Late-onset neutropenia and neurological relapse, during long-term rituximab therapy in myelin oligodendrocyte glycoprotein-antibody spectrum disorder

2018 ◽  
Vol 24 (12) ◽  
pp. 1645-1647 ◽  
Author(s):  
Damien Biotti ◽  
Fleur Lerebours ◽  
Fabrice Bonneville ◽  
Jonathan Ciron ◽  
Michel Clanet ◽  
...  

Late-onset neutropenia after rituximab therapy (LONART) is defined as a fall in the absolute neutrophil count below 500/mm3 at least 3 weeks after rituximab infusion, in the absence of any other explanation. LONART is rare during dysimmune conditions but can be life-threatening. We report on two patients with LONART and associated neurological relapse occurring in myelin oligodendrocyte glycoprotein (MOG)-antibody spectrum disorders. Rituximab was reintroduced in one patient, while the second patient was switched to tocilizumab. LONART can occur during anti-MOG spectrum disorders. Neurologists should be aware of this rare and treatable complication. Regular monitoring of blood cell counts is needed, and patients should be informed of the need to consult their physician if symptoms of infection appear.

2017 ◽  
Vol 44 (3) ◽  
pp. 176-188 ◽  
Author(s):  
Arthur Shiyovich ◽  
Harel Gilutz ◽  
Ygal Plakht

We evaluated the association between white blood cell counts and long-term mortality rates in 2,129 patients (mean age, 65.3 ± 13.5 yr; 69% men) who had survived acute myocardial infarction. We obtained white blood cell counts and differential counts of white blood cell subtypes within the first 72 hours of hospital admission. The primary outcome was all-cause death at 1, 5, and 10 years after acute myocardial infarction. In regard to death in the long term, we found significant negative linear associations (lymphocytes), positive linear associations (neutrophils and the neutrophil-to-lymphocyte ratio), and nonlinear U-shaped associations (basophils, eosinophils, monocytes, and total white blood cell count). After multivariate adjustment for the Soroka Acute Myocardial Infarction risk score, lymphocytes (strongest association), neutrophil-to-lymphocyte ratio, and eosinophils were independently associated with death for up to 10 years after hospital discharge. The independent associations weakened over time. We conclude that lymphocyte count, neutrophil-to-lymphocyte ratio, and eosinophil count are independently and incrementally associated with death in the long term after acute myocardial infarction.


1990 ◽  
Vol 68 (2) ◽  
pp. 375-380 ◽  
Author(s):  
L. L. Wickham ◽  
D. P. Costa ◽  
R. Elsner

Hematologic and rheologie characteristics of blood from captive and free-ranging sea otters, Enhydra lutris, and northern elephant seals, Mirounga angustirostris, were studied to evaluate short- and long-term responses to captivity. Red blood cell counts, white blood cell counts, hemoglobin concentrations, hematocrits, total plasma proteins, and mean corpuscular volume measurements were made on anticoagulated venous blood samples. Mean corpuscular hemoglobin concentrations were calculated. Viscosity measurements were made at shear rates from 11.5 to 230.4 s−1 on a Wells–Brookfield cone-plate viscometer. A capillary viscometer (radius, 500 μm) provided additional viscometric measurements. Comparisons of hematologic and rheologic data revealed only minor differences between captive and free-ranging seals and sea otters. Although hematologic variables were within the ranges reported in earlier wild vs. captive studies of these species, no evidence of short- (3 weeks) or long-term (> 6 months) acclimatization to captive exposure was found in the hemorheology of these marine mammals.


2020 ◽  
Vol 52 (4) ◽  
pp. 783-790
Author(s):  
Efstathios Mitsopoulos ◽  
Aikaterini Lysitska ◽  
Stavros Zanos ◽  
Aikaterini Mplatsa ◽  
Maria-Eleni Alexandrou ◽  
...  

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4382-4382
Author(s):  
Mohammad Abdus Sami ◽  
Maria Feychting ◽  
Niklas Hammar ◽  
Goran Walldius ◽  
Mieke Van Hemelrijck ◽  
...  

