Peripheral White Blood Cell Count Research Articles

To explore the rapid evaluation of the early pathogen of severe Chlamydophila psittaci pneumonia by bedside diagnostic bronchoscopy, so as to start effective anti-infection treatment before the results of macrogenome next generation sequencing (mNGS) test. The clinical data of three patients with severe Chlamydophila psittaci pneumonia who were successfully treated in the First Affiliated Hospital of Xinjiang Medical University, the First People's Hospital of Aksu District, and the First Division Hospital of Xinjiang Production and Construction Corps from October 2020 to June 2021 were retrospectively analyzed, including the rapid assessment of early pathogens by bedside diagnostic bronchoscopy and the use of antibiotics to start anti-infection treatment. These patients were successfully treated. The three patients were male, aged 63, 45 and 58 years old, respectively. Before the onset of the penumonia, they had a clear medical history of bird exposure. The clinical manifestations mainly included fever, dry cough, shortness of breath and dyspnea. One case had abdominal pain and lethargy. The results of laboratory examination indicated that the peripheral blood white blood cell count (WBC) of two patients were high [(10.2-11.9)×109/L], the percentage of neutrophils increased (85.2%-94.6%) and the percentage of lymphocytes decreased (3.2%-7.7%) in all 3 patients after admission to hospital and entering into intensive care unit (ICU). The procalcitonin (PCT) of 3 patients increased after admission, and still increased when entering ICU (0.3-4.8 ng/L), so did C-reactive protein (CRP, 58.0-162.0 mg/L) and erythrocyte sedimentation rate (ESR, 36.0-90.0 mm/1 h). After admission, serum alanine transaminase (ALT) increased in 2 cases (136.7 U/L, 220.5 U/L), so did aspartate transaminase (AST) in 2 cases (249.6 U/L, 164.2 U/L). ALT (162.2-267.9 U/L) and AST (189.8-223.2 U/L) increased in 3 patients when they entered ICU. The level of serum creatinine (SCr) of 3 patients were normal after admission and entering ICU. The chest computed tomography (CT) findings of 3 patients were acute interstitial pneumonia, bronchopneumonia and lung consolidation, of which 2 cases were accompanied by a small amount of pleural effusion, and 1 case was accompanied by more regular small air sacs. Multiple lung lobes were involved, but mainly one lung lobe. The oxygenation index (PaO2/FiO2) of the 3 patients admitting to ICU were 100.0, 57.5 and 105.4 mmHg (1 mmHg ≈ 0.133 kPa), respectively, which met with the diagnostic criteria of moderate and severe acute respiratory distress syndrome (ARDS). All three patients received endotracheal intubation and mechanical ventilation. Under the bedside bronchoscope, the bronchial mucosa of 3 patients were obviously congested and edematous, without purulent secretion, and there was 1 case with mucosal hemorrhage. Three patients underwent bedside diagnostic bronchoscopy, and the evaluation result of the pathogen was that it might be atypical pathogen infection, so they were given moxifloxacin, cisromet and doxycycline intravenously, respectively, and combined with carbapenem antibiotics intravenously. After 3 days, the detection results of mNGS in bronchoalveolar lavage fluid (BALF) showed that only Chlamydia psittaci was infected. At this time, the condition was significantly improved, and PaO2/FiO2 was significantly increased. Therefore, the antibiotic treatment scheme remained unchanged, and mNGS only served to verify the initial diagnosis. Two patients were extubated on the 7th and 12th day of admission to the ICU, respectively, while one patient was extubated on the 16th day of admission to the ICU due to nosocomial infection. All 3 patients were transferred to the respiratory ward after the condition was stable. The bedside diagnostic bronchoscopy based on clinical characteristics is conducive to not only the rapid assessment of the early pathogens of severe Chlamydia psittaci pneumonia, but also effective anti-infection treatment before the returning of mNGS test results, which can make up for the lag and uncertainty of the mNGS test results.

