Validation of a Non-Invasive Hemoglobin Estimation in Whole Blood Donors.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 2280-2280
Author(s):  
Murtadha K. Al-Khabori ◽  
Khalil Al Farsi ◽  
Mohammed Al-Huneini ◽  
Shahina Daar ◽  
Abdulhakeem Al-Hashim ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Whole Blood ◽  
Blood Donors ◽  
Conflicts Of Interest ◽  
Pearson Correlation ◽  
Tertiary Care ◽  
Blood Sampling ◽  
Normal Blood ◽  
Coefficient Of Determination ◽  
Non Invasive

Abstract Abstract 2280 Introduction: Pre-donation screening of blood donors are currently based on venous or capillary blood sampling. Adoption of a non-invasive hemoglobin estimation may increase blood donor recruitment. Masimo Pronto-7 Pulse CO-oximetry device is a spectrophotometry based device used to estimate the hemoglobin (Hb) level non-invasively, waiving the need of blood sampling. It has not been validated in normal blood donors. The primary objective of our study was to validate the pulse CO-oximetry based hemoglobin estimation in normal blood donors. Methods: We conducted a prospective observational study on 106 whole blood donors attending the blood bank of a tertiary care center over 4 weeks. We estimated a Spot Hemoglobin (Sp Hb) concentration using Masimo Pronto-7 Pulse CO-oximetry device (two measurements per donor) and compared it to a venous sample Hb (Reference Hemoglobin; Ref Hb) measured using Abbott CELL-DYN Sapphire hematology analyzer. We calculated Pearson correlation coefficient and coefficient of determination (R2). The multivariable linear regression model of predicting the estimation differences included age, gender, weight, height, blood pressure and reference hemoglobin. Results: We enrolled 106 donors (98 males, 8 females) with a mean age of 27 years (SD 6.2; 18–49) and a mean Ref Hb of 14.2 g/dL (SD 1.2; 11.5–17). The mean Sp Hb was 14.4 g/dL (SD 1.2; 11.3–16.7). The correlation coefficient between the Sp Hb and Ref Hb was 0.46 (R2 = 21%) with a mean difference of 0.2 g/dL (SD 1.2; −4.5 to 3). In the multivariable model, height (p =0.015) and Ref Hb level (p <0.001) were statistically significant predictors of the difference in measurement. There was a strong correlation between the two CO-oximetry Hb measurements (correlation coefficient 0.78, R2 = 60%). Conclusions: Our study demonstrated the validity of the CO-oximetry Hb measurement in normal blood donors and with good reproducibility. Larger prospective studies are needed to confirm our findings. Disclosures: No relevant conflicts of interest to declare.

Non-Invasive Hemoglobin Estimation in Patients with β-Thalassemia Major

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 5179-5179
Author(s):  
Murtadha K. Al-Khabori ◽  
Arwa Z. Al-Riyami ◽  
Mohammed Al-Huneini ◽  
Khalil Al Farsi ◽  
Abdulhakeem Al-Hashim ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Conflicts Of Interest ◽  
Pearson Correlation ◽  
Tertiary Care ◽  
Thalassemia Major ◽  
Primary Objective ◽  
Hemoglobin Level ◽  
Coefficient Of Determination ◽  
Care Hospital ◽  
Non Invasive

