scholarly journals Analysis of White Blood Cell Count and Its Differential Count in Gingival and Periodontal Conditions Associated with Bleeding Gingiva

2021 ◽  
pp. 911-917
Author(s):  
L. Sai Charan ◽  
Palati Sinduja ◽  
R. Priyadarshini
Keyword(s):  
Blood Cells ◽  
White Blood Cells ◽  
Clinical Pathology ◽  
Differential Count ◽  
Hormonal Changes ◽  
Vitamin K Deficiency ◽  
Medical Problems ◽  
Gingival Bleeding ◽  
K Deficiency ◽  
Wbc Count

Background: Bleeding gingiva is caused primarily due to the accumulation of plaque and calculus which eventually leads to gingivitis or periodontitis. Other causes of bleeding gingiva can be due to improper flossing, over brushing of the teeth and gingiva, hormonal changes due to pregnancy, ill-fitting dentures and any other dental appliances impinging the gingiva. The bleeding gingiva can also indicate serious health problems like leukemia, scurvy, idiopathic thrombocytopenic purpura, vitamin k deficiency and any bleeding disorder. Persistent gingival bleeding is a sign of serious medical problems like leukemia and platelet disorders. Leukemia is a group of cancer where there is an increased number of immature or abnormal white blood cells. In this study, the WBC and their differential count is analyzed in patients with bleeding gingiva to check the possibilities for the patient to get cancer. Aim: To measure and observe the WBC count and its differentials by testing the blood from patients with bleeding gingiva. Materials and Methods: The study was conducted in the clinical pathology lab at Saveetha Dental College and Hospitals, Chennai. 100 subjects were subjected to the study. Subjects with chief complaint of bleeding gingiva, without systemic diseases like diabetes, hypertension, and patients with the age of above 10 were included in the study. Results and Conclusion: This study was conducted to analyze the WBC count and differential count among the patients with bleeding gingiva. No significant correlation was found between bleeding gingiva and white blood cells & their differential count in this study.

scholarly journals Normal range of white blood cells and differential count of Sudanese in Khartoum state

2018 ◽  
Vol 5 (4) ◽  
pp. 784 ◽  
Author(s):  
Elmutaz H. Taha ◽  
Mohammed Elshiekh ◽  
Abdelrahim Alborai ◽  
Elnagi Y. Hajo ◽  
Abdelmohisen Hussein ◽  
...  
Keyword(s):  
Blood Cells ◽  
White Blood Cells ◽  
Differential Count ◽  
Reference Ranges ◽  
African Countries ◽  
The Mean ◽  
Automated Hematology Analyzer ◽  
Wbc Count ◽  
Age Range

Background: The normal physiological range for white blood cells and differential count are essential for diagnosis, treatment, follow up and screening. This study aimed at establishing the reference ranges of WBCs and differential count in Sudanese people.Methods: The present study included 444 healthy adult Sudanese from both sexes with age range of 20 – 60 years. Blood samples were obtained from brachial veins and drawn in EDTA tubes. WBCs and differential count were analyzed using Sysmex KX-21 automated hematology analyzer. Full clinical examination was performed, weight and height were measured, and BMI was calculated.Results: The mean WBC count was 5.1±1.5×103/ µl with a range of 3.6 ×103/µl to 6.6 ×103/µl. The mean WBCs count for males and females were 4.969×103/µl and 5.138×103/µl respectively. Neutrophils count was 2.430×103/µl (47%) and mean for lymphocyte count was 2.116×103/µl (41.1%).Conclusions: WBCs count was directly proportional to BMI. The WBCs count of Sudanese people was lower than that of Caucasians and similar to reports from other African countries.

scholarly journals Immediate and Residual Haematotoxicity in Mice Exposed to Wastewater from a Cocoa Processing Industry

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Okunola Adenrele Alabi
Keyword(s):  
Blood Cells ◽  
White Blood Cells ◽  
Residual Effect ◽  
Negative Control ◽  
Toxic Waste ◽  
Haematological Parameters ◽  
Differential Count ◽  
Allowable Limit ◽  
Processing Industry ◽  
Wbc Count

