scholarly journals Qualitative Evaluation of Platelet Concentrates Prepared with Different Methods

2021 ◽  
Author(s):  
. Varshashree ◽  
Subhashis Das ◽  
K Prabhakar
Keyword(s):  
Blood Cell ◽  
Tertiary Care ◽  
Quality Parameters ◽  
Platelet Concentrate ◽  
Director General ◽  
P Value ◽  
Platelet Concentrates ◽  
Distribution Width ◽  
Platelet Indices ◽  
Arterial Blood

Introduction: One of the most important responsibility of Blood Bank is to ensure uninterrupted supply of quality blood products, namely Platelet Concentrate (PC), which are in high demand particularly during pandemic. In India, PCs are of three types prepared by different methods like Platelet Rich Plasma-Platelet Concentrate (PRP-PC), Buffy Coat Platelet Concentrates (BC- PC), and Single Donor Platelets (SDP) units. Hence, establishing optimum quality standards across all the three types of PC remains a challenge in order to maximum benefit to recipients. Aim: To assess and compare the quality parameters of platelet concentrate prepared by PRP-PC, BC-PC and apheresis methods (SDP). Materials and Methods: This laboratory based observational study was conducted at rural, tertiary care, postgraduate, teaching hospital located at South India from December 2018 to November 2019. A total of 156 PCs were studied with 52 units belonging to PRP method, 52 units BC-PC method and the remaining were 52 units of SDP prepared by apheresis method. Quality parameters include volume, pH, swirling, White Blood Cell (WBC) count/bag, platelet count/bag and platelet indices. Platelet indices include Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), and Platelet Large Cell Ratio (PLCR). Arterial Blood Gas (ABG) analysis was also done to assess (pH, partial pressure of Carbon Dioxide (pCO2), plasma bicarbonate (pHCO3-)). The p-value less than 0.05 were considered statistically significant. Statistical Package for the Social Sciences (SPSS) software version 23.0 used for statistical analysis. Results: All the 156 PC units were analysed as per the Director General of Health Services (DGHS) India, criteria. Among the 156 platelet concentrates scored as per DGHS criteria, a score of 5 was obtained for 34.61% [18/52], 30.76 [16/52] and 11.5% [6/52] SDP, BC-PC and PRP-PC units, respectively. All the PC units were sterile and Red Blood Cell (RBC) contamination was within acceptable limits. Conclusion: In this study, quality parameters of SDP was better than BC-PC and PRP-PC but with improvement and more standardisation of procedures and storage, BC-PC units can give a yield similar to that of SDP units.

scholarly journals Comparison of Platelet Concentrates Prepared from Platelet Rich Plasma-Platelet Concentrate and Buffy Coat Poor-Platelet Concentrate on Storage Days 1 and 5

2016 ◽  
Vol 35 (2) ◽  
pp. 5
Author(s):  
Darinnat Buathong ◽  
Jarin Buakaew ◽  
Chutarat Nukfon
Keyword(s):  
Blood Cell ◽  
White Blood Cell ◽  
Platelet Rich Plasma ◽  
Buffy Coat ◽  
Platelet Concentrate ◽  
P Value ◽  
Platelet Concentrates ◽  
Hypotonic Shock ◽  
Shock Response ◽  
The Mean