Introduction Chronic neutropenia (CN) encompasses different blood disorders all characterized by low levels of neutrophils (absolute neutrophil count [ANC] <1500/µl for >3 months) and is associated with increased risk of recurrent and/or severe infections [Donadieu J. Exp RevHematol. 2021]. The most common chronic neutropenic disorders (CNDs) are chronic idiopathic neutropenia (CIN), which is not attributable to drugs or a specific infection or inflammatory, malignant, or genetic cause [Dale DC. Curr Opin Hematol. 2017]; cyclic neutropenia (CYN), characterized by recurrent episodes of neutropenia approximately every 21 days [Donadieu J. Exp Rev Hematol. 2021]; and severe congenital neutropenia (SCN), caused by genetic variants [Skokowa J. Nat Rev Dis Primers. 2018]. The current management strategy for CN is long-term treatment with injectable granulocyte colony-stimulating factor (G-CSF). Although typically effective in the short-term, G-CSF comes with many adverse effects such as bone pain and, especially for patients with SCN, an increased risk for hematologic malignancy [Newburger PE. Semin Hematol. 2013; Dale DC. Blood Advances. 2022]. Mavorixafor is an investigational oral antagonist of CXCR4 in clinical development for treatment of patients with multiple CNDs, including Warts, Hypogammaglobulinemia, Infections, and Myelokathexis (WHIM) syndrome [Dale DC. Blood. 2020]. Herein we report results of phase 1b, open-label, multicenter trial (NCT04154488) evaluating the safety, tolerability, and serving as a proof of concept for efficacy, of mavorixafor alone or with concurrent G-CSF use across several CNDs. Methods Patients aged ≥12 years with diagnosis of CIN, congenital neutropenia, or CYN ≥6 months prior and ANC <1000/µL at screening visits were included. Patients on G-CSF with ANC >1000/µL were also included. All patients with congenital neutropenia without documented genetic variants underwent genetic screening via a 642-gene comprehensive immune and cytopenia panel. Patients received ≥1 dose of mavorixafor (>50 kg, 400 mg; ≤50 kg, 200 mg), regardless of current treatment with or without G-CSF. Patients were monitored for hematologic parameters such as total white blood cell (WBC) and subset counts, including ANC, absolute lymphocyte count (ALC), and absolute monocyte count (AMC), over the course of 6 to 8 hours 1 day before receiving mavorixafor (day -1) and on the first day of mavorixafor treatment (day 1) and were followed for 30 days for safety and tolerability. Fold change in total peripheral WBC count, ANC, ALC, and AMC from day -1 levels was assessed. Results As of June 2022, 15 patients (CIN, n=11; congenital neutropenia, n=3; CYN, n=1) were enrolled and dosed. The mean (SD) age in years was 39.7 (17.2); 40% were male, and 60% were on G-CSF. All patients received ≥1 dose of mavorixafor once daily. The mean (SD) maximum fold change in ANC from day -1 to day 1 across all included patients was 4.72 (2.74) at peak over the course of 6 to 8 hours after dose 1. Table 1 shows fold change in ANC for individual participants, and Figure 1, by type of neutropenia. The mean (SD) maximum fold change in other hematologic parameters, including total WBC count, ALC, and AMC, from day -1 to day 1 was 3.14 (0.65), 3.05 (0.62), and 2.64 (0.80), respectively. For the subgroup of patients on G-CSF at day -1, the mean (SD) maximum fold change in total WBC count, ANC, ALC, and AMC from day -1 to day 1 was 2.87 (0.58), 3.67 (1.29), 3.07 (0.73), and 2.44 (0.59), respectively. For patients not on G-CSF, the mean (SD) maximum fold change in total WBC count, ANC, ALC, and AMC from day -1 to day 1 was 3.54 (0.52), 6.28 (3.45), 3.01 (0.47), and 2.95 (0.95), respectively. Treatment-emergent adverse events (AEs; n=11) were all grade 1; no serious AEs were reported. Conclusions Meaningful increases in ANC and all other hematologic parameters evaluated were observed on day 1 in all patients treated with ≥1 dose of mavorixafor. Responses were observed regardless of concurrent G-CSF use or type of CN. Mavorixafor treatment was well tolerated overall, with only mild AEs reported. This study supports the potential therapeutic use of mavorixafor in the treatment of CNDs beyond WHIM syndrome and underscores the possibility for mavorixafor to become the first oral treatment for CN. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Peripheral White Blood Cell Count Research Articles

Articles published on Peripheral White Blood Cell Count

Nonlinear low dose hematotoxicity of benzene; a pooled analyses of two studies among Chinese exposed workers

[Risk Factors and Prognosis of Cardiovascular Damage in Hypereosinophilia].

Etiological analysis of patients with sudden sensorineural hearing loss: a prospective case–control study

Repeated small-volume exchange transfusion for hyperleukocytosis in pediatric acute leukemia: A retrospective analysis.

Retrospective comparison of two different cell separators for autologous peripheral blood stem cell collection: Single center experience

Urban particulate air pollution linked to dyslipidemia by modification innate immune cells

Quantitative IVIM parameters evaluating perfusion changes in brain parenchyma in patients newly diagnosed with acute leukemia: Compared with healthy participants.

Neutrophil lymphocyte ratio (NLR) and systemic immune inflammatory index (SII) for the differential diagnosis of CT-negative mild acute ischemic stroke and transient ischemic attack

Application and curative effect of laparoscopic purse-string sutures in the treatment of adult acute complicated appendicitis

Fecal microbiota transplant for treatment of diarrhea in adult hospitalized horses-111 cases (2013-2018).

Serum 25-hydroxy vitamin-D levels in head and neck cancer chemoradiation therapy: Potential in cancer therapeutics.

Rapid evaluation of the early pathogen of severe Chlamydophila psittaci pneumonia by diagnostic bronchoscopy

Evaluation of differential white blood cell count and cheek pouch epithelium in 7,12-dimethylbenza[a]anthracene hamster carcinogenesis model, managed with three phytochemicals

[The peripheral blood inflammatory markers in Ménière's disease patients with and without migraine].

Effects of Low-Dose Colchicine on Serum High-Sensitivity C-Reactive Protein Level in Coronary Artery Disease Patients with Type 2 Diabetes Mellitus and Enhanced Inflammatory Response Protocol for a Randomized, Double-Blind, Placebo-Controlled, Phase 2, Dose-Finding Study

Mavorixafor for Patients with Chronic Neutropenic Disorders: Results from a Phase 1b, Open-Label, Multicenter Study

[Management and short-term outcomes of neonates born to mothers infected with SARS-CoV-2 Omicron variant].

[Clinical features of 19 children infected with the Omicron variant of severe acute respiratory syndrome coronavirus 2 in Hangzhou, China].

Increased CD8+ T cells in patients with Henoch–Schonlein purpura nephritis exhibit suppressive immune activity

Comparison of Suspected and Confirmed Internal External Ventricular Drain-Related Infections: A Prospective Multicenter United Kingdom Observational Study.

Lead the way for us