Abstract Abstract 5179 Introduction: Patients with β-thalassemia major receive regular blood transfusions. Non-invasive hemoglobin (Hb) estimation may simplify their care. Masimo Pronto-7 Pulse CO-oximetry device is used to non-invasively estimate the hemoglobin level but has not been previously validated in this group of patients. The primary objective of this study was to validate the pulse CO-oximetry based hemoglobin estimation in children and adults with thalassemia major. Methods: We conducted a prospective observational study on 108 children and adults with thalassemia major attending the daycare thalassemia center of a tertiary care hospital over 6 weeks. We estimated a spot Hemoglobin (Sp Hb) level using Masimo Pronto-7 Pulse CO-oximetry device (two measurements per patient) and compared it to a venous sample Hb (Reference Hemoglobin; Ref Hb) measured using Abbott CELL-DYN Sapphire hematology analyzer. We calculated Pearson correlation coefficient and coefficient of determination (R2). The multivariable linear regression model of predicting the estimation differences included age, gender, weight, height, blood pressure and reference hemoglobin. Results: We enrolled 108 patients (54 males, 54 females) with a mean age of 21. 6 years (SD 7. 3; 2. 5–38). There were 156 estimation episodes. The mean Ref Hb and SpHb were 9. 4 g/dL (SD 0. 9; 7. 1–12. 3) and 11. 1 g/dL (SD 1. 2; 7. 5–14. 7) respectively. The correlation coefficient between the Sp Hb and Ref Hb was 0. 49 (R2 = 24%) with a mean difference of 1. 7 g/dL (SD 1. 1; −1. 2 to 4. 3). In the multivariable model, Ref Hb level was the only statistically significant predictor of the difference in measurement (p =0. 002). There was a strong correlation between the two CO-oximetry Hb measurements (correlation coefficient 0. 70, R2 = 50%). Conclusions: Our results indicate that Masimo Pronto-7 Pulse CO-oximetry device overestimates the hemoglobin level and it cannot be recommended for patients with thalassemia major. Larger prospective studies are needed to confirm these results. Disclosures: No relevant conflicts of interest to declare.

Validation of a Non-Invasive Hemoglobin Estimation in Patients with Sickle Cell Disease

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4770-4770
Author(s):  
Murtadha K. Al-Khabori ◽  
Abdulhakeem Al-Hashim ◽  
Zeba Jabeen ◽  
Khalil Al Farsi ◽  
Mohammed Al-Huneini ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Correlation Coefficient ◽  
Sickle Cell ◽  
Conflicts Of Interest ◽  
Pearson Correlation ◽  
Tertiary Care ◽  
Coefficient Of Determination ◽  
Care Hospital ◽  
Cell Disease ◽  
Non Invasive

Abstract Abstract 4770 Introduction: The care of patients with Sickle Cell Disease (SCD) is frequently complicated by difficult venous access complicating blood sampling for laboratory investigations including hemoglobin (Hb) measurement. Non-invasive hemoglobin concentration monitoring is a potential solution, albeit not validated yet in patients with SCD. The primary objective of this study was to validate non-invasive pulse CO-oximetry based hemoglobin estimation in this patient population. Methods: We conducted a prospective observational study on patients with SCD admitted to the inpatient wards over 4 weeks in a tertiary care hospital. We estimated a spot Hemoglobin (Sp Hb) measurement using Masimo Pronto-7 Pulse CO-oximetry device (two measurements per patient) and compared it to a venous sample Hb (Reference Hemoglobin; Ref Hb) measured using Abbott CELL-DYN Sapphire hematology analyzer. We calculated Pearson correlation coefficient and coefficient of determination (R2). The multivariable linear regression model of predicting the estimation differences included age, gender, weight, height, blood pressure and reference hemoglobin. Results: We enrolled 98 patients (45 males, 53 females) with a mean age of 26 years (SD 8.8; 14–75) and a mean Ref Hb of 9.2 g/dL (SD 1.5; 5.3–13). The mean Sp Hb was 10.1 g/dL (SD 2.0; 5.3–14.5). The correlation coefficient between the Sp Hb and Ref Hb was 0.54 (R2 = 29%) with a mean difference of 0.9 g/dL (SD 1.7; −4.8 to 4.5). In the multivariable model, gender (p =0.042) and Ref Hb level (p=0.001) were statistically significant predictors for the difference in measurement. A strong correlation between the two CO-oximetry Hb measurements was obtained (correlation coefficient = 0.81, R2 = 65%). Conclusions: Our study demonstrated the validity of the CO-oximetry Hb measurement in adult patients with SCD. Larger prospective studies are needed to confirm our results. Disclosures: No relevant conflicts of interest to declare.

