ISSN 2997-1036
International Journal of Hematology | Vol. 7, No. 4, April 2016 | pp. 25–32
DOI: 10.46882/2016/IJH/000076
Original Article
Title: Evaluation of automated nucleated red blood cell enumeration parameters in predicting bone marrow stress in acute leukemias
Names of Authors: E. F. Chinedu¹, G. H. Haruna², I. J. Balogun³
Authors’ Affiliations: ¹Department of Haematology, University of Nigeria Teaching Hospital, Enugu, Nigeria; ²Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Nigeria; ³Department of Chemical Pathology, University of Ilorin, Ilorin, Nigeria
Abstract: The presence of nucleated red blood cells (NRBCs) in adult peripheral blood reflects disruption of the bone marrow-blood barrier, frequently indicating severe bone marrow infiltration. This study evaluated the performance and clinical significance of automated nucleated red blood cell counts, derived from a fluorescent flow cytometry cell counter, for predicting tumor burden in 48 adult patients with newly diagnosed acute myeloid or lymphoblastic leukemia. Automated parameters were validated via manual peripheral blood film examinations. Circulating nucleated red blood cells were detected in 64.5% (31 of 48) of leukemia patients, with a mean concentration of 4.8 ± 1.2 NRBC per 100 white blood cells. High absolute nucleated red blood cell counts correlated positively with bone marrow blast percentages (r = 0.56, P < 0.01) and inversely with total hemoglobin values. Furthermore, persistent elevations of nucleated red blood cells following initial induction therapy predicted primary chemoresistance or early disease relapse. Utilizing automated erythroblast enumeration provides a rapid, cost-effective indicator of severe marrow infiltration and systemic bone marrow stress.
Keywords: Nucleated red blood cells, acute leukemia, tumor burden, cell counter flags, marrow infiltration
Manuscript Timeline: Received: January 12, 2016; Revised: February 20, 2016; Accepted: March 08, 2016; Published: April 14, 2016