Objective: The purpose of this study is to assess the quality of platelet concentrates on storage days 1 and 5 prepared by platelet rich plasma-platelet concentrate (PRP-PC) and buffy coat poor-platelet concentrate (BC-PC) methods comparing to the American Association of Blood Banks (AABB) recommendations.Material and Method: Totally of 120 platelet concentrates (PC) units on storage days 1 and 5 (60 of PRP-PC triple blood bag and 60 of BC-PC quadruple AS-5 blood bag) were separated from whole blood donations at Songklanagarind Hospital. The prepared PC were assessed with 5 parameters such as volume, platelet count, white blood cell count per unit, pH, swirling phenomenon score and hypotonic shock response. The independent t-tests, paired Student’s t-tests and SPSS program were utilized in statistical analysis step.Results: The mean±standard deviation (S.D.) of each parameter were as follow : (1) Volume of PRP-PC and BC-PC met the standard (40-70 ml). (2) All of the platelet concentrates met the standard (≥ 5.5x1010/unit). The mean±S.D.: PRP-PC and BC-PC (day 1) were 6.820±1.480 x1010 and 7.010±1.300 x1010/unit (p-value=0.260), while PRP-PC and BC-PC (day 5) were 6.620±1.160x1010 and 6.720± 1.150x1010/unit (p-value=0.040). (3) The white blood cell in platelet concentrates met the standard (<0.2x1010/unit). The mean±S.D.: PRP-PC and BC-PC (day 1) were 0.030±0.017 x1010and 0.026±0.019x1010/unit (p-value=0.040), while PRP-PC and BC-PC (day 5) were0.033±0.013x1010 and 0.027±0.019x1010/unit (p-value= 0.580). (4) The pH of all units (PRP-PC and BC-PC) met the standard (≥6.2). The mean±S.D.: PRP-PC and BC-PC (day 1) were 7.430±0.330 and 7.750±0.160 (p-value=0.006), while PRP-PC and BC-PC (day 5) were 7.590±0.350 and 7.620±0.280 (p-value=0.710). The swirling phenomenon score and hypotonic shock response were the same as standard AABB and were not statistically difference.Conclusion: The quality of PRP-PC and BC-PC after storing on days 1 and 5 as follow (1) Volume of PRP-PC and BC-PC met the standard. (2) The platelet count per unit of PRP-PC and BC-PC (day 1), PRP-PC and BC-PC (day 5) were not statistically difference. (3) The white blood cell count per unit of PRP-PC and BC-PC (day 1) were statistically difference, while PRP-PC and BC-PC (day 5) were not statistically difference. (4) The pH of PRP-PC and BC-PC (day 1) were statistically difference, while PRP-PC and BC-PC (day 5) were not statistically difference. The swirling phenomenon score and hypotonic shock response of PRP-PC and BC-PC were not statistically difference. Platelet concentrates of both method storing on days 1 and 5 fulfilled the quality guideline of AABB.

scholarly journals A STUDY ON PLATELET COUNT AND PLATELET INDICES IN NEONATAL SEPSIS IN A TERTIARY CARE CENTER

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
Neha Sharma ◽  
G S Senger ◽  
Seema Meena ◽  
Priyanka Sharma
Keyword(s):  
Platelet Count ◽  
Neonatal Sepsis ◽  
Hematological Parameters ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Sepsis Group ◽  
P Value ◽  
Distribution Width ◽  
Platelet Indices

Background: The present study is undertaken to evaluate Platelet count and platelet indices in diagnosis of neonatal sepsis. Methods: This prospective observational study was conducted on 100 consecutive neonates (both inborn and out born), with clinical signs and symptoms of sepsis along with either positive culture (confirmed neonatal sepsis ) or other laboratory findings suggestive of bacterial and fungal infection in absence of positive cultures (probable sepsis), were included after written informed consent from parents. Results: 71 (71.00%) out of 100 cases had increased values of Platelet Distribution Width. In Proven sepsis group 31(86.11%) cases had increased values of PDW, in Probable sepsis 31(63.27%) and in No sepsis group 9(60.00%) cases were having increased values of PDW. This difference was statistically not significant (P value is 0.08). Conclusion: Platelet count and platelet indices, which are easily available hematological parameters in remote & resource poor areas of our country, should be taken into consideration for suspected cases of neonatal sepsis so that prompt treatment can be given, and morbidity and mortality can be reduced. Keywords: Sepsis, TPC, MPV, PDW.

scholarly journals Role of platelet distribution width and plateletcrit in assessment of nonthrombocytopenic preeclampsia and eclampsia in a tertiary care hospital of Odisha: an observational study

2020 ◽  
Vol 9 (5) ◽  
pp. 1996
Author(s):  
Kirtirekha Mohapatra ◽  
Pranati Mohanty ◽  
Nahida Nigar Sultana
Keyword(s):  
Platelet Count ◽  
Observational Study ◽  
Severe Disease ◽  
Tertiary Care ◽  
Measurement Tool ◽  
Care Hospital ◽  
Platelet Distribution Width ◽  
Distribution Width ◽  
Platelet Indices