Abstract This study investigated the constituents and haematotoxic potential of wastewater collected from a cocoa processing industry in mice. The mice were intraperitoneally injected for 5 consecutive days with 0.3mL of 1, 5, 10, 25 and 50% concentrations of the wastewater. Blood was collected from some mice on the last day of the injection to assess the immediate effect of the wastewater on selected haematological parameters while blood was collected from others 21 days after the last injection to assess its residual effect. Blood collected were analyzed using an Abacus Reflotron machine. Haematological parameters including packed cell volume (PCV), white blood cells (WBC), red blood cells (RBC), heamaglobin (HGB), lymphocytes, erythrocyte indices: Mean corpuscular heamaglobin count (MCHC), mean corpuscular heamablobin (MCH), mean corpuscular volume (MCV); leucocyte differential count: Neutrophils, Monocytes, Basophils and Eosinophils were analyzed. A significant decrease in basophils, MCH, MCHC, HGB, and PCV; and a significant increase in neutrophils, monocytes, eosinophils, MCV, total WBC count, and lymphocytes were observed in mice exposed to the wastewater compared to the negative control after 5 days. A similar trend of the alterations of the heamatological parameters was observed in mice 21 days after exposure, even though the values were numerically lower than in the 5 days exposed mice. Results further showed the presence of Zn, Cd, As, Mg, Ni, Cu, Fe, Cr, BOD, COD, and EC at concentrations higher than allowable limit by standard organization. Cocoa industry wastewater is capable of inducing hematotoxicity, therefore, proper waste management should be followed in the disposal of such toxic waste.

An Automated Method for Differential Blood Counting Using Microscope Color Image of Isolated WBC

2010 ◽  
Vol 1 (4) ◽  
pp. 35-48
Author(s):  
Anant R. Koppar ◽  
Venugopalachar Sridhar
Keyword(s):  
Blood Cells ◽  
Human Error ◽  
Color Image ◽  
White Blood Cells ◽  
Healthcare Delivery ◽  
Cost Effective ◽  
Turnaround Time ◽  
Differential Count ◽  
Flow Process ◽  
Automated Method

Healthcare Delivery Systems are becoming overloaded in developed and developing countries. It is imperative that more efficient and cost effective processes be employed by innovative applications of technology in the delivery system. One such process in Haematology that needs attention is “Generation of report on the Differential Count of Blood”. Most rural centers in India still employ traditional, manual processes to identify and count White Blood Cells under a microscope. This traditional method of manually counting the white blood cells is prone to human error and time consuming. Medical Imaging with innovative application of algorithms can be used for recognizing and analyzing the images from blood smears to provide an efficient alternative for differential counting and reporting. In this regard, the objective of this paper is to provide a simple and pragmatic software system built on innovative yet simple imaging algorithms for achieving better efficiency and accuracy of results. The resulting work-flow process has enabled truly practical tele-pathology by enabling e-collaboration between lesser skilled technicians and more skilled experts, which cuts down the total turnaround time for differential count reporting from days to minutes. The system can be extended to detect malarial parasites in blood and also cancerous cells.

scholarly journals Subchronic Oral Toxicity Study of Decitabine in Combination With Tetrahydrouridine in CD-1 Mice

2014 ◽  
Vol 33 (2) ◽  
pp. 75-85 ◽  
Author(s):  
Pramod Terse ◽  
Kory Engelke ◽  
Kenneth Chan ◽  
Yonghua Ling ◽  
Douglas Sharpnack ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Combination Therapy ◽  
Food Consumption ◽  
Blood Cells ◽  
Recovery Period ◽  
White Blood Cells ◽  
Clinical Pathology ◽  
High Dose ◽  
Severe Toxicity ◽  
Oral Toxicity

