vitro migration of human eosinophils and basophils towards PGD₂. The release of eosinophils from the isolated perfused hind limb of the guinea pig was potently stimulated by PGD₂, and this effect was prevented by AZ11665362. In all assays tested, AZ11665362 was at least 10 times more potent than ramatroban.
Conclusions  AZ11665362 is a potent CRTH2 antagonist that is capable of blocking the migration of eosinophils and basophils, and the rapid mobilization of eosinophils from bone marrow. AZ11665362 might hence be useful for the treatment of allergic diseases.     

Automatic analysis of normal bone marrow blood cells using the XE-2100 automated hematology analyzer

The bone marrow aspiration test conventionally has been performed by visual methods, using a light microscope, because automatic blood cell analyzers cannot adequately capture erythroblasts and immature granulocytes (IGs) (Tatsumi et al.: Osaka City Med J 1988;34:135-146; Tatsumi et al.: Am J Clin Pathol 1986;86:50-54). With the development of the XE-2100 automatic blood cell analyzer (Sysmex Corporation, Kobe, Japan) in 1999, the classification of erythroblasts and IGs by means of flow cytometry (Zini et al.: Infus Ther Transfus Med 2001;28:277-279; Briggs et al.: Sysmex J Int 1999;9:113-119) became possible. In the present study we classified cells in 65 bone marrow aspiration specimens by the microscopic method and with the XE2100, and compared the results. A good correlation was found in the nucleated red blood cell (NRBC), white blood cell (WBC), and total nucleated cell (TNC) counts; the myeloid/erythroid ratio (M/E ratio); neutrophils, lymphocytes, eosinophils, and IGs in the immature myeloid information (IMI) channel; and the total cell count. These items can all be analyzed in about 54 sec with the XE2100, which is faster than with the microscopic method. Therefore, analysis of bone marrow aspiration specimens with this apparatus appears to be very useful for clinical screening as well as laboratory testing.     

Smoking and serum alpha 1-antitrypsin in 1296 healthy men (author's transl)]

Serum alpha 1-antitrypsin (alpha 1AT) was measured by radial immunodiffusion in 1296 healthy men aged 18--50 years. Other biological criteria, including leukocyte count and alpha 2-globulins were measured and the subjects were given a detailed questionnaire on their smoking habits. Results showed a very strong positive relationship between smoking and serum alpha 1AT: the heavy smokers had a serum alpha 1AT 20% higher than the non-smokers, and among subjects who stopped smoking, the level returned rapidly to normal. There were also close interrelationships between serum alpha 1AT, smoking, leukocyte count and a alpha 2-globulins. A discussion of these results is presented.     

不同剂量~(60)Co辐照血血细胞超微结构的变化

目的　了解经不同剂量60 Co辐照血红细胞、白细胞 (嗜中性粒细胞、嗜碱性粒细胞、嗜酸性粒细胞、淋巴细胞与单核细胞 )、血小板超微结构的变化。方法　应用透射电子显微镜观察细胞形态。结果　经不同剂量60 Co辐照后血液部分嗜中性粒细胞与淋巴细胞 ,出现细胞超微结构异常与细胞凋亡现象 ,占有核细胞的 7%～ 2 4 %。且随着辐照剂量的增加 ,嗜中性粒细胞与淋巴细胞超微结构发生异常与凋亡比例也有所增加。未发现嗜碱性粒细胞、嗜酸性粒细胞、单核细胞、血小板与红细胞超微结构的异常。结论　经 1 5～ 35GY60 Co辐照后血液除部分嗜中性粒细胞与淋巴细胞超微结构有影响外 ,其他血细胞超微结构几乎没有影响     

网织红细胞参数在急性白血病化疗中的应用价值

目的研究急性白血病化疗前后网织红细胞参数变化的临床意义。方法 32例急性白血病化疗的患者,化疗后好转。用自动化血液分析仪Sysmex 2000检测患者的网织红细胞比率(RET%)、网织红细胞绝对值((RET#)、低荧光强度的网织红细胞(LFR)、中荧光强度的网织红细胞(MFR)、高荧光强度的网织红细胞(HFR)、白细胞(WBC)、中性粒细胞绝对值(ANC)以及未成熟网织红细胞比率(IRF)。结果急性白血病化疗患者IRF、MFR、HFR化疗后一直减低,化疗第7天降到最低,在化疗第14天开始恢复,化疗第21天恢复至化疗前水平。LFR于化疗第7天开始升高,化疗14d开始降低,WBC和网织红细胞绝对值计数于化疗第7、14天一直降低,化疗21d开始恢复。结论 IRF、MFR、HFR、LFR是反应骨髓恢复的敏感指标,较WBC和网织红细胞的绝对值早7d。