Background: Preeclampsia (PE) is a major cause of maternal and foetal morbidity and mortality in pregnancy. A decreased platelet count is observed during the progression of preeclampsia, and is considered a marker of the severity of preeclampsia. Considering the role of the PDW, PCT and platelet indices during the disease, the aim of this study was to evaluate the feasibility of using platelet indices as a severity marker for PE.Methods: This was a prospective, observational study, hospital-based study, from 2017-19 with 400 pregnant women being included on the basis of a predefined inclusion and exclusion criteria, through antenatal clinic, and labour room of the department of obstetrics and gynecology, S. C. B. Medical College, Cuttack, Odisha, India.Results: Study found that platelet count and plateletcrit showed a significant negative correlation with MAP whereas platelet distribution width showed a maximum positive correlation. In the preeclampsia group, subjects with PCT <0.22% were at risk of developing severe disease with a sensitivity of 53.5% and a high specificity of 85.5%. The AUC of 0.75 showed that it has a good predictability. In the eclampsia group, subjects with PCT <0.16% had a risk of developing severe disease with a sensitivity of 89.5% and specificity of 73.7%. The AUC 0.9 shows PCT to be a good predictor for assessing severity of eclampsia.Conclusions: This study suggests that platelet distribution width and plateletcrit are useful in risk evaluation of preeclampsia. These are a valid measurement tool to predict the severe progression of PE even when normal platelet counts are observed.

scholarly journals Study of Platelet Indices in Patients with Metabolic Syndrome

2019 ◽  
Vol 05 (01) ◽  
pp. 010-014 ◽  
Author(s):  
Uma Maheswara Reddy ◽  
Aditya Khandekar ◽  
Sourya Acharya ◽  
Samarth Shukla ◽  
Neema Acharya
Keyword(s):  
United States ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Systolic Blood Pressure ◽  
Tertiary Care ◽  
Serum Triglyceride ◽  
Atherogenic Dyslipidemia ◽  
Distribution Width ◽  
Platelet Indices

Abstract Introduction Metabolic syndrome (MetS) is a combination of abdominal obesity, atherogenic dyslipidemia, elevated blood pressure, and elevated plasma glucose. MetS patients have higher chances of developing insulin resistance, visceral adiposity, atherogenic dyslipidemia, and thus coronary artery disease and stroke. Alteration of platelet indices in diabetes mellitus, atherosclerosis, and other proinflammatory states has been described in multiple studies. Thus, this study was carried out to assess platelet indices in MetS. Objectives This study was carried out to assess platelet indices in MetS. Methods A cross-sectional study was carried out at Acharya Vinoba Bhave Rural Hospital, a tertiary care center over a period of 2 months from June 1, 2018 to July 31, 2018. Fifty patients diagnosed as having MetS, and 50 healthy controls were chosen. Estimation of anthropometric parameters including waist circumference; measurement of blood pressure; biochemical parameters including lipid profile; and platelet indices including plateletcrit, mean platelet volume (MPV), and platelet distribution width (PDW) were carried out. Statistical Analysis Statistical analyses were carried out using inferential statistics, including chi-square test and Student's unpaired t-test, and software SPSS version 22.0 (IBM Corporation, Armonk, New York, United States) with GraphPad Prism version 6.0 (Informer Technologies, Inc. Los Angeles, California, United States) was used, with p < 0.05 being considered as significant. Results A statistically significant, positive correlation was found between the waist circumference, systolic blood pressure, serum triglyceride levels, and plateletcrit, with the MetS status of patients (p < 0.05). Conclusion This study revealed that MetS is a proinflammatory and prothrombotic state, characterized by alteration of platelet indices. Plateletcrit was shown to be a statistically significant biomarker along with other parameters such as waist circumference, systolic blood pressure, and serum triglyceride levels. Early detection and follow-up of patients using these markers can lead to an overall decline in morbidity and mortality owing to MetS.

scholarly journals A Study to Evaluate Use of Platelet Indices in Hyperdestructive Thrombocytopenia: A Two-year Experience from Tertiary Care Rural Hospital

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Roniya Francis ◽  
Shruthi N Shetageri ◽  
Roopa A N ◽  
S R Raja Parthiban
Keyword(s):  
Tertiary Care ◽  
Study Groups ◽  
The Body ◽  
Parasitic Infections ◽  
Control Group ◽  
Platelet Destruction ◽  
Distribution Width ◽  
Platelet Indices ◽  
Group I ◽  
Group Ii

