ERYTHROBLASTS IN PERIPHERAL BLOOD AS AN OCCASIONAL FINDING IN MULTIPLE SCLEROSIS PATIENTS TREATED WITH NATALIZUMAB
(Abstract release date: 05/19/16)
EHA Library. Piris Villaespesa M. 06/09/16; 135018; PB2118
Mr. Miguel Piris Villaespesa
Contributions
Contributions
Abstract
Abstract: PB2118
Type: Publication Only
Background
Natalizumab (NTZ) is a recombinant humanized IgG4 monoclonal antibody directed against the α4 subunit of the α4 β1 (VLA-4) integrin of the lymphocytes. VLA-4 plays a critical role in erythropoiesis and is involved in mobilization of hematopoietic progenitors to peripheral blood. NTZ is used in autoimmune diseases such as multiple sclerosis and Crohn disease, and has been reported to induce CD34+ hematopoietic progenitor cells mobilization and erythroblasthaemia in multiple sclerosis patients.
Aims
To identify and report the presence of erythroblasts in peripheral blood in our cohort of NTZ-treated patients.
Methods
Peripheral blood smears (PBS) of patients treated with NTZ from September 2014 to February 2016 were retrospectively reviewed. PBS were prepared and dyed with May-Grünwald-Giemsa stain and examined by light microscopy by an experienced hematologist. The cohort included 53 patients treated on a monthly basis at different time points.
Results
A total of 82 PBS were reviewed in 53 patients. Fifteen of them (28.3%) showed 1 or more erythroblasts in peripheral blood. Mean time on treatment when PBS was reviewed was 20.5 months (1-74). Mean time on treatment when erythroblastaemia was documented was 14 months (1-71). Once erythroblastemia was described, mean follow up was 10.67 months. No hematologic malignancy was reported in these patients.
Conclusion
The pressence of erythroblasts in peripheral blood is usually a sign of alarm requiring further investigation since it is generally associated with severe underlying disorders. As previously data support, NTZ is a cause of erythroblastemia and should be taken in consideration in differential diagnosis in cases with erythroblasts in peripheral blood, at any time while on therapy. Knowledge of this frequent side effect is crucial for the correct interpretation of PBS in NTZ-treated patients and to avoid unnecessary diagnostic procedures.Investigation of the mechanisms underlying this effect is needed in order to estimate its repercussion and potential benefits.
Session topic: E-poster
Keyword(s): Erythroid progenitor, Peripheral blood progenitor cell, Side effects
Type: Publication Only
Background
Natalizumab (NTZ) is a recombinant humanized IgG4 monoclonal antibody directed against the α4 subunit of the α4 β1 (VLA-4) integrin of the lymphocytes. VLA-4 plays a critical role in erythropoiesis and is involved in mobilization of hematopoietic progenitors to peripheral blood. NTZ is used in autoimmune diseases such as multiple sclerosis and Crohn disease, and has been reported to induce CD34+ hematopoietic progenitor cells mobilization and erythroblasthaemia in multiple sclerosis patients.
Aims
To identify and report the presence of erythroblasts in peripheral blood in our cohort of NTZ-treated patients.
Methods
Peripheral blood smears (PBS) of patients treated with NTZ from September 2014 to February 2016 were retrospectively reviewed. PBS were prepared and dyed with May-Grünwald-Giemsa stain and examined by light microscopy by an experienced hematologist. The cohort included 53 patients treated on a monthly basis at different time points.
Results
A total of 82 PBS were reviewed in 53 patients. Fifteen of them (28.3%) showed 1 or more erythroblasts in peripheral blood. Mean time on treatment when PBS was reviewed was 20.5 months (1-74). Mean time on treatment when erythroblastaemia was documented was 14 months (1-71). Once erythroblastemia was described, mean follow up was 10.67 months. No hematologic malignancy was reported in these patients.
Conclusion
The pressence of erythroblasts in peripheral blood is usually a sign of alarm requiring further investigation since it is generally associated with severe underlying disorders. As previously data support, NTZ is a cause of erythroblastemia and should be taken in consideration in differential diagnosis in cases with erythroblasts in peripheral blood, at any time while on therapy. Knowledge of this frequent side effect is crucial for the correct interpretation of PBS in NTZ-treated patients and to avoid unnecessary diagnostic procedures.Investigation of the mechanisms underlying this effect is needed in order to estimate its repercussion and potential benefits.
