Study for the diagnostic screening of paroxsymal nocturnal hemoglobinuria in Turkey: Prospective multicentric evaluation of suspected patients.


Journal

Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis
ISSN: 1473-0502
Titre abrégé: Transfus Apher Sci
Pays: England
ID NLM: 101095653

Informations de publication

Date de publication:
Oct 2019
Historique:
received: 22 05 2019
revised: 23 07 2019
accepted: 16 08 2019
pubmed: 23 9 2019
medline: 30 4 2020
entrez: 23 9 2019
Statut: ppublish

Résumé

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare disease presenting with variable and various clinical findings. PNH might be overlooked and diagnosis may be delayed due to low awareness about PNH. This is the first multicenter study in Turkey, investigating the efficiency of diagnostic screening of PNH by multiparameter flow cytometry (FCM) according to consensus guidelines. We evaluate the efficiency of consensus clinical indications for PNH testing with FCM in 1689peripheral blood samples from 20 centers between January 2014 and December 2017. Overall, at the 20 centers contributing to this study, PNH clone were detected in 62/1689 samples (3.6%) by FCM test. 75.8% (n = 47) of patients with PNH clone had aplastic anemia, 3.2% (n = 2) had Coombs (-) hemolytic anemia, 6.5% (n = 4) had unexplained cytopenia, 3.2% (n = 2) had MDS with refractory anemia, 1.6% (n = 1) had hemoglobinuria and 9.7% (n = 6) had others (elevated LDH, splenomegaly, etc.). In contrast, we detect no PNH clone test in patients who were screened for unexplained thrombosis. Our study showed that current clinical indications for PNH testing are highly efficient and diagnostic screening of suspected patients for PNH with FCM is recommended. However, advanced screening algorithms are required for patients presenting with unexplained thrombosis and normal complete blood count.

Sections du résumé

BACKGROUND BACKGROUND
Paroxysmal nocturnal hemoglobinuria (PNH) is a rare disease presenting with variable and various clinical findings. PNH might be overlooked and diagnosis may be delayed due to low awareness about PNH. This is the first multicenter study in Turkey, investigating the efficiency of diagnostic screening of PNH by multiparameter flow cytometry (FCM) according to consensus guidelines.
METHODS METHODS
We evaluate the efficiency of consensus clinical indications for PNH testing with FCM in 1689peripheral blood samples from 20 centers between January 2014 and December 2017.
RESULTS RESULTS
Overall, at the 20 centers contributing to this study, PNH clone were detected in 62/1689 samples (3.6%) by FCM test. 75.8% (n = 47) of patients with PNH clone had aplastic anemia, 3.2% (n = 2) had Coombs (-) hemolytic anemia, 6.5% (n = 4) had unexplained cytopenia, 3.2% (n = 2) had MDS with refractory anemia, 1.6% (n = 1) had hemoglobinuria and 9.7% (n = 6) had others (elevated LDH, splenomegaly, etc.). In contrast, we detect no PNH clone test in patients who were screened for unexplained thrombosis.
CONCLUSIONS CONCLUSIONS
Our study showed that current clinical indications for PNH testing are highly efficient and diagnostic screening of suspected patients for PNH with FCM is recommended. However, advanced screening algorithms are required for patients presenting with unexplained thrombosis and normal complete blood count.

Identifiants

pubmed: 31542336
pii: S1473-0502(19)30184-3
doi: 10.1016/j.transci.2019.08.021
pii:
doi:

Types de publication

Clinical Trial Journal Article Multicenter Study

Langues

eng

Pagination

659-662

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Auteurs

Osman Ilhan (O)

Ankara University School of Medicine, Turkey.

Zehra Narli Ozdemir (ZN)

Ankara University School of Medicine, Turkey. Electronic address: zehra.narli@gmail.com.

Gulsum Ozet (G)

Ankara University School of Medicine, Turkey.

Mesude Falay (M)

Ankara University School of Medicine, Turkey.

Mustafa Yenerel (M)

Ankara University School of Medicine, Turkey.

Tulin Tuglular (T)

Ankara University School of Medicine, Turkey.

Mehmet Turgut (M)

Ankara University School of Medicine, Turkey.

Birol Guvenc (B)

Ankara University School of Medicine, Turkey.

Ali Unal (A)

Ankara University School of Medicine, Turkey.

Orhan Ayyıldız (O)

Ankara University School of Medicine, Turkey.

Neslihan Andic (N)

Ankara University School of Medicine, Turkey.

Abdullah Hacıhanefioglu (A)

Ankara University School of Medicine, Turkey.

Fahri Sahin (F)

Ankara University School of Medicine, Turkey.

Mehmet Sencan (M)

Ankara University School of Medicine, Turkey.

Ridvan Ali (R)

Ankara University School of Medicine, Turkey.

Guner Hayri Ozsan (GH)

Ankara University School of Medicine, Turkey.

Rahsan Yildirim (R)

Ankara University School of Medicine, Turkey.

Eyup Naci Tiftik (EN)

Ankara University School of Medicine, Turkey.

Anıl Tombak (A)

Ankara University School of Medicine, Turkey.

Ozan Salim (O)

Ankara University School of Medicine, Turkey.

Emin Kaya (E)

Ankara University School of Medicine, Turkey.

Olga Meltem Akay (OM)

Ankara University School of Medicine, Turkey.

Vahap Okan (V)

Ankara University School of Medicine, Turkey.

Mustafa Pehlivan (M)

Ankara University School of Medicine, Turkey.

Guray Saydam (G)

Ankara University School of Medicine, Turkey.

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