Excessive EDTA induces morphologic changes in bone marrow smears that mimic specific features of dysplasia

Lee, S.-H.; Weyden, Carrie van der; Mayson, Eleni; Desai, Sanjay

doi:10.1111/ijlh.12015

Cited by 9 publications

(5 citation statements)

References 11 publications

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“…Human BM samples were collected under regional anaesthesia from an entry site on the posterior superior iliac spine of patients in the prone position. Samples were stained with May-Grunwald-Giemsa or haematoxylin and eosin, according to routine methods (19). Stored BM samples were reassessed by a haematopathologist for study purposes.…”

Section: Human Bm Histologymentioning

confidence: 99%

Downregulation of hypoxia-inducible factor-1α contributes to impaired megakaryopoiesis in immune thrombocytopenia

Qi¹,

You²,

Pan³

et al. 2017

Thromb Haemost

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Impaired megakaryocyte maturation and exaggerated platelet destruction play a pivotal role in the pathogenesis of immune thrombocytopenia (ITP). Previous studies have shown that HIF-1α promotes the homing and engraftment of haematopoietic stem cells (HSCs), thereby stimulating HSC differentiation. However, whether HIF-1α plays a role in megakaryocytic maturation and platelet destruction in ITP remains elusive. Using enzyme-linked immunosorbent assays (ELISAs), we demonstrated that there were lower HIF-1α levels in the bone marrow (BM) of ITP patients than in that of healthy donors and patients with chemotherapy-related thrombocytopenia. Subjects with lower megakaryocyte (<100/slide) and platelet (<30 × 10/L) counts exhibited significantly decreased BM HIF-1α levels, compared to those with higher megakaryocyte (≥100/slide) and platelet (≥30 × 10/L) counts. To test whether HIF-1α regulates megakaryopoiesis and platelet production, megakaryocytes derived from mouse BM cells were treated with an HIF-1α activator (IOX-2; 50 µM) or inhibitor (PX-478; 50 µM). PX-478 significantly decreased HIF-1α expression, cell size, and the populations of CD41-positive and high-ploidy cells. Importantly, to evaluate the role of HIF-1α as a potential therapeutic target in ITP, mouse BM cells were incubated with plasma from ITP patients in the presence or absence of IOX-2. IOX-2 significantly attenuated the ITP plasma-induced decrease in cell size as well as the proportions of CD41-positive and high-ploidy cells. In addition, IOX-2 increased the number of megakaryocytes from mouse BM cells treated with ITP plasma. Our findings indicate that decreased HIF-1α may contribute to impaired megakaryopoiesis in ITP, and HIF-1α may provide a potential therapy for ITP patients.

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Section: Human Bm Histologymentioning

confidence: 99%

Downregulation of hypoxia-inducible factor-1α contributes to impaired megakaryopoiesis in immune thrombocytopenia

Qi¹,

You²,

Pan³

et al. 2017

Thromb Haemost

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“…These events in blood alter the size of the original 68 Ga‐particles when cell binding has occurred. If size is described in terms of diameter (μm or nm, rather than g/mol or daltons for molecular weight) and a spherical shape of the particle is assumed, then an opsonin is approximately 0.5 nm, an immunoglobulin approximately 10–28 nm, and a neutrophil is 12–15 μm . If one 68 Ga‐particle binds to one opsonin, and that opsonin binds to one immunoglobulin molecule, then the overall size of this complex has increased by <1% over the longest dimension.…”

Section: Discussionmentioning

confidence: 99%

⁶⁸Ga‐Ca‐phytate particles: A potential lung perfusion agent of synthetic origin prepared in a cold kit format

Hsieh

Ali

Praehofer

et al. 2016

Labelled Comp Radiopharmac

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The objective of this study was to investigate the radiosynthesis of Ga-Ca-phytate particles and then characterize the formulation for radiochemical purity, radioactive particle size distribution, and biodistribution in normal rats. This radiotracer was prepared using a commercial phytate cold kit after reconstitution with saline, Ga-chloride generator eluent, calcium chloride, and air, then heating at 100°C for 30 minutes to achieve 99% radiochemical purity of Ga-particles that were 21% 3-5 μm, 8% 5-15 μm, and 71%>15 μm in diameter. This optimal formulation was stable for 2 hours at room temperature. Intravenous administration of Ga-particles in rats resulted in an uptake of 93% in the lungs, 4% in the liver plus spleen, and 3% in the carcass after 20 minutes. Two-thirds of the carcass activity was radioactive blood, likely to be Ga-transferrin. The positron emission tomography image was superior than the Tc-MAA image because it displayed high lung uptake against a low background. Low uptake by the liver, spleen did not interfere with the diagnostic quality, and faint activity in the submandibular (salivary) glands was due to Ga-transferrin. The preclinical data so far indicate that Ga-Ca-phytate particles have good potential as a lung perfusion imaging agent.

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“…EDTA can induce cell clumping secondary to the presence of cell membrane-bound antibodies. Prolonged storage and high concentrations of EDTA can also cause hyperosmolar effect and bursting of cell membranes 1 2. Technical factors during the preparation of smears can also contribute to the distortion of cells.…”

Section: Descriptionmentioning

confidence: 99%

Distorted normal cells mimicking metastatic deposits in bone marrow aspirate

Thapa,

Balasubramanian,

Hajra

et al. 2024

BMJ Case Rep

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Excessive EDTA induces morphologic changes in bone marrow smears that mimic specific features of dysplasia

Abstract: Excessive EDTA induces morphologic changes in BM smears that mimic the specific dysplastic features of hypolobated neutrophils, small neutrophils, and micromegakaryocytes. BM aspirates should be collected into an appropriate concentration of EDTA to minimize such artifacts.

Cited by 9 publications

References 11 publications

Downregulation of hypoxia-inducible factor-1α contributes to impaired megakaryopoiesis in immune thrombocytopenia

Downregulation of hypoxia-inducible factor-1α contributes to impaired megakaryopoiesis in immune thrombocytopenia

⁶⁸Ga‐Ca‐phytate particles: A potential lung perfusion agent of synthetic origin prepared in a cold kit format

Distorted normal cells mimicking metastatic deposits in bone marrow aspirate

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Excessive EDTA induces morphologic changes in bone marrow smears that mimic specific features of dysplasia

Abstract: Excessive EDTA induces morphologic changes in BM smears that mimic the specific dysplastic features of hypolobated neutrophils, small neutrophils, and micromegakaryocytes. BM aspirates should be collected into an appropriate concentration of EDTA to minimize such artifacts.

Cited by 9 publications

References 11 publications

Downregulation of hypoxia-inducible factor-1α contributes to impaired megakaryopoiesis in immune thrombocytopenia

Downregulation of hypoxia-inducible factor-1α contributes to impaired megakaryopoiesis in immune thrombocytopenia

68Ga‐Ca‐phytate particles: A potential lung perfusion agent of synthetic origin prepared in a cold kit format

Distorted normal cells mimicking metastatic deposits in bone marrow aspirate

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Product

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⁶⁸Ga‐Ca‐phytate particles: A potential lung perfusion agent of synthetic origin prepared in a cold kit format