Background: High-grade B-cell lymphoma with rearrangements of MYC and BCL2 and/or BCL6 (BCL2/BCL6), also known as double-hit lymphoma (DHL) and/or triple-hit lymphoma (THL), is a new entity of B-cell lymphoma in the 2017 WHO Classification. We retrospectively investigated D/THL and their clinico-laboratory features among cases of large B-cell lymphoma involving the bone marrow (BM), including diffuse large B-cell lymphoma, Burkitt lymphoma, and B-cell lymphomas with medium to large lymphoid cells, by additional FISH analysis of BM aspirates. Methods: A total of 111 patients diagnosed with aggressive B-cell lymphomas or B-cell lymphoma involving the BM with medium to large-sized malignant lymphocytes were reviewed from January 2000 to January 2018. Patients with available BM aspirates were evaluated by immunophenotyping by flow cytometry, chromosome, and FISH analysis for MYC and/or BCL2/BCL6 rearrangements. Results: In total, 23/111 (20.7%) showed MYC rearrangement, and eight (7.2%) were reclassified as D/THL on BM after FISH analysis for MYC and BCL2/BCL6. The detection of CD5(-)/CD10(+) based on flow cytometry was strongly associated with D/THL. A complex karyotype with aberrations related to regions in MYC and BCL2/BCL6 was significantly associated with D/THL. When the MYC FISH results of 28 BM aspirates and formalin-fixed paraffin-embedded tissue specimens were compared, 14% were discrepant. Conclusions Immunophenotypic and cytogenetic characteristics facilitate the diagnosis of D/THL in the cases with BM-involving aggressive B-cell lymphomas.

No abstract available.
Hyperparathyroidism* ; Multiple Myeloma* ; Plasma Cells* ; Plasma*

Background: Transfusion reactions are major considerations in transfusions. Appropriate transfusion practices are essential to minimize the risk of transfusion reactions, such as using irradiated and leukoreduced blood components for indicated patients. This study examined the effectiveness of an electronic prescription system modification in promoting the appropriate use of these blood components. Methods: The blood component prescription data from seven years (Jan 2016∼Dec 2022) were analyzed retrospectively. The proportion of irradiated units was calculated for each half-year. Each transfusion was categorized by cancer diagnosis, blood component type, and visit type. Statistical comparisons were performed to assess the changes in the use of irradiated blood units and leukoreduced red cell components before and after the system modification. Results: This study analyzed 33,701 blood component prescriptions. The average number of irradiated units per prescription increased significantly from 0.21 to 0.77 after system modification. All patient groups, excluding transfusion in the operating room, showed a significant increase in irradiated unit use (P≤0.001). In addition, the percentage of leukoreduced red cell components increased significantly after the intervention (P<0.001). Conclusion Modification of the electronic prescription system was effective in promoting the appropriate use of irradiated blood components among clinicians. This intervention can reduce transfusion reactions and improve patient outcomes by ensuring the correct selection of blood components for the indicated patients.

Background: Transfusion reactions are major considerations in transfusions. Appropriate transfusion practices are essential to minimize the risk of transfusion reactions, such as using irradiated and leukoreduced blood components for indicated patients. This study examined the effectiveness of an electronic prescription system modification in promoting the appropriate use of these blood components. Methods: The blood component prescription data from seven years (Jan 2016∼Dec 2022) were analyzed retrospectively. The proportion of irradiated units was calculated for each half-year. Each transfusion was categorized by cancer diagnosis, blood component type, and visit type. Statistical comparisons were performed to assess the changes in the use of irradiated blood units and leukoreduced red cell components before and after the system modification. Results: This study analyzed 33,701 blood component prescriptions. The average number of irradiated units per prescription increased significantly from 0.21 to 0.77 after system modification. All patient groups, excluding transfusion in the operating room, showed a significant increase in irradiated unit use (P≤0.001). In addition, the percentage of leukoreduced red cell components increased significantly after the intervention (P<0.001). Conclusion Modification of the electronic prescription system was effective in promoting the appropriate use of irradiated blood components among clinicians. This intervention can reduce transfusion reactions and improve patient outcomes by ensuring the correct selection of blood components for the indicated patients.

Background: Transfusion reactions are major considerations in transfusions. Appropriate transfusion practices are essential to minimize the risk of transfusion reactions, such as using irradiated and leukoreduced blood components for indicated patients. This study examined the effectiveness of an electronic prescription system modification in promoting the appropriate use of these blood components. Methods: The blood component prescription data from seven years (Jan 2016∼Dec 2022) were analyzed retrospectively. The proportion of irradiated units was calculated for each half-year. Each transfusion was categorized by cancer diagnosis, blood component type, and visit type. Statistical comparisons were performed to assess the changes in the use of irradiated blood units and leukoreduced red cell components before and after the system modification. Results: This study analyzed 33,701 blood component prescriptions. The average number of irradiated units per prescription increased significantly from 0.21 to 0.77 after system modification. All patient groups, excluding transfusion in the operating room, showed a significant increase in irradiated unit use (P≤0.001). In addition, the percentage of leukoreduced red cell components increased significantly after the intervention (P<0.001). Conclusion Modification of the electronic prescription system was effective in promoting the appropriate use of irradiated blood components among clinicians. This intervention can reduce transfusion reactions and improve patient outcomes by ensuring the correct selection of blood components for the indicated patients.