Decitabine (5-aza-2′-deoxycytidine; DAC) in combination with tetrahydrouridine (THU) is a potential oral therapy for sickle cell disease and β-thalassemia. A study was conducted in mice to assess safety of this combination therapy using oral gavage of DAC and THU administered 1 hour prior to DAC on 2 consecutive days/week for up to 9 weeks followed by a 28-day recovery to support its clinical trials up to 9-week duration. Tetrahydrouridine, a competitive inhibitor of cytidine deaminase, was used in the combination to improve oral bioavailability of DAC. Doses were 167 mg/kg THU followed by 0, 0.2, 0.4, or 1.0 mg/kg DAC; THU vehicle followed by 1.0 mg/kg DAC; or vehicle alone. End points evaluated were clinical observations, body weights, food consumption, clinical pathology, gross/histopathology, bone marrow micronuclei, and toxicokinetics. There were no treatment-related effects noticed on body weight, food consumption, serum chemistry, or urinalysis parameters. Dose- and gender-dependent changes in plasma DAC levels were observed with a Cmax within 1 hour. At the 1 mg/kg dose tested, THU increased DAC plasma concentration (∼10-fold) as compared to DAC alone. Severe toxicity occurred in females receiving high-dose 1 mg/kg DAC + THU, requiring treatment discontinuation at week 5. Severity and incidence of microscopic findings increased in a dose-dependent fashion; findings included bone marrow hypocellularity (with corresponding hematologic changes and decreases in white blood cells, red blood cells, hemoglobin, hematocrit, reticulocytes, neutrophils, and lymphocytes), thymic/lymphoid depletion, intestinal epithelial apoptosis, and testicular degeneration. Bone marrow micronucleus analysis confirmed bone marrow cytotoxicity, suppression of erythropoiesis, and genotoxicity. Following the recovery period, a complete or trend toward resolution of these effects was observed. In conclusion, the combination therapy resulted in an increased sensitivity to DAC toxicity correlating with DAC plasma levels, and females are more sensitive compared to their male counterparts.

scholarly journals Platelet Activation in End-Stage Renal Disease Is Mediated By Extracellular Nucleosomes That Originate from White Blood Cells

