scholarly journals Digital AI in Hematology - Integration of the Scopio Labs x100 Scanner with Newly Implemented AI Capabilities into Routine Clinical Workflow

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4932-4932
Author(s):  
Christian Salib ◽  
Swati Bhardwaj ◽  
Shafinaz Hussein ◽  
Siraj El Jamal ◽  
Bruce Petersen ◽  
...  
Keyword(s):  
Peripheral Blood ◽  
Lymphoblastic Leukemia ◽  
The United States ◽  
Cell Counting ◽  
Clinical Workflow ◽  
Report Generation ◽  
Full Field ◽  
Cell Quantification ◽  
Tumor Boards ◽  
Reference Images

Abstract BACKGROUND Digital pathology and artificial intelligence (AI) are areas of growing interest in pathology. A number of institutes have already integrated digital imaging into routine workflow, relying on AI algorithms for the detection of various cancers and mitotic activity quantification. Despite the use of whole slide imaging (WSI) for tissue evaluation, the field of hematology has lagged behind. While many hospitals rely on limited technologies for automated peripheral blood evaluation (e.g. CellavisionTM), the Scopio LabsTM X100 digital scanner provides high resolution oil-immersion level dynamic images of large scanned areas (https://scopiolabs.com/hematology/). With recent FDA-clearance and newly implemented AI capabilities, the Scopio Labs scanner allows for clear and accurate cytomorphologic characterization and cell quantification for peripheral blood smears (PBS). To this end, we aimed to be one of the few pioneering institutes in the United States to adopt early and implement this technology into our routine workflow as a 'hub and spoke' model for optimized case assessment, data sharing and result reporting across multiple satellite locations within our hospital health system. DESIGN A Scopio x100 digital scanner was deployed at our main hospital site, with an anticipated secondary scanner for installment at a satellite laboratory. PBS flagged for hematopathologist review from two satellite laboratories were scanned, and full-field digitalized slides were evaluated by hematopathologists following AI automated analyses. RESULTS 311 peripheral smears were scanned since April 2021 and representative slides were digitalized at 100x magnification (Figure 1, weblink: https://demo.scopiolabs.com/#/view_scan/9231acaf-f898-4649-950d-a41c26c2baaa) with rapid monolayer, monolayer, full-field, and full-field cytopenia scan options available. The automated AI capabilities classified cells into lineage-specific categories with quantification based on cytomorphologic features (Figure 2). Other AI features include additional cell assignment, cell annotation and comments accessible to all users, finalized report PDF generation, export, upload into our current PowerPath TM software with linkage to the corresponding flow cytometry and bone marrow biopsy reports; and the ability to share digitalized slides with clinicians, laboratory personnel and trainees using uniquely generated weblinks. Images can be used for lectures and tumor boards. Additionally, an 80-case study set for PBS was created for medical students, residents and fellow teaching purposes, including cases displaying acute B-cell lymphoblastic leukemia (B-ALL), acute myelomonocytic leukemia (AMML), hypersegmented neutrophils in COVID-19(+) patients, myelodysplastic syndrome (MDS), atypical lymphocytes, hemoglobinopathies, platelet disorders and various lymphomas. Overall improvements were made to the following areas: CLINICAL WORK/DIAGNOSIS 1. Time-saving due to pre-categorization of cells into lineage-specific groups for pathologist review 2. Minimizes subjectivity in cell counting and cellularity assessment EDUCATION 1. Case-based collection with flow and molecular being maintained here 2. Efficient case retrieval with retained annotations/comments for teaching purposes 3. Wide array of digitalized images for hematology atlas and publications ARCHIVING 1. Collection of reference images (intra/inter departmental) for an array of morphological entities for clinical reference and refined diagnosis (e.g. Bethesda reference images for pap by ASC) 2. Digital catalogue for long-term case follow-up and retrospective review CONCLUSION The Scopio Labs X100 digital system provides an efficient and cost-effective web-based tool to streamline clinical workflow and enhance PBS evaluation. With its recent AI capabilities of cell quantification, lineage-assignment and report-generation, we aim to continue our efforts to fully integrate Scopio Labs into our routine daily clinical workflow for reviewing PBS specimens. CONFLICT OF INTEREST STATEMENT The authors have nothing to disclose with regard to the submitted work Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

