Leucocytosis Predicts Survival in Metastatic Non Small Cell Lung Carcinoma Patients—A Retrospective Review of a Single Institution Data

Background: Tumor-related leukocytosis is a paraneoplastic syndrome that is encountered occasionally in the clinical course of patients with lung carcinoma. The aim of this study is to evaluate the prognostic significance of leucocytosis in patients with metastatic non small cell lung carcinoma. Methods: We retrospectively reviewed 205 cases of metastatic non small cell lung carcinoma diagnosed between January 2007 and December 2012 at the department of medical oncology, Hassan II University Hospital of Fez, Morocco. Clinical and laboratory data were collected including white blood cells at baseline. Leucocytosis was studied in relation to overall survival and progression free survival. Results: The frequency of leucocytosis was of 57.5%. Patients with leucocytosis had shorter overall survival (OS, p = 0.015) and disease-free survival (DFS, p 0.0001) than those without leucocytosis. In multivariable analysis, patients with leucocytosis had a significantly greater risk of death and recurrence than those without leucocytosis. Conclusion: Leucocytosis was valuable for predicting the prognosis of patients with metastatic non small cell lung carcinoma.

Initial leucocytosis and other significant indicators of poor outcome in severe traumatic brain injury: an observational study

Background:Globally,severe traumatic brain injury(TBI)has been the principal cause of mortality among individuals aged 45 and below.The incidence of road traffic accidents in Malaysia is one of the highest in the world with thousands of victims sustaining severe disabilities.The aim of this study is to determine the association between leucocytosis and extended Glasgow Outcome Scale(GOSE)scores as well the relationship of other factors and the outcomes of severe TBI.Methods:This was a retrospective observational study.A total of 44 consecutive patients who were admitted to Sarawak General Hospital from January 1,2018,to September 30,2018,with severe TBI were included.Data were collected from discharge summaries and hospital medical records.Chi-square and t test were used.SPSS was employed.Results:Of a total of 44 patients with severe TBI,18 patients(41%)died during the same admission.The mean age of patients was 37.1 years with 93.2%of affected patients being male.56.9%of patients presented with a Glasgow Coma Scale(GCS)of 6 and less.A large percentage(86.3%)were discharged with a GOSE of less than 7.Older age and low admission GCS(6 and less)were significantly associated with poor GOSE scores on discharge and after 6 months(p<0.05)on multivariate analysis.Leucocytosis on admission was also associated with poor outcomes where patients with higher total white counts on presentation attaining lower GOSE scores(p<0.05).Conclusion:We concluded that leucocytosis was significantly associated with poor outcomes in severe TBI patients in addition to other factors such as advanced age and poor GCS on arrival.

Hematological indices as predictors of mortality in dengue shock syndrome: A retrospective study

Objective:To explore predictive hematological parameters on admission which are associated with mortality in NS1 positive dengue shock syndrome patients.Methods:Demographic characteristics,hematological parameters,and the outcome of NS1 positive dengue shock syndrome patients without any comorbidity and coexisting infections were collected from the Intensive Care Unit and the results were compared between the survivor and non-survivor groups.Results:The mean age was(30.77±11.48)years and 56(56.6%)patients were males.Out of the total 99 patients,72(72.27%)patients were successfully discharged and 27(27.27%)patients eventually succumbed to death.The most common hematological finding was thrombocytopenia(95.95%),followed by anemia(52.52%)and decreased mean platelet volume(37.37%).After controlling other variables,logistic regression analysis showed that absolute neutrophil count and mean platelet volume were associated with mortality.Conclusions:Total leucocyte count,absolute neutrophil count,and total platelet count are significantly higher,and mean platelet volume is significantly lower in the non-survivor group as compared to the survivor group.Absolute neutrophil count and mean platelet volume are predictors associated with mortality.

Acute and Chronic Toxicity of Thioacteamide and Alterations in Blood Cell Indices in Rats

Background: Thioacetamide (TAA) has been used extensively in the development of suitable animal models of acute and chronic liver injury employing various doses, times and routes of its administration, particularly in drinking water due to its resemblance with human liver fibrosis and cirrhosis. The aim of this study was to investigate and compare hematological alteration during the acute and chronic liver inflammation. Methods: Acute Liver inflammation was induced in Wistar rats via intraperitoneal injection of thioacetamide and the animals were sacrificed 12 h after the TAA administration. Induction of chronic liver inflammation was performed by continuous administration of TAA in the drinking water (200 mg/L) during 18 weeks of experiment. After that all animals were sacrificed and Blood samples were collected for further analysis. Results: Single intra peritoneal injection of TAA (300 mg/kg B.W.) induced an acute condition with hematological changes including leukocytosis with marked neutrophilia (P = 0.0429), lymphopenia, thrombocytosis as well as increased hemoglobin concentration (P 0.05) and decline of erythrocytic count (P = 0.0009). Eighteen weeks of uninterrupted supply of TAA (200 mg/L) in drinking water lead to chronic inflammation and the hematological alterations were leucopenia (P = 0.0197) accompanied with neutropenia and thrombocytopenia. Increase in RBCs (P = 0.0073) and Hb contents was also observed with a decline of red cell indices. Conclusion: Taken together these findings we can conclude that the animals respond differently under acute and chronic inflammatory condition with TAA administration. Leukocytosis with marked neutrophilia, thrombocytosis as well as increased hemoglobin concentration and decline of erythrocytic count were observed in acute while leucopenia accompanied with neutropenia and thrombocytopenia and increase in RBCs, Hb and Hct was also observed with a decline of other red cell indices during chronic phase.