Background: Transfusion reactions are major considerations in transfusions. Appropriate transfusion practices are essential to minimize the risk of transfusion reactions, such as using irradiated and leukoreduced blood components for indicated patients. This study examined the effectiveness of an electronic prescription system modification in promoting the appropriate use of these blood components. Methods: The blood component prescription data from seven years (Jan 2016∼Dec 2022) were analyzed retrospectively. The proportion of irradiated units was calculated for each half-year. Each transfusion was categorized by cancer diagnosis, blood component type, and visit type. Statistical comparisons were performed to assess the changes in the use of irradiated blood units and leukoreduced red cell components before and after the system modification. Results: This study analyzed 33,701 blood component prescriptions. The average number of irradiated units per prescription increased significantly from 0.21 to 0.77 after system modification. All patient groups, excluding transfusion in the operating room, showed a significant increase in irradiated unit use (P≤0.001). In addition, the percentage of leukoreduced red cell components increased significantly after the intervention (P<0.001). Conclusion Modification of the electronic prescription system was effective in promoting the appropriate use of irradiated blood components among clinicians. This intervention can reduce transfusion reactions and improve patient outcomes by ensuring the correct selection of blood components for the indicated patients.

Next-generation sequencing (NGS) is currently used in the clinical setting for targeted therapies and diagnosis of hematologic malignancies. Accurate detection of somatic variants is challenging because of tumor purity, heterogeneity, and the complexity of genetic alterations, with various issues ranging from high detection design to test implementation. This article presents guidelines developed through consensus among a panel of experts from the Korean Society for Genetic Diagnostics. They are based on experiences with the validation processes of NGS-based somatic panels for hematologic malignancies, with reference to previous international recommendations. These guidelines describe basic parameters with emphasis on the design of a validation protocol for NGS-based somatic panels to be used in practice. In addition, they suggest thresholds of key metrics, including minimum coverage, mean coverage with uniformity index, and minimum variant allele frequency, for the initial diagnosis of hematologic malignancies.
Clothing ; Consensus ; Diagnosis ; Gene Frequency ; Hematologic Neoplasms ; Population Characteristics

Background: Intraoperative measurement of intact parathyroid hormone (iPTH) levels is crucial for confirming complete removal of hyperfunctioning parathyroid glands during parathyroidectomy and for detecting parathyroid gland damage during thyroidectomy. The use of plasma samples can shorten the turnaround time (TAT) for iPTH. The present study explored the effectiveness of using plasma samples for iPTH quantitation by comparison with the corresponding serum samples. We also evaluated the analytical performance of iPTH. Methods: The TAT of plasma and serum samples analyzed in March 2019 was compared. In addition, comparative evaluation of the iPTH levels in 100 paired plasma and serum samples were performed. Analytical performances including within-run and within-laboratory precision, and linearity were evaluated in plasma samples using the ADVIA Centaur iPTH assay (Siemens Healthineers, Germany). The reference range was verified with plasma samples collected from 20 healthy adults. Results: Plasma iPTH tests showed shorter TAT values (P<0.001) and higher iPTH levels (P<0.001) than serum. Correlation analysis between plasma and serum iPTH levels showed a strong positive correlation (r=0.925). The within-run and within-laboratory precision values were within the manufacturer's recommendation. iPTH showed linearity from 5.1 to 1,670.0 pg/mL (R2=0.999). The plasma iPTH levels from 20 healthy adults were within the reference range, thus validating our method. Conclusions The plasma iPTH levels were higher than the serum levels, with a strong positive correlation. The TAT of plasma samples was considerably shorter than that of serum. iPTH quantitation from plasma samples is preferable when rapid results are required.

We recently encountered a case of hereditary spherocytosis coexisting with Gilbert's syndrome. Patient was initially diagnosed with Gilbert's syndrome and observed, but other findings suggestive of concurrent hemolysis, such as splenomegaly and gallstones were noted during the follow-up period. Therefore, further evaluations, including a peripheral blood smear, osmotic fragility test, autohemolysis test, and red blood cell membrane protein test were performed, and coexisting hereditary spherocytosis was diagnosed. Genotyping of the conjugation enzyme uridine diphosphate-glucuronosyltransferase was used to confirm Gilbert's syndrome. Because of the high prevalence rates and similar symptoms of these 2 diseases, hereditary spherocytosis can be masked in patients with Gilbert's syndrome. In review of a case and other article, the possibility of the coexistence of these 2 diseases should be considered, especially in patients with unconjugated hyperbilirubinemia who also have splenomegaly and gallstones.
Adult ; Erythrocytes/physiology ; Gallstones/etiology ; Genotype ; Gilbert Disease/complications/*diagnosis/genetics ; Glucuronosyltransferase/genetics ; Hemolysis ; Humans ; Hyperbilirubinemia/etiology ; Male ; Polymorphism, Single Nucleotide ; Spherocytosis, Hereditary/complications/*diagnosis/genetics ; Splenomegaly/etiology

No abstract available.
Adolescent ; Chromosomes, Human, Pair 11 ; Chromosomes, Human, Pair 4 ; Gene Rearrangement ; Histone-Lysine N-Methyltransferase/*genetics ; Humans ; Male ; Myeloid-Lymphoid Leukemia Protein/*genetics ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/*genetics