Background: Thrombocytopenia is one of the most common causes of abnormal bleeding and is defined as platelet counts < 1.5 lakhs/cumm. Three processes can cause thrombocytopenia, namely: Deficient platelet production, accelerated platelet destruction, and abnormal pooling of the platelets within the body. Of these, accelerated platelet destruction is the most common cause for thrombocytopenia and has variety of etiologies. The usefulness of bone marrow analysis in assessing accelerated platelet destruction is still debated. Therefore, a new simple and non-invasive diagnostic approach for thrombocytopenia is needed. Aims and Objectives: The present study was done with an aim to evaluate the use of platelet indices, namely, mean platelet volume (MPV), Platelet Distribution Width (PDW), and Platelet Large Cell Ratio (P-LCR) in differentiating the various causes of hyperdestructive thrombocytopenia. Materials and Methods: This was a prospective study conducted over a period of 2 years and consisted of 206 cases of hyperdestructive thrombocytopenia. After recording relevant clinical details, platelet count along with platelet indices – MPV, PDW, and P-LCR was recorded. Based on the etiopathology identified, cases were categorized into three groups: Group I: Immunologic – cases of Immune thrombocytopenic purpura (ITP), Group II: Non-immune: Cases of sepsis and other non-immune causes of platelet destruction, and Group III: Viral and parasitic infections. Platelet indices were compared between the study groups and the control group which included 100 healthy individuals. Comparison was done among the three study groups as well. Results & Conclusions: Dengue accounted for the highest number of 131 (89.72%) cases in the study. MPV, PDW, and P-LCR were significantly higher (P < 0.0001) when compared to the healthy controls except P-LCR in Group II. A statistically significant increase in MPV was noted among ITP cases when compared to other causes of thrombocytopenia. There wa

scholarly journals ANALYSIS PLATELET INDICES IN PATIENT TYPE 2 DIABETES MELLITUS WITH VASCULAR COMPLICATION

2019 ◽  
Vol 26 (1) ◽  
pp. 102
Author(s):  
Nelly Tolla Taggara
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Clinical Pathology ◽  
Vascular Complication ◽  
P Value ◽  
Distribution Width ◽  
Patient Type ◽  
Platelet Indices

ANALYSIS PLATELET INDICES IN PATIENT TYPE 2 DIABETES MELLITUS WITH VASCULAR COMPLICATION      Nelly1, Suci Aprianti2 ,Darmawaty ER31Medical Doctor Specialist Education Program of Clinical Pathology, Faculty of Medicine, Hasanuddin University/Dr. Wahidin Sudirohusodo hospital, Makassar2Departement of Clinical Pathology, Faculty of Medicine, Hasanuddin University3Departement of Clinical Pathology, Faculty of Medicine, Hasanuddin University /Dr. Wahidin Sudirohusodo Hospital, Makassar ABSTRACT Introduction :Type 2 Diabetes Mellitus(T2DM) is an endocrin disease that is marked by hyperglycemic condition due to a decrease increase in insulin secretion and insulin resistance or both. Indonesia is the 7th country with the highest incidence of diabetes mellitus in the world. Progression of the disease is slow and cause vascular endothelial damage. The increase  of platelet indices is suspected to be an indications   of vascular complicationsObjective :To evaluate the  platelet indices in diabetics patients with complication and correlate these indices with GDP and HbA1c. Materials and methods :We analyzed platelet indices and biochemical data of patients seen in outpatients by clinicans of  wahidin soedirohusodo hospitals. 120 patients with type 2 diabetes mellitus were included with 64 patients vascular complication and 56 patients without complication.Result :We observed an increase in mean platelet volume (MPV): 9,96 + 1.99vs 8.87 + 1.35(p-value: 0,001) ;in platelet distribution width (PDW): 15.29 + 3.45 vs 12.36 + 2.819(p-value: 0,000; without increase  plateletcrit (PCT); 0.28 + 0.14 vs 0.25 + 0.12 (p-value: 0.168). we observed  a correlation between FBG with PDW (P=0.044).Conclusion :The study findings point to the significant differences in platelet indices (MPV and PDW) in patients with T2DM with complication and without complication, suggesting the presence of platelet in diabetics type 2 patients more reactive and aggregatable  in this group of individuals. These suggest that platelet evaluation may be useful in the early detection of long term complication in diabetics patients.Keyword :T2DM, platelet indices, complication vascular   

scholarly journals The Role of Red Blood Cell Distribution Width for Predicting 1-year Mortality in Patients Admitted to the Emergency Department with Severe Dyspnoea

2017 ◽  
Vol 36 (1) ◽  
pp. 32-38
Author(s):  
Gianni Turcato ◽  
Gianfranco Cervellin ◽  
Gian Luca Salvagno ◽  
Eleonora Zaccaria ◽  
Giuseppe Bartucci ◽  
...  
Keyword(s):  
Emergency Department ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Arterial Blood ◽  
Increased Risk ◽  
Red Blood Cell Distribution ◽  
Severe Dyspnoea