Relationship between Invasive and Non-Invasive Hemodynamic Measures in Experimental Pulmonary Hypertension

2020 ◽  
Vol 16 (1) ◽  
pp. 47-53
Author(s):  
Vicente Benavides-Córdoba ◽  
Mauricio Palacios Gómez
Keyword(s):  
Heart Rate ◽  
Pulmonary Hypertension ◽  
Ejection Fraction ◽  
Right Ventricle ◽  
Correlation Coefficient ◽  
Pearson Correlation ◽  
Systolic Pressure ◽  
Control Group ◽  
Pearson Correlation Coefficient ◽  
Non Invasive

Introduction: Animal models have been used to understand the pathophysiology of pulmonary hypertension, to describe the mechanisms of action and to evaluate promising active ingredients. The monocrotaline-induced pulmonary hypertension model is the most used animal model. In this model, invasive and non-invasive hemodynamic variables that resemble human measurements have been used. Aim: To define if non-invasive variables can predict hemodynamic measures in the monocrotaline-induced pulmonary hypertension model. Materials and Methods: Twenty 6-week old male Wistar rats weighing between 250-300g from the bioterium of the Universidad del Valle (Cali - Colombia) were used in order to establish that the relationships between invasive and non-invasive variables are sustained in different conditions (healthy, hypertrophy and treated). The animals were organized into three groups, a control group who was given 0.9% saline solution subcutaneously (sc), a group with pulmonary hypertension induced with a single subcutaneous dose of Monocrotaline 30 mg/kg, and a group with pulmonary hypertension with 30 mg/kg of monocrotaline treated with Sildenafil. Right ventricle ejection fraction, heart rate, right ventricle systolic pressure and the extent of hypertrophy were measured. The functional relation between any two variables was evaluated by the Pearson correlation coefficient. Results: It was found that all correlations were statistically significant (p <0.01). The strongest correlation was the inverse one between the RVEF and the Fulton index (r = -0.82). The Fulton index also had a strong correlation with the RVSP (r = 0.79). The Pearson correlation coefficient between the RVEF and the RVSP was -0.81, meaning that the higher the systolic pressure in the right ventricle, the lower the ejection fraction value. Heart rate was significantly correlated to the other three variables studied, although with relatively low correlation. Conclusion: The correlations obtained in this study indicate that the parameters evaluated in the research related to experimental pulmonary hypertension correlate adequately and that the measurements that are currently made are adequate and consistent with each other, that is, they have good predictive capacity.

scholarly journals Comparison of four methods to measure haemoglobin concentrations in whole blood donors (COMPARE): a diagnostic accuracy study

2020 ◽  
Author(s):  
Steven Bell ◽  
Michael Sweeting ◽  
Anna Ramond ◽  
Ryan Chung ◽  
Stephen Kaptoge ◽  
...  
Keyword(s):  
Whole Blood ◽  
Blood Donors ◽  
Blood Donation ◽  
Haemoglobin Concentration ◽  
Reference Standard ◽  
Non Invasive ◽  
Haematology Analyser ◽  
Haemoglobin Measurement ◽  
Accuracy Study ◽  
Sensitivity Specificity