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4909-4909
Author(s):  
Trung Phan ◽  
McMillan Ryan ◽  
Leonidas Skiadopoulos ◽  
Amanda Walborn ◽  
Debra Hoppensteadt ◽  
...  
Keyword(s):  
Platelet Count ◽  
Platelet Activation ◽  
Blood Cells ◽  
White Blood Cells ◽  
Positive Correlation ◽  
Cell Counts ◽  
Wbc Count ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Introduction Extracellular nucleosomes in plasma (PNs) are complexes of DNA and histones that are released during cell death and inflammatory responses. End-stage renal disease (ESRD) represents a complex syndrome where inflammation, endothelial dysfunction, and hemostatic aberrations contribute to the observed vascular manifestations. The purpose of this investigation is to profile PNs in patients with ESRD and to demonstrate their relevance to blood cells and platelet activation products. Methods Pre-dialysis plasma samples from patients undergoing maintenance hemodialysis (n = 90) at Loyola University outpatient dialysis unit were collected under an approved IRB protocol. Plasma samples from healthy individuals (n = 50) were purchased from a biobank as a control (George King Biomedical, Overland Park, Kansas). Complete blood count profiles, including white blood cells (WBCs), red blood cells (RBCs), and platelets were obtained from the patients' medical records. The levels of PNs in ESRD patients and healthy volunteers were measured using the Cell Death Detection ELISA PLUS assay (Roche Diagnostics, Mannheim, Germany). MP-TF levels were measured using the Zymuphen MP-TF kit (Hyphen BioMed, Neuville-sur-Oise, France). PDGF levels were measured using the Human PDGF-BB Quantikine ELISA Kit (R&D Systems, Minneapolis, Minnesota). Human PF4 levels were measured using the Zymutest PF4 ELISA Kit (Hyphen BioMed, Neuville-sur-Oise, France). All individual results were tabulated and analyzed using the statistical software GraphPad Prism 7. The Mann-Whitney test for non-parametric data was utilized in comparing ESRD to control groups. PN levels were correlated with cell counts and platelet activation factors using the non-parametric Spearman correlation. Individual cell counts were also correlated with platelet activating factors using the same method. Results In the ESRD patients, the average hematocrit was 31.7 ± 4.4 %, the average WBC count was 6.5 ± 4.0 K/uL, and the average platelet count was 179.4 ± 66.3 K/uL. The levels of PNs in the ESRD patients (15.5 ± 14.1 Arbitrary Units (AU)) were markedly higher in comparison to that of the controls (6.74 ± 13.7 AU; p < 0.0001). Similarly, MP-TF levels were significantly elevated in ESRD patients (3.00 ± 1.42 pg/mL) compared to normal (0.363 ± 0.263 pg/mL; p < 0.0001). PF4 levels were also significantly elevated in ESRD patients (95.3 ± 35.3 ng/mL) compared to normal (27.4 ± 19.8 ng/mL; p < 0.0001). While PDGF levels were higher in the ESRD group (116.0 ± 172.5 pg/mL) in comparison to the controls (82.7 ± 113.5 pg/mL), this increase was not statistically significant (p = 0.405). A positive correlation was observed between PNs and WBCs (p = 0.024; r = 0.244). PN levels did not show a correlation with RBC (p = 0.448; r = 0.083) and platelet levels (p = 0.545; r = 0.066). Furthermore, there was no correlation between PNs and MP-TF (p = 0.501; r = 0.077), PDGF (p = 0.314; r = 0.110) and PF4 (p = 0.524; r = -0.070) in the ESRD patients. However, the platelet count showed a positive correlation with PDGF (p = 0.044; r = 0.218) and MP-TF (p = 0.042; r = 0.237). Similarly, the WBC count showed a positive correlation with the platelet count (p < 0.0001; r = 0.476) and PDGF (p = 0.016; r = 0.260). Conclusion This study clearly demonstrates that extracellular nucleosomes are elevated in the plasma of patients with ESRD. The fact that the PN levels correlated with the number of circulating white blood cells suggest that the PNs originate from these cells. Since the ESRD patients exhibited platelet activation, as evident by the observed increase in PDGF, MP-TF and PF4, it is plausible that this activation is mediated by PNs originating from the WBCs. As observed by the positive correlation between WBCs, PDGF, and platelet count, this study underscores the potential role of nucleosomes originating from WBCs in the activation of platelets. These results are consistent with previously reported observations that extracellular histones can induce platelet activation in a TLR2 and TLR4 dependent manner (http://www.ncbi.nlm.nih.gov/pubmed/21673343). Disclosures No relevant conflicts of interest to declare.

scholarly journals Quantification of Blood Cells and Blood Disease Detection Using Image Processing

2021 ◽  
Author(s):  
K. Rahimunnisa ◽  
V. Aparna ◽  
R.K. Harrini ◽  
K. Kamalini
Keyword(s):  
Blood Cells ◽  
White Blood Cells ◽  
Input Image ◽  
The Body ◽  
Total Blood ◽  
Major Drawback ◽  
Blood Diseases ◽  
Blood Disease ◽  
Wbc Count ◽  
The Right

RBC (Red Blood Cells) and WBC (White Blood Cells) are the main constituents of blood. WBC fight infections by attacking bacteria and viruses, that invade the body, while RBC transports oxygen in the body. Many blood diseases can be detected using RBC and WBC count values. Immunity-related blood diseases like Leukopenia and Leukocytosis can be easily detected using the WBC count value. The manual counting method of blood cells in laboratories takes at least one day to get the blood results, which becomes a major drawback for healthcare sectors to diagnose the disease at the right time. More expensive pathological tests are also a major drawback. Accurate counting of blood cells is essential in the accurate diagnosis of the disease. The proposed system is used to calculate the RBC and WBC Count, Total blood Count, RBC and percentage and the blood disease (Leukocytosis, Leukopenia) from the input blood smear image. This will help laboratories to perform the counting of blood cells with high accuracy and less workload. This is achieved by pre-processing that involves grayscale conversion, image enhancement, noise removal, binary conversion of input image, followed by plane extraction and threshold-based Segmentation. The blood disease (Leukocytosis and Leukopenia) is detected using WBC percentage-based classification methodology. This approach obtained an accuracy of 98.4%, specificity of 88.889%, precision of 99.58%, F - Measure of 99.50%. Morphological operations are implemented using MATLAB software.