Summary Background: Universally accepted and validated instruments for predicting the outcome of patients presenting to the emergency department (ED) with severe dyspnoea do not exist so far, nor are they regularly used by the emergency physicians. This study hence aimed to establish whether red blood cell distribution width (RDW) may be a predictive parameter of 1-year mortality in a population of patients admitted to the ED with severe dyspnoea attributable to different underlying disorders. Methods: We retrospectively evaluated all the patients undergoing arterial blood gas analysis for severe dyspnoea (irrespective of the cause) during admission to ED of University Hospital of Verona from September 1, 2014 to November 31, 2014. Results: The final study population consisted of 287 patients for whom complete clinical and laboratory information was available. Overall, 36 patients (12.5%) died after a 1-year follow-up. The RDW value was found to be considerably increased in patients who deceased during the follow-up compared to those who survived (17.2% versus 14.8%; p<0.001). In both univariate and multivariate analyses, the RDW value was found to be a significant predictor of 1-year mortality. In particular, patients with RDW ≥ 15.0% displayed a 72% increased risk of 1-year mortality after multiple adjustments. Conclusions: The measurement of RDW, a very simple and inexpensive laboratory parameter, may represent an important factor for predicting medium-term mortality in patients presenting to the ED with severe dyspnoea.

scholarly journals Analysis of Platelet Indices and its correlation with platelet count In Dengue

2020 ◽  
Vol 11 (SPL2) ◽  
pp. 284-289
Author(s):  
Dhanya Menon ◽  
Ganthimathy Sekhar ◽  
Siddharth A R ◽  
Sridevi M
Keyword(s):  
Platelet Count ◽  
Dengue Infection ◽  
Large Cell ◽  
Health Concern ◽  
P Value ◽  
Distribution Width ◽  
Platelet Indices ◽  
Ns1 Antigen ◽  
Automated Hematology Analyzer

Dengue is a global arboviral disease of growing public health concern. Several parameters have been used to detect the infection and severity of dengue. Recent evidence suggests that platelet indices can be used to assess the severity and prognosis of dengue infection. This retrospective study aims at assessing the role of the platelet indices – Mean Platelet Volume (MPV), Platelet Distribution Width, (PDW), P-LCR (Platelet Large Cell Ratio) and Plateletcrit (PCT) and its correlation with the platelet count in 50 Dengue NS1 antigen positive cases and to find the sex ratio and the age-wise distribution of the dengue cases. The indices were obtained using an Automated Hematology analyzer and were compared with the platelet count, considering p-value <0.05 as statistically significant. Thrombocytopenia was found in a majority of the cases and PDW and PLCR were found to be inversely proportional to the platelet count. MPV was found to have no correlation with the platelet count. Hence, we conclude that Platelet count, PDW, and P-LCR can be used as predictors of Dengue infection and severity, whereas MPV cannot be used as a predictor of Dengue infection or severity.

scholarly journals Role of platelet parameters and hematological profile in dengue positive cases

2021 ◽  
Vol 8 (1) ◽  
pp. 23
Author(s):  
Rashim Passi ◽  
B. P. Baviskar ◽  
R. R. Karle
Keyword(s):  
Platelet Count ◽  
Hematological Parameters ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Care Hospital ◽  
Cross Sectional ◽  
Distribution Width ◽  
Platelet Indices ◽  
Ns1 Antigen

<p class="abstract"><strong>Background:</strong> Dengue is an endemic in tropical and sub-tropical regions of the world and also in various parts of India. Recent evidence indicates that platelet indices can be used to assess the severity and prognosis of dengue. This study aimed to assess the role of the platelet indices-mean platelet volume (MPV), platelet distribution width (PDW), platelet to large cell ratio (P-LCR), plateletcrit (Pct) and hematological parameters like hemoglobin (Hb), hematocrit (Hct) with the platelet count in dengue NS1 antigen positive cases.</p><p class="abstract"><strong>Methods:</strong> An observational cross-sectional study conducted on cases of dengue over a period of 3 months admitted with serological positivity (NS1 antigen) in a tertiary care hospital, Loni. The platelet indices like MPV, PDW, Pct, P-LCR and hematological parameters like Hb, Hct were noted using Sysmex XN-3100 Automated hematology analyzer and compared with platelet count.</p><p class="abstract"><strong>Results:</strong> Relationship between various platelet indices like MPV, PDW, P-LCR and PCT and hematological parameters like Hb, TLC and Hct were related with platelet count. Dengue positive cases were inversely related to MPV, PDW, P-LCR, Hb and Hct and directly related to Pct. In the present study Pct, P-LCR, Hb and Hct were statistically significant in correlation with platelet count.</p><p class="abstract"><strong>Conclusions:</strong> Pct, P-LCR, Hb and Hct along with platelet count can be used to assess the predictive outcomes in case of dengue infection.</p><p>.</p>

scholarly journals Anisocytosis Predicts Worse Survival in Secondary Polycythemia

