International Journal of Hematology

International Journal of Hematology | Vol. 16, No. 8, August 2025 | pp. 57–64
DOI: 10.46882/2025/IJH/000186

Original Article

Title: Evaluation of baseline plasma protein C activity as an independent predictor of recurrent macrovascular thrombosis in focal segmental glomerulosclerosis

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: Massive renal loss of low-molecular-weight regulatory proteins via porous glomerular structures creates a severe hypercoagulable state in nephrotic-range focal segmental glomerulosclerosis, but the predictive utility of functional protein C tracking remains under-analyzed. This prospective study evaluated baseline plasma free protein S and protein C functional activity in 54 adult patients presenting with active focal segmental glomerulosclerosis to track correlations with serum albumin depletion and 1-year thromboembolic outcomes. Protein C activity was quantified via chromogenic substrate assays prior to initiating intensive immunosuppressive therapies. Severe protein C activity reduction (< 55.0%) was identified in 29.6% (16 of 54) of the nephrotic patients. Multivariable Cox proportional hazards analysis revealed that baseline protein C activity below 55.0% was an independent predictor of acute deep vein thrombosis or pulmonary embolism within a 12-month observation window (hazard ratio = 3.84, P < 0.01). Protein C depression correlated inversely with serum albumin levels (r = -0.65, P < 0.001) and positively with D-dimer concentrations. Screening for functional protein C activity provides clear prognostic utility, helping identify high-risk autoimmune renal populations requiring early prophylactic anticoagulation.

Keywords: Focal segmental glomerulosclerosis, protein C activity, hypercoagulability, albuminuria, thromboembolism

Manuscript Timeline: Received: May 12, 2025; Revised: June 20, 2025; Accepted: July 09, 2025; Published: August 14, 2025

International Journal of Hematology | Vol. 16, No. 2, February 2025 | pp. 9–16
DOI: 10.46882/2025/IJH/000180

Short Communication

Title: Evaluation of automated microcytic cell mathematical indices in predicting latent iron deficiency in volunteer multi-donation female blood donors

Names of Authors: B. C. Akpan¹, D. E. Usman²

Authors’ Affiliations: ¹Department of Haematology, University of Calabar, Calabar, Nigeria; ²Department of Clinical Pharmacology, Ahmadu Bello University, Zaria, Nigeria

Abstract: Frequent blood donations in childbearing female cohorts deplete growth-associated iron pools, often inducing latent iron deficiency before total hemoglobin screening tests fall below acceptable thresholds. This diagnostic study evaluated the predictive performance of the Mentzer index and the Green and King mathematical cell counter formulas for identifying latent iron depletion in 120 regular female blood donors presenting with normal total hemoglobin levels (≥ 12.5 g/dl). Calculated indices were cross-validated against biochemical serum ferritin reference parameters. Latent iron deficiency, defined by a serum ferritin below 20 ng/ml, was confirmed in 24.1% (29 of 120) of the donor cohort. The Green and King formula achieved an isolated sensitivity of 89.6% and a positive predictive value of 76.1% for predicting depleted iron reserves, significantly outperforming the Mentzer index model (P < 0.05). Utilizing automated cell counter mathematical formulas offers an efficient, low-cost screening protocol to detect latent iron-restricted erythropoiesis and preserve donor safety.

Keywords: Blood donors, latent iron deficiency, Mentzer index, Green and King formula, donor selection

Manuscript Timeline: Received: November 15, 2024; Revised: December 22, 2024; Accepted: January 11, 2025; Published: February 18, 2025

International Journal of Hematology | Vol. 16, No. 1, January 2025 | pp. 1–8
DOI: 10.46882/2025/IJH/000179

Original Article

Title: Immunophenotypic profile and clinical stage stratification of B-cell chronic lymphoproliferative disorders utilizing CD200 and CD319 expression markers