scholarly journals Haematological Changes in Donors Post Apheresis

2021 ◽  
Author(s):  
. Nikhil ◽  
Subhashish Das ◽  
. Snigdha
Keyword(s):  
Platelet Count ◽  
Blood Cells ◽  
Complete Blood Count ◽  
White Blood Cells ◽  
Haemoglobin Concentration ◽  
Point Of View ◽  
Haematological Parameters ◽  
Cross Sectional ◽  
Wbc Count ◽  
Rbc Count

Introduction: The productivity, quality of platelet apheresis collection has improved because of the considerable advancement in the automated cell separators. Automated cell separators have lot of sizeable scientific advances, but the alertness has been centered to Platelet Concentrates (PCs) quality than on safety of donor. Aim: To find the changes in haematological parameters and the consequences of apheresis and plateletpheresis on donor’s health. Materials and Methods: It was observational cross-sectional study done in laboratory at RL Jalappa Blood Bank, Tamaka, Kolar, Karnataka, India. The study was done from March 2019 to August 2020. A total of 300 healthy donors (plateletpheresis donors) were involved in the study. The plateletpheresis (Haemonetics MCS), predonation and postdonation haematological parameters such as haemoglobin concentration, Haematocrit (Hct), platelet, white and red blood cell count were calculated in all donors. The samples for Complete Blood Count (CBC) were secured from the donors, at the beginning and end of the procedure. Postdonation haematological parameters such as platelet count, haemoglobin, haematocrit, White Blood Cells (WBC), Red Blood Cells (RBC) counts of the donor was inscribed and comparison was done with the pre donation haematological parameters. Quality control of all Single Donor Platelet (SDP) products was done. All donors were evaluated for adverse donor reactions. The mean pre and post plateletpheresis values comparison was done utilising paired t-test. Statistical analysis was accomplished utilising Statistical Package for the Social Sciences (SPSS) software version 16.0. Results: Platelet count, haemoglobin, WBC count, RBC count and haematocrit were jotted down from 262 donors and a significant decrease was noticed in these parameters postdonation. Donor parameter platelet count (lac/mL) value was decreased from 273.57-224.28 whereas WBC count (cu/mm) predonation value decreased from 9.91-8.86 Postdonation, haemoglobin (g/dL) value decreased from 14.46-12.91, haematocrit (%) decreased slightly from 45.19-44.19, RBC count (million/mm3) decreased from 5.21-5.01. This concluded that the values decreased postdonation. Conclusion: The study conducted was safe from donor’s point of view. SDP is very effective in treatment of thrombocytopenia and is safe from recipient’s point of view.

scholarly journals Comparison the effect of aqueous leaves extract of Melia azedarach L. and Anastatica hierochuntic with antibiotic (Enrofloxaccin) on some blood and biochemical traits of broiler

2012 ◽  
Vol 36 (0A) ◽  
pp. 56-61
Author(s):  
زيادطارق محمد ضنكي
Keyword(s):  
Blood Cells ◽  
Tap Water ◽  
White Blood Cells ◽  
Cholesterol Concentration ◽  
Melia Azedarach ◽  
Biochemical Traits ◽  
Blood Tests ◽  
Serum Cholesterol Concentration ◽  
Wbc Count ◽  
Protein Serum