SUMMARYObjectiveTo compare four haemoglobin measurement methods in whole blood donors.BackgroundTo safeguard donors, blood services measure haemoglobin concentration in advance of each donation. NHS Blood and Transplant’s (NHSBT) usual method has been capillary gravimetry (copper sulphate), followed by venous HemoCue® (spectrophotometry) for donors failing gravimetry. However, gravimetry/venous HemoCue® results in 10% of donors being inappropriately bled (i.e., with haemoglobin values below the regulatory threshold).MethodsThe following were compared in 21,840 blood donors (aged ≥18 years) recruited from 10 mobile centres of NHSBT in England, with each method compared with the Sysmex XN-2000 haematology analyser, the reference standard: 1) gravimetry/venous HemoCue®; 2) “post donation” approach, i.e., estimating current haemoglobin concentration from that measured by a haematology analyser at a donor’s most recent prior donation; 3) capillary HemoCue®; and 4) non-invasive spectrometry (MBR Haemospect® or Orsense NMB200®). We assessed each method for sensitivity; specificity; proportion of donors who would have been inappropriately bled, or rejected from donation (“deferred”) incorrectly; and test preference.ResultsCompared with the reference standard, the methods ranged in test sensitivity from 17.0% (MBR Haemospect®) to 79.0% (HemoCue®) in men, and from 19.0% (MBR Haemospect®) to 82.8% (HemoCue®) in women. For specificity, the methods ranged from 87.2% (MBR Haemospect®) to 99.9% (gravimetry/venous HemoCue®) in men, and from 74.1% (Orsense NMB200®) to 99.8% (gravimetry/venous HemoCue®) in women. The proportion of donors who would have been inappropriately bled ranged from 2.2% in men for HemoCue® to 18.9% in women for MBR Haemospect®. The proportion of donors who would have been deferred incorrectly with haemoglobin concentration above the minimum threshold ranged from 0.1% in men for gravimetry/venous HemoCue® to 20.3% in women for OrSense®. Most donors preferred non-invasive spectrometry.ConclusionIn the largest study reporting head-to-head comparisons of four methods to measure haemoglobin prior to blood donation, our results support replacement of venous HemoCue® with the capillary HemoCue® when donors fail gravimetry. These results have had direct translational implications for NHS Blood and Transplant in England.

scholarly journals Modelamiento matemático de la mortalidad por COVID-19 en China

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Olegario Marín Machuca ◽  
Jessica Blanca Vargas Ayala ◽  
Ulert Marín Sánchez ◽  
Fredy Anibal Alvarado Zambrano ◽  
Elena Elizabeth Lon Kan Prado ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Correction Factor ◽  
Death Rate ◽  
Model Equation ◽  
Pearson Correlation ◽  
Coefficient Of Determination ◽  
Pearson Correlation Coefficient ◽  
Republic Of China ◽  
Palabras Clave ◽  
Independent Variable

<p>Se ha desarrollado un modelo matemático que permita analizar el comportamiento de la mortalidad en la República Popular de China ocasionado por COVID-2019. Se aplicó el modelo logístico para los datos reportados entre 11 de enero y el 12 de abril del 2020. El modelo formulado fue linealizado y planteado en dos formas. La primera, evaluando el factor de corrección B, que hace las veces de cantidad máxima de fallecidos. Se determinaron los parámetros A, k y r, obteniendo el modelo (Ecuación 7), con un coeficiente de correlación r=-0,9660 y el coeficiente de determinación r^2×100=93,31 %. La segunda forma, con el mismo valor de B, introduciendo un factor de corrección para la variable independiente, t, que hace las veces de “periodo”. Se determinaron los parámetros A, k y r, obteniendo el modelo (Ecuación 10), con un coeficiente de correlación r=-0,9668 y el coeficiente de determinación r^2×100=93,48 %; lo que demuestra buena estimación del modelo (Ecuación 7 y Ecuación 10). Asimismo, se evaluó la velocidad de mortalidad, derivando, ordinariamente los modelos (Ecuación 7 y Ecuación 10), obteniendo los modelos de velocidad (Ecuación 8 y Ecuación 11); concluyendo que la máxima velocidad de mortalidad fue de 118 personas por día el día 24 de febrero de 2020.</p><p>Palabras clave: comportamiento, coronavirus, modelo logístico, mortalidad.</p><p> </p><p><strong>ABSTRACT </strong></p><p>A mathematical model has developed in order to analyze the behavior of mortality in the People's Republic of China caused by COVID-2019. The logistical model was applied for the data reported between January 11th and April 12th, 2020. The model formulated was linearized and raised in two forms. The first, pre-evaluating correction factor B, representing the maximum number of deaths. Parameters A, k and r, were assessed obtaining the model (Equation 7), with a Pearson correlation coefficient r=-0,9660 and the coefficient of determination r2x100=93.31%. The second form, with the same value of B, by entering a correction factor for the independent variable t as a "period", Parameters A, k and r, were assessed obtaining the model (Equation 10), with a Pearson correlation coefficient r=-0,9668 and the coefficient of determination r2x100=93.48%; deducting good estimation of the model (Equation 7 and Equation 10). In addition, the death rate was evaluated, ordinating the models (equations 7 and 10), and obtaining the speed models (Equation 8 and Equation 11); describing the maximum death rate was 118 people per day on February 24th 2020.</p><p>Keywords: behavior, coronavirus, logistical model, mortality.</p>