High-Dose Vincristine Sulfate Liposome Injection (Marqibo®) Is Not Associated With Clinically Meaningful Hematologic Toxicity

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2676-2676
Author(s):  
Olivia R. Deitcher ◽  
John Glaspy ◽  
Rene Gonzalez ◽  
Takami Sato ◽  
Agop Bedikian ◽  
...  
Keyword(s):  
Peripheral Blood ◽  
Hematologic Malignancy ◽  
Lymphoblastic Leukemia ◽  
Philadelphia Chromosome ◽  
The United States ◽  
Cumulative Exposure ◽  
High Dose ◽  
Hematologic Toxicity ◽  
Median Dose ◽  
Vincristine Sulfate

Abstract Background The treatment of hematologic malignancy patients with heavily pre-treated, advanced, relapsed, or refractory disease and those with advanced age, active infection, cardiovascular disease, recent surgery, or poor performance status may require therapies with limited hematologic toxicity and associated peripheral blood cytopenias. Cancer and concomitant chemotherapy related anemia, neutropenia, and thrombocytopenia in patients with hematologic malignancy complicate evaluation of hematologic toxicity related to new drugs. Vincristine sulfate liposome injection (VSLI; Marqibo®) is a new drug developed to optimize vincristine (VCR) pharmacokinetics and facilitate VCR dose-intensification and densification. VSLI is active in untreated and relapsed lymphomas, and was recently approved in the United States for relapsed and refractory adult Philadelphia chromosome-negative acute lymphoblastic leukemia. Methods We assessed the hematologic toxicity of VSLI 2.25 mg/m2 administered every 14 days (Cohort 1) or 7 days (Cohort 2) in 54 patients with metastatic uveal melanoma, a cancer not known to involve the bone marrow. Cohort 1 patients could have received 1 prior systemic therapy. Cohort 2 patients must not have received any prior systemic chemotherapy, immunotherapy, cancer vaccine, or hepatic arterial chemotherapy for metastatic disease. Results Patients in Cohort 2 received a higher median number of VSLI doses (6 vs. 4) over a shorter median time period (5.7 weeks vs. 8.7 weeks) resulting in a larger median cumulative exposure (22.6 mg vs. 17.7 mg) and near doubling of median dose density (4.0 mg/week vs. 2.2 mg/week) compared to patients in Cohort 1. Despite greater VSLI exposure and dose density, Cohort 2 had a smaller decrease from baseline in median neutrophil count and greater increase from baseline in median platelet count compared to Cohort 1. Both Cohorts experienced similar gradual decreases in hemoglobin concentration over time that were attributed to cancer-associated anemia and frequent blood sampling. Hematologic adverse events (AEs) were uncommon and mostly Grade 1 or 2. There were no Grade 4 hematologic AEs. Conclusions VSLI at its approved dose resulted in a low incidence of clinically meaningful hematologic toxicity. A near doubling of median dose density did not have an impact on the reported incidence and severity of hematologic AEs. VSLI may be well suited for use alone or in combination with myelosuppresive drugs and in patients unable to tolerate peripheral blood cytopenias. Disclosures: Silverman: Talon Therapeutics: Employment. Deitcher:Talon Therapeutics: Employment, Equity Ownership.

scholarly journals Outcomes for Children and Adolescents With Cancer: Challenges for the Twenty-First Century

2010 ◽  
Vol 28 (15) ◽  
pp. 2625-2634 ◽  
Author(s):  
Malcolm A. Smith ◽  
Nita L. Seibel ◽  
Sean F. Altekruse ◽  
Lynn A.G. Ries ◽  
Danielle L. Melbert ◽  
...  
Keyword(s):  
United States ◽  
Childhood Cancer ◽  
Cancer Mortality ◽  
Lymphoblastic Leukemia ◽  
The United States ◽  
Mortality Rates ◽  
Mortality Data ◽  
Childhood Cancers ◽  
Essential Information ◽  
The Impact