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 1254-1254
Author(s):  
Jose Nahun Galeas ◽  
Nilupa Gaspe ◽  
Kith Pradhan ◽  
Hernando Cordero ◽  
Anjali Budhathoki ◽  
...  
Keyword(s):  
Blood Cell ◽  
Polycythemia Vera ◽  
Chronic Hypoxia ◽  
Conflicts Of Interest ◽  
P Value ◽  
Red Cell ◽  
Distribution Width ◽  
Mean Values ◽  
Cell Counts ◽  
Obstructive Sleep

Abstract Background: Red cell overproduction in certain lung and heart conditions causing hypoxia is a well-known entity. This mechanism is thought to be compensatory to the chronic hypoxia. But how this red cell overproduction and other red cell variables affect the morbidity and mortality of these secondary or reactive erythrocytosis patients has not been studied. Our goal is to see the effect of red cell parameters and other routinely obtained laboratory values in the clinical outcomes of secondary erythrocytosis patients in our ethnically diverse and large urban population. Methods: Patients ≥ 18 years of age seen at our center from 1998 to 2015 with a diagnosis of polycythemia or erythrocytosis, either primary or secondary, with follow up of at least one year, were included. This was done with the help of Clinical Looking Glass software after obtaining Institutional Review Board approval. Secondary erythrocytosis was confirmed by evaluating each medical record in detail. After confirming diagnosis, further evaluation and data collection were obtained including demographic variables, the following lab values at diagnosis and the mean values since diagnosis: Hemoglobin (Hb), Mean Corpuscular Volume( MCV), Red Cell Distribution Width ( RDW), White Blood Cell counts ( WBC), platelet counts and albumin level. All analyses were conducted using STATA statistical software. Kaplan-Meier curves were constructed to compare survival by various subgroups. Hazard ratios were calculated using multivariate Cox regression models to adjust for co-variates to compare mortality risk and identify potential independent predictors of mortality. Results: 190 patients with secondary erythrocytosis and 69 patients with Primary Polycythemia Vera were included in the study. Our population with secondary erythrocytosis consisted of 48 % Hispanic, 27 % Caucasian and 25% African American subjects. The main causes of secondary erythrocytosis were Lung and cardiac diseases, namely Chronic Obstructive Pulmonary Disease (COPD) in 29% and Obstructive Sleep Apnea (OSA) in 15%. Figure 1 depicts the various causes of secondary erythrocytosis. We found significant higher survival in patients with secondary erythrocytosis compared to Primary Polycythemia Vera (p value: 0.05) as shown in Figure 2a. Amongst the various laboratory parameters, the strongest interaction with the disease status was of mean RDW with secondary erythrocytosis. Subjects with high mean RDW had significantly worse survival in the secondary erythrocytosis group with a p value of 1.02*10-6. Another intriguing finding was that higher hemoglobin levels, both at diagnosis and mean values, were not associated with worse survival in these patients. When we further evaluated secondary erythrocytosis patients with high RDW (> 16.1) to normal RDW, there was a very significantly worse survival in patients with high RDW (p-value = 7*10-5). Also, when we compared secondary erythrocytosis with high RDW and Primary Polycythemia patients, there was no difference in survival (Figures 2b and c). Conclusions: This is a novel study in a minority rich population regarding the different common lab parameters in secondary erythrocytosis. RDW is a ubiquitously reported lab value. RDW is a measure of the range of variation of red blood cell volume that is reported as part of a standard complete blood count. Anisocytosis is when RBCs are of unequal sizes, thus equivalent to high RDW. Increased RDW has been linked to worse survival in various lung and heart diseases in the past. Our study proves this concept in the patients with reactive erythrocytosis often found in advanced lung and heart disease patients. Furthermore, our study gives a very strong possible explanation for this finding; that disordered overproduction of red blood cells under the stress of chronic hypoxia leads to higher RDW. The degree of hypoxia and resulting dyserythropoiesis might not be very obvious to the treating clinician and observing the trend of RDW could be very helpful in these situations. We conclude that high RDW in patients with secondary erythrocytosis should be taken very seriously and all attempts should be made to treat the underlying condition causing high hemoglobin. Disclosures No relevant conflicts of interest to declare.

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