scholarly journals Donor Hemovigilance Programme in managing Blood Transfusion Needs: Complications of Whole Blood Donation

2013 ◽  
Vol 3 (6) ◽  
pp. 459-463 ◽  
Author(s):  
S Mangwana
Keyword(s):  
Blood Transfusion ◽  
Adverse Effects ◽  
Adverse Events ◽  
Whole Blood ◽  
Blood Donors ◽  
Blood Donation ◽  
Tertiary Care ◽  
Care Hospital ◽  
Blood Donations ◽  
Vasovagal Reactions

Background: Hemovigilance like quality systems and audits have become an integral part of Blood Transfusion Services in the developed countries and has contributed greatly to its development. Hemovigilance begins with donors and must enable the collection of information on reactions occurring during the donation of blood, selections of donors and to prevent such incidents. The aim of study was to help identify the trends of adverse events , occurring in blood donors at a tertiary-care hospital, to recommend best practices to improve donor care and safety Materials and Methods: This record-based study was conducted on all adverse events related to allogenic whole blood donations performed over 24 months. All whole blood donations were analyzed. All adverse events occurring during or at the end of the donation were noted using a standardized format and analyzed determining significance at p<0.05. Results: Overall rate was 0.3% with vasovagal reactions constituting 82%, and 18% mild syncopal reactions (p<0.001). Immediate vasovagal reaction with injury was very rare (0.007%). Vasovagal reactions showed a significant association with young age, female gender, first time donation status. Mean age of persons recording adverse effects was 30.23 ± 7.49 years as compared to those without adverse effects, 31.14 ± 8.56 years. Conclusion: Donor safety is an essential perquisite to increase voluntary blood donation. AE analysis helps in identifying the blood donors at risk of AE, applying appropriate motivational strategies, predonation counseling, care during and after donation, developing guidelines and hemovigilance programme in countries with limited resources. DOI: http://dx.doi.org/10.3126/jpn.v3i6.8993   Journal of Pathology of Nepal (2013) Vol. 3, 459-463

scholarly journals Quantification of total haemoglobin concentrations in human whole blood by spectroscopic visible-light optical coherence tomography

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Colin Veenstra ◽  
Saskia Kruitwagen ◽  
Dafne Groener ◽  
Wilma Petersen ◽  
Wiendelt Steenbergen ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visible Light ◽  
Correlation Coefficient ◽  
Whole Blood ◽  
Ex Vivo ◽  
Pearson Correlation ◽  
Pearson Correlation Coefficient ◽  
Optical Coherence ◽  
Human Whole Blood ◽  
Total Haemoglobin

Abstract The non-invasive quantification of total haemoglobin concentrations [tHb] is highly desired for the assessment of haematologic disorders in vulnerable patient groups, but invasive blood sampling is still the gold standard in current clinical practice. This work demonstrates the potential of visible-light spectroscopic optical coherence tomography (sOCT) for quantifying the [tHb] in human whole blood. To accurately quantify the [tHb] from the substantial optical attenuation by blood in the visible wavelength range, we used a combination of zero-delay acquisition and focus tracking that ensures optimal system sensitivity at any depth inside the sample. Subsequently, we developed an analysis model to adequately correct for the high scattering contribution by red blood cells to the sOCT signal. We validate our method and compare it to conventional sOCT (without focus tracking and zero-delay acquisition) through ex-vivo measurements on flowing human whole blood, with [tHb] values in the clinical range of 7–23 g/dL. For our method with optimized sensitivity, the measured and expected values correlate well (Pearson correlation coefficient = 0.89, p < 0.01), with a precision of 3.8 g/dL. This is a considerable improvement compared to conventional sOCT (Pearson correlation coefficient = 0.59, p = 0.16; precision of 9.1 g/dL).