Names of Authors: W. A. Adebayo¹, X. Y. Emeka², Z. Z. Salami³

Authors’ Affiliations: ¹Department of Haematology, University of Ibadan, Ibadan, Nigeria; ²Department of Haematology, University of Calabar Teaching Hospital, Calabar, Nigeria; ³Department of Pathology, Lagos University Teaching Hospital, Lagos, Nigeria

Abstract: Multiparameter flow cytometry immunophenotyping plays an important role in separating overlapping mature B-cell malignancies. This prospective study evaluated the diagnostic performance of combining CD200 and CD319 (SLAMF7) markers to differentiate chronic lymphocytic leukemia from mantle cell lymphoma and marginal zone lymphoma in 55 adult patients presenting with persistent absolute lymphocytosis. Lineage markers and monotypic light chain restriction were established using flow cytometry. Chronic lymphocytic leukemia was confirmed in 38 cases, while 17 were diagnosed with non-CLL mature B-cell variants. Strong, uniform surface expression of CD200 paired with positive CD319 was detected in 94.7% (36 of 38) of the chronic lymphocytic leukemia cases. In contrast, mantle cell lymphoma cohorts demonstrated a complete absence of CD200 alongside dim or negative CD319 and bright CD20 expression (P < 0.001). Marginal zone lymphoma variants exhibited variable CD319 paired with negative or dim CD200 parameters. High expression density for CD200 correlated with early clinical presentation (Binet Stage A). Incorporating CD200 and CD319 into standard screening protocols provides excellent diagnostic specificity, reducing borderline scores and helping classify mature B-cell expansions.

Keywords: Chronic lymphocytic leukemia, CD200, CD319, flow cytometry, lymphoproliferative disorders, immunophenotyping

Manuscript Timeline: Received: October 14, 2024; Revised: November 25, 2024; Accepted: December 10, 2024; Published: January 15, 2025

International Journal of Hematology | Vol. 16, No. 11, November 2025 | pp. 81–88
DOI: 10.46882/2025/IJH/000189

Original Article

Title: Immunophenotypic profile and clinical stage stratification of B-cell chronic lymphoproliferative disorders utilizing CD200 and CD321 expression markers

Names of Authors: W. A. Adebayo¹, X. Y. Emeka², Z. Z. Salami³

Authors’ Affiliations: ¹Department of Haematology, University of Ibadan, Ibadan, Nigeria; ²Department of Haematology, University of Calabar Teaching Hospital, Calabar, Nigeria; ³Department of Pathology, Lagos University Teaching Hospital, Lagos, Nigeria

Abstract: Multiparameter flow cytometry immunophenotyping plays an important role in separating overlapping mature B-cell malignancies. This prospective study evaluated the diagnostic performance of combining CD200 and CD321 (JAM1) markers to differentiate chronic lymphocytic leukemia from mantle cell lymphoma and marginal zone lymphoma in 55 adult patients presenting with persistent absolute lymphocytosis. Lineage markers and monotypic light chain restriction were established using flow cytometry. Chronic lymphocytic leukemia was confirmed in 38 cases, while 17 were diagnosed with non-CLL mature B-cell variants. Strong, uniform surface expression of CD200 paired with positive CD321 was detected in 94.7% (36 of 38) of the chronic lymphocytic leukemia cases. In contrast, mantle cell lymphoma cohorts demonstrated a complete absence of CD200 alongside dim or negative CD321 and bright CD20 expression (P < 0.001). Marginal zone lymphoma variants exhibited variable CD321 paired with negative or dim CD200 parameters. High expression density for CD200 correlated with early clinical presentation (Binet Stage A). Incorporating CD200 and CD321 into standard screening protocols provides excellent diagnostic specificity, reducing borderline scores and helping classify mature B-cell expansions.