Session topic: E-poster
Keyword(s): Erythroid progenitor, Peripheral blood progenitor cell, Side effects
Abstract: PB2118
Type: Publication Only
Background
Natalizumab (NTZ) is a recombinant humanized IgG4 monoclonal antibody directed against the α4 subunit of the α4 β1 (VLA-4) integrin of the lymphocytes. VLA-4 plays a critical role in erythropoiesis and is involved in mobilization of hematopoietic progenitors to peripheral blood. NTZ is used in autoimmune diseases such as multiple sclerosis and Crohn disease, and has been reported to induce CD34+ hematopoietic progenitor cells mobilization and erythroblasthaemia in multiple sclerosis patients.
Aims
To identify and report the presence of erythroblasts in peripheral blood in our cohort of NTZ-treated patients.
Methods
Peripheral blood smears (PBS) of patients treated with NTZ from September 2014 to February 2016 were retrospectively reviewed. PBS were prepared and dyed with May-Grünwald-Giemsa stain and examined by light microscopy by an experienced hematologist. The cohort included 53 patients treated on a monthly basis at different time points.
Results
A total of 82 PBS were reviewed in 53 patients. Fifteen of them (28.3%) showed 1 or more erythroblasts in peripheral blood. Mean time on treatment when PBS was reviewed was 20.5 months (1-74). Mean time on treatment when erythroblastaemia was documented was 14 months (1-71). Once erythroblastemia was described, mean follow up was 10.67 months. No hematologic malignancy was reported in these patients.
Conclusion
The pressence of erythroblasts in peripheral blood is usually a sign of alarm requiring further investigation since it is generally associated with severe underlying disorders. As previously data support, NTZ is a cause of erythroblastemia and should be taken in consideration in differential diagnosis in cases with erythroblasts in peripheral blood, at any time while on therapy. Knowledge of this frequent side effect is crucial for the correct interpretation of PBS in NTZ-treated patients and to avoid unnecessary diagnostic procedures.Investigation of the mechanisms underlying this effect is needed in order to estimate its repercussion and potential benefits.
Session topic: E-poster
Keyword(s): Erythroid progenitor, Peripheral blood progenitor cell, Side effects
Type: Publication Only
Background
Natalizumab (NTZ) is a recombinant humanized IgG4 monoclonal antibody directed against the α4 subunit of the α4 β1 (VLA-4) integrin of the lymphocytes. VLA-4 plays a critical role in erythropoiesis and is involved in mobilization of hematopoietic progenitors to peripheral blood. NTZ is used in autoimmune diseases such as multiple sclerosis and Crohn disease, and has been reported to induce CD34+ hematopoietic progenitor cells mobilization and erythroblasthaemia in multiple sclerosis patients.
Aims
To identify and report the presence of erythroblasts in peripheral blood in our cohort of NTZ-treated patients.
Methods
Peripheral blood smears (PBS) of patients treated with NTZ from September 2014 to February 2016 were retrospectively reviewed. PBS were prepared and dyed with May-Grünwald-Giemsa stain and examined by light microscopy by an experienced hematologist. The cohort included 53 patients treated on a monthly basis at different time points.
Results
A total of 82 PBS were reviewed in 53 patients. Fifteen of them (28.3%) showed 1 or more erythroblasts in peripheral blood. Mean time on treatment when PBS was reviewed was 20.5 months (1-74). Mean time on treatment when erythroblastaemia was documented was 14 months (1-71). Once erythroblastemia was described, mean follow up was 10.67 months. No hematologic malignancy was reported in these patients.
Conclusion
The pressence of erythroblasts in peripheral blood is usually a sign of alarm requiring further investigation since it is generally associated with severe underlying disorders. As previously data support, NTZ is a cause of erythroblastemia and should be taken in consideration in differential diagnosis in cases with erythroblasts in peripheral blood, at any time while on therapy. Knowledge of this frequent side effect is crucial for the correct interpretation of PBS in NTZ-treated patients and to avoid unnecessary diagnostic procedures.Investigation of the mechanisms underlying this effect is needed in order to estimate its repercussion and potential benefits.
Session topic: E-poster
Keyword(s): Erythroid progenitor, Peripheral blood progenitor cell, Side effects
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