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Introduction: Platelet transfusion is a standard treatment to prevent bleeding in patients with hematological malignancies. Although transfusions can improve platelet count, their impact on platelet function remains controversial. Methods: We conducted flow cytometry to assess platelet function before and after transfusion and performed subgroup analyses to examine differences based on blood type, corrected count increment (CCI), and platelet microparticles. Results: Overall, 50 patients who received prophylactic platelet transfusion were enrolled. CD42b expression increased, whereas CD41 expression decreased after transfusion. Apheresis platelets exhibited the lowest expression of PAC‐1 and P‐selectin when exposed to agonist stimulations. PAC‐1 expression increased under high adenosine diphosphate (ADP) stimulation, while P‐selectin expression increased under both high ADP and thrombin receptor‐activating peptide stimulation. In the subgroup analysis, patients with a CCI >4500 and those with the same blood types exhibited a more significant increase in PAC‐1 and P‐selectin expression under agonist stimulation. When comparing apheresis platelets collected on different days, only the percentage of platelet‐derived microparticles showed a significant increase. Conclusion: Prophylactic transfusion improved platelet function. Platelet function significantly improved in patients with a CCI >4500, those with the same blood types as that of apheresis platelets, or those with platelet‐derived microparticle levels <4.7%. No significant improvement in platelet function was noted after the transfusion of different blood types with acceptable compatibility or the transfusion of incompatible blood types. Our results suggest that transfusing platelets with the same blood type remains the optimal choice. [ABSTRACT FROM AUTHOR]

Immune thrombocytopenia (ITP) is known as an immune-mediated disease and often evolves to chronic type in adult. Corticosteroids only work in around 60% of patients. This study evaluated the roles of subgroup lymphocytes from peripheral blood in ITP adults with different treatment response. Between October 2009 and March 2017, 37 adults were newly diagnosed as ITP requiring treatment. The patients were separated into two groups: 23 patients with platelet count <50,000/μL with corticosteroid dependence or second-line treatment (Poor-responder Group), and 14 patients with platelet counts <50,000/μL with standard steroid treatment, which stopped within three months (Good-responder Group). Subgroup lymphocyte percentages of peripheral blood were determined through flow cytometry before treatment. Data analysis with Mann–Whitney test and receiver operating characteristic curves were performed using GraphPad Prism (Version 7). A p -value of <0.05 was considered significant. Lymphocyte percentage was significantly lower in Poor-responder Group than in Good-responder Group (p = 0.008). In subgroup lymphocytes, higher percentages of CD19+ B lymphocytes were found in Good-responder Group (p = 0.03). In Poor-responder Group, a higher CD2+ and CD56+ lymphocytes were observed (p = 0.02 and 0.03). By the cut-off value of percentage of CD56+ lymphocytes with 24.5% or CD2+ lymphocytes with 85.7%, the specificity showed 92.86%. This study found that newly diagnosed ITP patients with increased percentages of CD56+ or CD2+ lymphocytes in peripheral blood associated with a poorer response to steroid treatment. • Corticosteroids only work in around sixty percentages of ITP patients. • Higher CD56+ and CD2+ lymphocytes have a poorer response to steroid treatment. • High specificity prediction with CD56 > 24.5% and CD2 > 85.7% for steroid response in ITP [ABSTRACT FROM AUTHOR]

Abstract: Objective: Flow cytometry is becoming an important tool in the characterization of different hematological disorders. The aim of our study was to detect very rare populations in hematological malignancies using the comprehensive concept of immunophenotyping. Patients and Methods: Six patients, including three with acute myeloid leukemia, one with acute lymphoblastic leukemia, one with myelodysplastic syndrome, and one with B-cell lymphoma, were enrolled in this study. Serial bone marrow aspirates were analyzed by three-color multidimensional flow cytometry. Results: The core principles for the use of flow cytometric analysis are understanding deviations in abnormal antigen expression from normal cellular differentiating pathways and characterizing different patterns of antigenic aberrancy for each patient. Our results demonstrate that multidimensional flow cytometry can be used to: (1) monitor minimal residual disease after treatment; (2) aid in the differential diagnosis of cases, which are difficult to evaluate using conventional morphology; and (3) help in the staging of lymphoproliferative disorders. Conclusion: After selecting appropriate combinations of monoclonal antibodies, and applying advanced knowledge in immunophenotyping, flow cytometry is very sensitive and specific for the detection of rare populations in hematological disorders. [Copyright &y& Elsevier]