Keywords: Chronic lymphocytic leukemia, CD200, CD321, flow cytometry, lymphoproliferative disorders, immunophenotyping

Manuscript Timeline: Received: August 18, 2025; Revised: September 25, 2025; Accepted: October 14, 2025; Published: November 15, 2025

International Journal of Hematology | Vol. 16, No. 12, December 2025 | pp. 89–96
DOI: 10.46882/2025/IJH/000190

Short Communication

Title: Evaluation of automated microcytic cell mathematical indices in predicting latent iron deficiency in volunteer multi-donation adolescent female blood donors

Names of Authors: B. C. Akpan¹, D. E. Usman²

Authors’ Affiliations: ¹Department of Haematology, University of Calabar, Calabar, Nigeria; ²Department of Clinical Pharmacology, Ahmadu Bello University, Zaria, Nigeria

Abstract: Frequent blood donations in childbearing adolescent cohorts deplete biological iron pools, often inducing latent iron deficiency before total hemoglobin screening tests fall below acceptable thresholds. This diagnostic study evaluated the predictive performance of the Mentzer index and the Green and King mathematical cell counter formulas for identifying latent iron depletion in 120 regular adolescent female blood donors presenting with normal total hemoglobin levels (≥ 12.5 g/dl). Calculated indices were cross-validated against biochemical serum ferritin reference parameters. Latent iron deficiency, defined by a serum ferritin below 20 ng/ml, was confirmed in 24.1% (29 of 120) of the donor cohort. The Green and King formula achieved an isolated sensitivity of 89.6% and a positive predictive value of 76.1% for predicting depleted iron reserves, significantly outperforming the Mentzer index model (P < 0.05). Utilizing automated cell counter mathematical formulas offers an efficient, low-cost screening protocol to detect latent iron-restricted erythropoiesis and preserve donor safety.

Keywords: Blood donors, latent iron deficiency, Mentzer index, Green and King formula, donor selection

Manuscript Timeline: Received: September 15, 2025; Revised: October 22, 2025; Accepted: November 10, 2025; Published: December 14, 2025

International Journal of Hematology | Vol. 16, No. 10, October 2025 | pp. 73–80
DOI: 10.46882/2025/IJH/000188

Original Article

Title: Evaluation of automated immature reticulocyte fraction and red blood cell fragmentation flags in separating iron deficiency from hemolytic uremic syndrome variations

Names of Authors: Q. S. Abubakar¹, U. T. Maina²

Authors’ Affiliations: ¹Department of Haematology, National Hospital, Abuja, Nigeria; ²Department of Pathology, Bayero University, Kano, Nigeria

Abstract: Severe microcytic anemia fragments can mimic schistocytes on automated counters, requiring robust laboratory separation parameters to prevent inappropriate therapeutic decisions. This prospective diagnostic study evaluated the performance of automated immature reticulocyte fractions (IRF) and fragmented red blood cell (FRC) flags for separating absolute iron deficiency anemia from microangiopathic hemolytic uremic syndrome variations. Evaluations were conducted on 125 adult patients presenting with thrombocytopenia and microcytosis, and diagnoses were validated via serum ferritin, complement gene panels, and manual visual blood film schistocyte counts. Hemolytic uremic syndrome variants were confirmed in 50 cases, while 75 presented with severe iron deficiency anemia. The mean immature reticulocyte fraction was significantly higher in the microangiopathic cohort compared to the iron-deficient group (0.34 ± 0.08 versus 0.12 ± 0.03, P < 0.001), reflecting an intense bone marrow response. Conversely, automated fragmentation flags were elevated in both groups. Receiver operating characteristic analysis established a combined IRF and FRC model that achieved a diagnostic sensitivity of 91.2% and a specificity of 88.4% for identifying true destructive processes. Utilizing automated reticulocyte maturity indices provides an efficient, low-cost asset for screening complex hemolytic environments.

Keywords: Immature reticulocyte fraction, fragmented red cells, iron deficiency anemia, schistocytes, cell counter indices

Manuscript Timeline: Received: July 20, 2025; Revised: August 25, 2025; Accepted: September 12, 2025; Published: October 14, 2025