Purpose This report provides an overview of current childhood cancer statistics to facilitate analysis of the impact of past research discoveries on outcome and provide essential information for prioritizing future research directions. Methods Incidence and survival data for childhood cancers came from the Surveillance, Epidemiology, and End Results 9 (SEER 9) registries, and mortality data were based on deaths in the United States that were reported by states to the Centers for Disease Control and Prevention by underlying cause. Results Childhood cancer incidence rates increased significantly from 1975 through 2006, with increasing rates for acute lymphoblastic leukemia being most notable. Childhood cancer mortality rates declined by more than 50% between 1975 and 2006. For leukemias and lymphomas, significantly decreasing mortality rates were observed throughout the 32-year period, though the rate of decline slowed somewhat after 1998. For remaining childhood cancers, significantly decreasing mortality rates were observed from 1975 to 1996, with stable rates from 1996 through 2006. Increased survival rates were observed for all categories of childhood cancers studied, with the extent and temporal pace of the increases varying by diagnosis. Conclusion When 1975 age-specific death rates for children are used as a baseline, approximately 38,000 childhood malignant cancer deaths were averted in the United States from 1975 through 2006 as a result of more effective treatments identified and applied during this period. Continued success in reducing childhood cancer mortality will require new treatment paradigms building on an increased understanding of the molecular processes that promote growth and survival of specific childhood cancers.

A CLINICOPATHOLOGICAL STUDY OF ACUTE AND CHRONIC LEUKEMIA IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 72-74
Author(s):  
Sarat Das ◽  
Prasanta Kr. Baruah ◽  
Sandeep Khakhlari ◽  
Gautam Boro
Keyword(s):  
Acute Myeloid Leukemia ◽  
Acute Lymphoblastic Leukemia ◽  
Peripheral Blood ◽  
Myeloid Leukemia ◽  
Blood Smear ◽  
Lymphoblastic Leukemia ◽  
Peripheral Blood Smear ◽  
Care Hospital ◽  
Cytochemical Study ◽  
Acute Myeloid

Introduction: Leukemias are neoplastic proliferations of haematopoietic stem cells and form a major proportion of haematopoietic neoplasms that are diagnosed worldwide. Typing of leukemia is essential for effective therapy because prognosis and survival rate are different for each type and sub-type Aims: this study was carried out to determine the frequency of acute and chronic leukemias and to evaluate their clinicopathological features. Methods: It was a hospital based cross sectional study of 60 patients carried out in the department of Pathology, JMCH, Assam over a period of one year between February 2018 and January 2019. Diagnosis was based on peripheral blood count, peripheral blood smear and bone marrow examination (as on when available marrow sample) for morphology along with cytochemical study whenever possible. Results: In the present study, commonest leukemia was Acute myeloid leukemia (AML, 50%) followed by Acute lymphoblastic leukemia (ALL 26.6%), chronic myeloid leukemia (CML, 16.7%) and chronic lymphocytic leukemia (CLL, 6.7%). Out of total 60 cases, 36 were male and 24 were female with Male:Female ratio of 1.5:1. Acute lymphoblastic leukemia was the most common type of leukemia in the children and adolescents. Acute Myeloid leukemia was more prevalent in adults. Peripheral blood smear and bone Conclusion: marrow aspiration study still remains the important tool along with cytochemistry, immunophenotyping and cytogenetic study in the diagnosis and management of leukemia.

Peripheral blood count abnormalities among patients with hepatitis C in the United States

Hepatology ◽  
2002 ◽  
Vol 35 (4) ◽  
pp. 947-952 ◽  
Author(s):  
Michael B. Streiff ◽  
Shruti Mehta ◽  
David L. Thomas
Keyword(s):  
United States ◽  
Hepatitis C ◽  
Peripheral Blood ◽  
Blood Count ◽  
The United States ◽  
Peripheral Blood Count

scholarly journals Therapeutic Effect of Exogenous Treg Cells on Collagen-Induced Arthritis and Rheumatoid Arthritis