scholarly journals Correlation of Infinium HumanMethylation450K and MethylationEPIC BeadChip arrays in cartilage

2019 ◽  
Author(s):  
Kathleen Cheung ◽  
Marjolein J. Burgers ◽  
David A. Young ◽  
Simon Cockell ◽  
Louise N. Reynard
Keyword(s):  
Dna Methylation ◽  
Correlation Coefficient ◽  
Whole Blood ◽  
Pearson Correlation ◽  
Cell Types ◽  
Poor Correlation ◽  
450K Array ◽  
Human Cartilage ◽  
Cpg Sites ◽  
Cpg Site

AbstractBackgroundDNA methylation of CpG sites is commonly measured using Illumina Infinium BeadChip platforms. The Infinium MethylationEPIC array has replaced the Infinium Methylation450K array. The two arrays use the same technology, with the EPIC array assaying 865859 CpG sites, almost double the number of sites present on the 450K array. In this study, we compare DNA methylation values of shared CpGs of the same human cartilage samples assayed using both platforms.MethodsDNA methylation was measured in 21 human cartilage samples using the Illumina Infinium Methylation450K BeadChip and the Infinium methylationEPIC array. Additional matched 450K and EPIC data in whole tumour and whole blood were downloaded from GEO GSE92580 and GSE86833 respectively. Data were processed using the Bioconductor package Minfi. Additionally, DNA methylation of six CpG sites was validated for the same 21 cartilage samples by use of pyrosequencing.ResultsIn cartilage samples, overall sample correlations between methylation values generated by the two arrays were high (Pearson correlation coefficient r > 0.96). However, 50.5% of CpG sites showed poor correlation (r < 0.2) between arrays. Sites with limited variance and with either very high or very low methylation levels in cartilage exhibited lower correlation values, corroborating prior studies in whole blood. Bisulfite pyrosequencing did not highlight one array as generating more accurate methylation values that the other. For a specific CpG site, the array methylation correlation coefficient differed between cartilage, tumour and whole blood, reflecting the difference in methylation variance between cell types. These patterns can be observed across different tissues with different CpG site variances. When performing differential methylation analysis, the mean probe correlation co-efficient increased with increasing Δβ threshold used.ConclusionCpG sites with low variability within a tissue showed poor reproducibility between arrays. However, variance and thus reproducibility differs across different tissue types. Therefore, researchers should be cautious when analysing methylation of CpG sites that show low methylation variance within the cell type of interest, regardless of platform or method used to assay methylation.

scholarly journals PENGARUH LOAN TO DEPOSIT RATIO (LDR) TERHADAP EARNING PER SHARE (EPS) DI PT BNI Tbk. PERIODE 2008-2017

2020 ◽  
Vol 3 (2) ◽  
pp. 133-141
Author(s):  
R. Deden Adhianto
Keyword(s):  
Correlation Coefficient ◽  
Confidence Level ◽  
Degrees Of Freedom ◽  
Quantitative Method ◽  
Pearson Correlation ◽  
Coefficient Of Determination ◽  
Pearson Correlation Coefficient ◽  
Test Results ◽  
Know How ◽  
Strong Relation

This research aims to know how much the effetc of loan to deposit ratio (LDR) against earning per share (EPS) at PT Bank BNI Tbk. The method that is used in this research is quantitative method. By taking samples of research from 2008 to 2017. Based on the analysis of the data, it indicates that the loan to deposit ratio has strong relation with earning per share as of the value of pearson correlation coefficient is 0,902%. Loan to deposit ratio also has positive and significan effect on the earning per share with a coefficient of determination amounted to 81,36 % and T test results showes t calculate>t table amounted to (5,898>2,360) confidence level (0,05) with degrees of freedom 8 therefore Ho rejected and H1 accepted. The suggestion given to maintain level the BI’ LDR standar, to avoid problem decrease in CAR standar and result high EP.