Abstract Background: The presence of myeloid-derived inflammation is associated with different malignancies, including Leukemia. Certain risk factors (i.e., age, exposure to carcinogens including chemical and radiation), common gene mutations (such as the BCR-ABL fusion gene), and inflammatory markers (such as C-reactive protein (CRP)) have been associated with the risk of developing Leukemia, however cost-effective and widely acceptable predictor markers are not yet available. This study aimed to investigate the association of standard laboratory inflammatory biomarkers and blood cell counts and the long-term risk of Leukemia in a cohort of healthy individuals. Methods: Individuals from the Swedish Apolipoprotein Risk Study (AMORIS) cohort (n=124609, Male 56.7% vs. Female 43.3 ,>20 years of age) with baseline measurements of C-reactive protein (CRP), albumin, haptoglobin, white blood cell count, mean corpuscular volume (MCV) and platelets were included in the study. Multivariable cox proportional hazard regression analysis adjusted for age, sex, comorbidities (CCI), and socioeconomic status was performed to assess the association of the biomarkers and leukemia diagnosis (ICD-7 (204) Swedish National Cancer Register linkage). Individuals with a leukemia diagnosis within a year of the blood measurement were excluded to account for reverse causation. Considering the time of diagnosis and version of ICD, which was used, it was not possible to stratify patients based on current leukemia classification, including myeloid/ lymphoid or acute/ chronic. Results: A total of 218 participants (0.2%) developed leukemia over a median follow-up time of 17.54 years. Albumin (leukemia free mean=43.23 vs leukemia mean=42.90 (g/l); p<.001) WBC (leukemia free mean=6.62 vs leukemia mean=9.71 (WBC*×10 9/L); p<.001) and platelets (leukemia free mean=257.00 vs leukemia mean=248.99 (Platelets×10 9/L); p<.001) were all statistically significantly associated with risk of leukemia. When analyzing continuous values, the Hazard Ratio (HR) of albumin was: 1.04 (95%Confidence Interval (CI): 0.98-1.09); the HR of WBC was: 1.09 (95%CI 1.08-1.10) and HR for platelets was: 0.99 (95%CI 0.99-1.00). The analyses of the quartiles presented similar trends, albumin (HR Q4 vs Q1: 1.45 (95%CI 0.90-2.32);HR Q3 vs Q1: 1.62 (95%CI 1.04-2.52); HR Q2 vs Q1: 1.80 (95%CI 1.17-2.78)) (p for trend= 0.006), WBC (HR Q4 vs Q1: 3.57 (95%CI 2.38-5.36) ;HR Q3 vs Q1: 1.50 (95%CI 0.96-2.37); HR Q2 vs Q1: 0.84 (95%CI 0.51-1.40)) (p for trend= 0.08) and platelets (HR Q4 vs Q1: 0.77 (95%CI 0.54-1.11) ;HR Q3 vs Q1: 0.63(95%CI 0.43-0.92); HR Q2 vs Q1: 0.58 (95%CI: 0.40-0.86)) (p for trend =0.003). Conclusion: The present study presented a positive association between increasing albumin levels and high numbers of WBC and risk of Leukemia, while a negative association was found with high platelet counts, which highlight these markers as potential markers of long-term risk of Leukemia. The potential clinical use of these markers in the early detection of leukemia needs to be evaluated in further studies. Disclosures Kordasti: Alexion: Honoraria; Beckman Coulter: Honoraria; Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Celgene: Research Funding.


1996 ◽  
Vol 76 (02) ◽  
pp. 184-186 ◽  
Author(s):  
Kenji lijima ◽  
Fumiyo Murakami ◽  
Yasushi Horie ◽  
Katsumi Nakamura ◽  
Shiro Ikawa ◽  
...  

SummaryA 74-year-old female developed pneumonia following herpes simplex encephalitis. Her white blood cell counts reached 28,400/μl, about 90% of which consisted of granulocytes. The polymorphonuclear (PMN) elastase/α1-arantitrypsin complex levels increased and reached the maximum of 5,019 ng/ml, indicating the release of a large amount of elastase derived from the granulocytes. The mechanism of PMN elastase release was most likely to be granulocyte destruction associated with phagocytosis. The cleavage of fibrinogen and fibrin by PMN elastase, independent of plasmin, was indicated by the presence of the fragments in immunoprecipitated plasma from the patient corresponding to elastase-induced FDP D and DD fragments and the absence of fragments corresponding to plasmin-induced FDP D and DD fragments on SDS-PAGE. These findings suggested that the large amount of PMN elastase released from the excessive numbers of granulocytes in this patient with herpes simplex encephalitis and pneumonia, induced the cleavage of fibrinogen and fibrin without the participation of plasmin.


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