2019 ◽  
Author(s):  
Shutong Li ◽  
Hongxing Wang ◽  
Hui Wu ◽  
Guoqing Zhang ◽  
Xiaotian Chang
Keyword(s):  
Rheumatoid Arthritis ◽  
Flow Cytometry ◽  
Peripheral Blood ◽  
Synovial Fibroblast ◽  
Treg Cells ◽  
Cell Counting ◽  
Fibroblast Cells ◽  
Collagen Induced Arthritis ◽  
Gm Csf

Abstract Background Regulatory T (Treg) cells have anti-inflammatory and anti-autoimmune functions. The proportion and functions of Treg cells are perturbed in rheumatoid arthritis (RA) patients. Methods Human Treg cells were induced to amplify in vitro and cocultured with RA synovial fibroblast cells (RASFs). The proliferation and apoptosis of RASFs were determined by the cell counting kit-8 (CCK-8) assay and flow cytometry, respectively. Human Treg cells were also injected to collagen-induced arthritis (CIA) rats via the tail vein. Changes in lymphocyte subtypes and cytokines in the peripheral blood and spleen were observed by flow cytometry. Results After coculture with the Treg cells, the proliferation of RA synovial fibroblast cells decreased (p<0.01), and the rate of apoptosis increased (p=0.037). The human Treg cells were injected into the tail veins of collagen-induced arthritis (CIA) rats. The severity of the CIA was reduced (p<0.01) following the injection, the percentages of rat endogenous Treg cells in the peripheral blood and spleen increased significantly (p=0.007 and p<0.01, respectively), and the proportion of B cells decreased (p=0.031). The levels of interleukin IL-5 and IL-6 and the Th1/Th2 ratio in the peripheral blood were significantly decreased (p=0.013, 0.009 and 0.012, respectively). The number of NK cells and the levels of IL-4, IL-13, TNF-α, IFN-γ and GM-CSF in the peripheral blood and spleen did not change significantly. Conclusion These results suggest that exogenous Treg cells play a therapeutic role in RA and CIA. Treg cell treatment could serve as a therapy for RA.

scholarly journals Pharmacogenomic markers of glucocorticoid response in the initial phase of remission induction therapy in childhood acute lymphoblastic leukemia

2018 ◽  
Vol 52 (3) ◽  
pp. 296-306 ◽  
Author(s):  
Vladimir Gasic ◽  
Branka Zukic ◽  
Biljana Stankovic ◽  
Dragana Janic ◽  
Lidija Dokmanovic ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Acute Lymphoblastic Leukemia ◽  
Peripheral Blood ◽  
Initial Phase ◽  
Lymphoblastic Leukemia ◽  
Childhood Acute Lymphoblastic Leukemia ◽  
Remission Induction ◽  
Induction Treatment ◽  
Glucocorticoid Response ◽  
Blast Count

AbstractBackgroundResponse to glucocorticoid (GC) monotherapy in the initial phase of remission induction treatment in childhood acute lymphoblastic leukemia (ALL) represents important biomarker of prognosis and outcome. We aimed to study variants in several pharmacogenes (NR3C1,GSTsandABCB1) that could contribute to improvement of GC response through personalization of GC therapy.MethodsRetrospective study enrolling 122 ALL patients was carried out to analyze variants ofNR3C1(rs33389, rs33388 and rs6198),GSTT1(null genotype),GSTM1(null genotype),GSTP1(rs1695 and rs1138272) andABCB1(rs1128503, rs2032582 and rs1045642) genes using PCR-based methodology. The marker of GC response was blast count per microliter of peripheral blood on treatment day 8. We carried out analysis in which cut-off value for GC response was 1000 (according to Berlin-Frankfurt-Munster [BFM] protocol), as well as 100 or 0 blasts per microliter.ResultsCarriers of rareNR3C1rs6198 GG genotype were more likely to have blast count over 1000, than the non-carriers (p = 0.030).NR3C1CAA (rs33389-rs33388-rs6198) haplotype was associated with blast number below 1000 (p = 0.030).GSTP1GC haplotype carriers were more likely to have blast number below 1000 (p = 0.036), below 100 (p = 0.028) and to be blast negative (p = 0.054), whileGSTP1GT haplotype and rs1138272 T allele carriers were more likely to be blasts positive (p = 0.034 and p = 0.024, respectively).ABCB1CGT (rs1128503-rs2032582-rs1045642) haplotype carriers were more likely to be blast positive (p = 0.018).ConclusionsOur results have shown thatNR3C1rs6198 variant andGSTP1rs1695-rs1138272 haplotype are the most promising pharmacogenomic markers of GC response in ALL patients.