Serum Free Light Chain Is Not a Good Biomarker to Predict Post-Transplant Lymphoprolipherative Disorder Development in Renal Transplanted Patients

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 5079-5079
Author(s):  
Rodrigo Carlini Fernando ◽  
Edgar Gil Rizzatti ◽  
Walter Moises Tobias Braga ◽  
Melina Gonçalves Santos ◽  
Mariana Bleker Oliveira ◽  
...  
Keyword(s):  
Blood Donors ◽  
Conflicts Of Interest ◽  
University Hospital ◽  
Normal Blood ◽  
Reference Ranges ◽  
Normal Range ◽  
Serum Free ◽  
Post Transplant ◽  
Significant Difference ◽  
Comparison Groups

Abstract Abstract 5079 Introduction: Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening Epstein-Barr virus (EBV)-driven B-cell malignancy occurring in 1–4% of renal transplanted patients. EBV DNA quantification has become a useful tool for identifying patients at risk of developing PTLD. However, studies on EBV load differ in source of sample, methodology and patients' characteristics, making it difficult to compare data from different studies. Therefore, other less expensive and more reproducible methods to predict PTLD development are needed. Recently, some studies have shown a correlation between increased levels of serum free light chains (sFLC) and high risk of development of lymphoproliferative diseases in autoimmune disorders, hepatitis C and Acquired Immune Deficiency Syndrome (AIDS). However, none of those studies has assessed the value of sFLC as a predictive biomarker for the development of lymphoproliferative disorders. Objectives: The aim of the present study was to determine the predictive value of sFLC quantification for the development of PTLD, using serum samples from a nested case-control cohort of renal transplanted patients and from EBV-positive and negative subjects as comparative groups. Material and Methods: Ten new cases of PTLD after renal transplant were enrolled at University Hospital São Paulo and Hospital do Rim e Hipertensão, Brazil. Forty-six controls (4–5 per case) matched by age, date of transplant, type and dosage of immunosuppression, and history of rejection episodes were selected from the cohort. The diagnosis of PTLD was confirmed histologically by two experienced pathologists and classified using the WHO criteria. The comparison groups consisted of 5 HIV-infected/AIDS individuals with CD4 count less than 100 cells/mm3, 5 recently diagnosed and untreated Hodgkin′s lymphoma patients, 4 normal blood donors and 2 children aged from 6 to 18 months (with EBV-negative serology). The samples were collected and stored at −80°C for 10 to 12 years and all of them were in conditions of use for the current study. In all samples, serum κ and λ FLC concentrations were measured by nephelometry and compared with reference ranges (κ: 0. 33–1. 94 mg/dL; λ: 0. 57–2, 63 mg/dL). However, as cases and controls do not have always “normal” renal function, the ratio between κ and λ was compared with a new reference range for patients with kidney failure (renal range, κ/λ: 0. 37–3. 17), whereas for comparison groups, who have normal renal clearance, the ratio was compared with the normal range (κ/λ: 0. 26–1. 65). Results: sFLC levels were abnormal (κ and/or λ above the normal range) in 90% of cases and 65% of controls (matched transplanted patients with no PTLD). There was no statistically significant difference between all groups, except for λ FLC concentrations between PTLD cases and normal blood donors and EBV-negative children (p=0. 016). The κ/λ sFLC ratios of cases and controls were within the renal range and even within normal range, i. e., no monoclonal cases were detected by this method using two cut-offs possibilities. Conclusion: Our results suggest that sFLC is not useful to predict PTLD development in renal transplanted recipients. Therefore, more studies are needed to find a biomarker capable of predicting the development of PTLD in renal transplanted recipients. Disclosures: No relevant conflicts of interest to declare.

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