This experiment were conducted to compare the effect of aqueous leaves extract of Melia azedarach and Anastatica hierochuntic with the antibiotic (Enrofloxaccin) for 49 days, 270 chicks one day old (Ross 308) were randomly distributed into 6 treatments with 3 replicates per treatment and 15 chicks per replicate (45 chicks/treatment). The first treatment were the control, antibiotic (enrofloxaccin) were used in the second treatment at rate of 0.5 ml per liter of tap water, in the 3rd and 4th treatment the aqueous leaves extract of Anastatica hierochuntic were used at rate of 10 and 15 mg/L respectively, and in the 5th and 6th treatment the aqueous leaves extract of Melia azedarach were used at rate of 10 and 15 mg / ml resp. At the end of experiment, blood samples were collected for whole blood tests; Red and White Blood Cells count, biochemical serum tests were also involved ; the concentrate of total cholesterol, glucose, and total protein. The Data showed that using aqueous leaves extract of Anastatica hierochuntic at rate of 10 and 15 mg/L leading to significant increase in serum cholesterol concentration , while , protein serum concentration were significantly decreased in control and in 6th treatment where the aqueous extract of Melia azedarach were used at rate of 15 mg /ml , and there is no significant differences between the treatments in RBC , WBC count , and glucose concentration

scholarly journals Risk Factors of White Blood Cell Progression Among Patients With Chronic Lymphocytic Leukemia at Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia

2022 ◽  
Vol 21 ◽  
pp. 117693512110699
Author(s):  
Gedam Derbew Addisia ◽  
Awoke Seyoum Tegegne ◽  
Denekew Bitew Belay ◽  
Mitiku Wale Muluneh ◽  
Mahider Abere Kassaw
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Blood Cell ◽  
White Blood Cell ◽  
Blood Cells ◽  
White Blood Cells ◽  
Lymphocytic Leukemia ◽  
Bahir Dar ◽  
Felege Hiwot Referral Hospital ◽  
Wbc Count

Background: Leukemia is a type of cancers that start in the bone marrow and produce a serious number of abnormal white blood cells. Bleeding and bruising problems, fatigue, fever, and an increased risk of infection are among symptoms of the disease. The main objective of this study is to identify the determinant of the progression rate of white blood cells among patients with chronic lymphocytic leukemia at Felege Hiwot Referral Hospital (FHRH), Bahir Dar, Ethiopia. Methods: A retrospective study design was conducted on 312 patients with chronic lymphocytic leukemia at FHRH, Bahir Dar, Ethiopia under treatment from 1 January 2017 to 31 December 2019. A linear mixed-effects model was considered for the progression of the white blood cell data. Results: The estimated coefficient of the fixed effect intercept was 84.68, indicating that the average white blood cell (WBC) count of the patients was 84.68 at baseline time by excluding all covariates in the model ( P-value <.001). Male sex ( β = 2.92, 95% confidence interval [CI] 0.58, 0.5.25), age ( β = .17, 95% CI 0.08, 0.28), widowed/divorced marital status ( β = 3.30, 95% CI 0.03, 6.57), medium chronic lymphocytic leukemia (CLL) stage ( β = −4.34, 95% CI −6.57, −2.68), high CLL stage ( β = −2.76, 95% CI −4.86, −0.67), hemoglobin ( β = .15, 95% CI 0.07, 0.22), platelet ( β = .09, 95% CI 0.02, 0.17), lymphocytes ( β = .16, 95% CI 0.03, 0.29), red blood cell (RBC) ( β = .17, 95% CI 0.09, 0.25), and follow-up time ( β = .27, 95% CI 0.19, 0.36) were significantly associated with the average WBC count of chronic lymphocytic leukemia patients. Conclusions: The finding showed that age, sex, lymphocytic, stage of chronic lymphocytic leukemia, marital status, platelet, hemoglobin, RBC, and follow-up time were significantly associated with the average WBC count of chronic lymphocytic leukemia patients. Therefore, health care providers should give due attention and prioritize those identified factors and give frequent counseling about improving the health of chronic lymphocytic leukemia patients.