Cures in Childhood Cancer

1990 ◽  
Vol 11 (10) ◽  
pp. 311-317
Author(s):  
Allen R. Chauvenet ◽  
Marcia M. Wofford
Keyword(s):  
Childhood Cancer ◽  
Lymphoblastic Leukemia ◽  
Disease Free Survival ◽  
Great Majority ◽  
The United States ◽  
Study Group ◽  
Cooperative Study Group ◽  
Staging Systems ◽  
Diagnosis Of Cancer ◽  
Pediatric Oncology Group

Dramatic advances have been made in the treatment and potential cure of childhood cancer in the past two decades. In the case of the most common childhood malignancy, acute lymphoblastic leukemia, Mauer wrote in 1969 that he did "not think that the attempt to encourage parents by discussion of the possibility of a cure being found is any real help to the parents in facing the inevitable consequences of this disease." By 1973, Pochedley, while noting that the great majority of patients would die from disease, commented that "remissions can last five or more years and in a few patients they seem to be permanent." In 1989, Poplack stated that "about 60% of children with this disease achieve prolonged disease-free survival (over 5 years from diagnosis) and most of these patients are considered to be cured." In this review, data are presented in support of the conclusion that cures can be found for oven half of the children in this country in whom the diagnosis of cancer is made. The focus is not on clinical presentations but on staging systems, treatment principles, and outcomes for the most common pediatric malignancies. DATA ANALYSIS AND POTENTIAL BIAS IN DATA In the United States, the great majority of children with cancer are treated by pediatric hematologists/oncologists who are members of a cooperative study group (the Pediatric Oncology Group and the Children's Cancer Study Group); major reports of treatment results are based on data concerning children participating in groupwide, multi-institution studies, in single large institutions (usually with affiliates), or in intergroup studies.

scholarly journals Elevated low density lipoprotein receptor activity in leukemic cells with monocytic differentiation

Blood ◽  
1984 ◽  
Vol 63 (5) ◽  
pp. 1186-1193 ◽  
Author(s):  
S Vitols ◽  
G Gahrton ◽  
A Ost ◽  
C Peterson
Keyword(s):  
Bone Marrow ◽  
Peripheral Blood ◽  
Lymphoblastic Leukemia ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Receptor Activity ◽  
Myelogenous Leukemia ◽  
Leukemic Cells ◽  
Low Density ◽  
Degradation Rates

Abstract The receptor-mediated degradation of 125I-low density lipoprotein (LDL) was compared in normal white blood cells and leukemic cells. The cells were isolated from the peripheral blood and bone marrow of healthy subjects and patients with newly diagnosed leukemia. The cells from most of the 40 consecutive patients with acute myelogenous leukemia showed markedly higher degradation rates as compared to mononuclear cells and granulocytes from peripheral blood and nucleated cells from the bone marrow of healthy individuals. Leukemic cells from patients with monocytic (FAB-M5) or myelomonocytic leukemia (FAB-M4) exhibited the highest degradation rates. The rate of receptor-mediated degradation of 125I-LDL was also high in leukemic cells from all three patients with chronic myelogenous leukemia in blast crisis, as well as in two of three patients with acute undifferentiated leukemia. In contrast, leukemic cells isolated from two patients with acute lymphoblastic leukemia showed low rates. In most cases, there was little difference in LDL receptor activity between leukemic cells isolated from peripheral blood and those from bone marrow. Hypocholesterolemia was a frequent finding in the leukemic patients. There was an inverse correlation between the plasma cholesterol level and the rate of receptor-mediated degradation of 125I-LDL by the leukemic cells. Studies are now in progress to investigate the possibilities of using LDL as a carrier of cytotoxic drugs in the treatment of leukemia.

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