The Extramedullar Dissemination of Acute Myeloid Leukemic Cells Depends on CD31 (PECAM-1) and CD38 Coexpression Level.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 1896-1896 ◽  
Author(s):  
Olivier Herault ◽  
Nathalie Gallay ◽  
Jorge Domenech ◽  
Philippe Colombat ◽  
Christian Binet
Keyword(s):  
Blood Cells ◽  
De Novo ◽  
White Blood Cells ◽  
Transendothelial Migration ◽  
Expression Level ◽  
Leukemic Cells ◽  
P Value ◽  
Cd38 Expression ◽  
Wide Range ◽  
Wbc Count

Abstract The number of peripheral white blood cells (WBC) shows a wide range in acute myeloblastic leukemia (AML) patients. A high WBC count constitutes an adverse prognosis factor when at presentation and (myelo)monocytic subtypes were more frequently associated with extramedullar tumor sites. Marrow endothelial cells express CD31 and CD31/CD31 interaction is known to promote the migration in physiological mechanisms, as for example transendothelial migration of neutrophiles and monocytes in diapedesis. CD31 is a specific receptor of CD38 which is associated with numerous molecules on the surface of blood cells. Moreover, CD38 could interact with hyaluronate, a component of the extracellular matrix, 2 hyaluronate-binding sites having been reported in its extracellular domain. These elements lead us to postulate that CD31 and CD38 are colocalized on AML cells and that an excess of CD31 promotes the egress of the cells from the marrow compartment, while an excess of CD38 favors their anchorage to marrow microenvironment. The CD38/CD31 colocalization was demonstrated using FRET and cocapping strategies. FRET experiments were performed with a 488 nm laser flow cytometer, Cy3-conjugated anti-CD38 mAb and FITC-conjugated mAb against CD31. For cocapping experiments, we induced capping of CD31 with anti-CD31 mAb at 37°C; the cells were then fixed and labeled with anti-CD38 mAb. Transendothelial migration has been studied using anti-CD31 mAb and anti-CD38 blocking mAbs in Transwell® experiments performed with TrHBMEC cell line. To study the CD38/hyaluronate interaction, cells were treated or not with all-trans retinoic acid to induce CD38 overexpression just before plating the cells onto hyaluronate-coated dish. The in vivo influence of CD31 and CD38 coexpression level was evaluated by studying the phenotype of marrow leukemic cells (S/N ratio of the MFI) and the WBC count of 78 consecutive patients with newly diagnosed de novo AML. In all experiments, P value <0.05 has been considered as statistically significant. FITC-conjugated anti-CD31 induced increase in MFI of Cy-3 by 108.4% and we observed a CD31/CD38 cocapping. The inhibition of migration by anti-CD31 blocking mAb ranged from 2% to 66% of control and was correlated to the CD31 expression level (R=0.9236; P<0.0001), while migration in presence of anti-CD38 blocking mAb was about 80% of the control without correlation with CD38 expression level, suggesting a lesser role in the transendothelial migration process. The blasts exposed to ATRA exhibited a 1.3±0.1-fold increase in the CD38 expression (S/N of MFI) and a 40±10 % increase in adhesion to hyaluronate. The expression of CD31 and CD38 on the membrane of marrow leukemic cells of the AML patients were correlated (R=0.6621; P<0.0001). Moreover, peripheral WBC count was correlated with the CD31/CD38 ratio (R=0.5286; P=0.0129) and an excess of CD31 antigen was associated with an increased peripheral WBC count when comparing patients with ratio >1 to those with ratio <1 (P<0.0001). Interestingly, CD31/CD38 ratio was higher in AML (myelo)monocytic subtypes when comparing M4/M5 to all other FAB subtypes (1.2±0.1 and 0.7±0.1, respectively; P<0.0001). These findings suggest that extramedullar dissemination of AML cells depends on CD31 and CD38 coexpression level and give new insights into novel strategies to reduce the number of extramedullar tumor sites, notably in AML (myelo)monocytic subtypes.

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