Browsing by Author "Kottahachchi, D. U."

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    An attempt to establish a cutoff value for peripheral blood hematopoietic progenitor cell count to predict the viable CD34 count in multiple myeloma patients undergoing autologous peripheral blood stem cell transplantation
    (Faculty of Science, University of Kelaniya Sri Lanka, 2023) Hewapathirana, T. D.; Perera, T. C.; Tudugala, R.; Suresh, S.; Kottahachchi, D. U.
    Multiple myeloma (MM) is a common hematological malignancy characterized by the proliferation of abnormal plasma cells in the bone marrow, leading to immune dysfunction and bone damage. Autologous peripheral blood stem cell transplantation (aPBSCT) is a pivotal treatment for MM, extending survival rates. The success of aPBSCT relies on the composition of the mobilized peripheral blood cells, particularly the hematopoietic progenitor cells in peripheral blood (HPC_PB). In aPBSCT, viable CD34 cell count (V_CD34) which is enumerated by the flow cytometer (FC) is used to calculate the minimum stem cell yield required for a successful transplantation. Therefore, detecting the optimal HPC_PB count in relation to V_CD34 is crucial for enhancing the effectiveness of aPBSCT and also for the proper management of MM patients. To establish a cutoff value for HPC_PB using an automated hematology analyzer (AHA) as a predictor for V_CD34 in the peripheral blood of MM patients undergoing aPBSCT. This initiative aims to replace or supplement the flow cytometry (FC) facility with AHA, as AHA provides a cost-effective, user-friendly, faster, and more accessible method for assessing cellular profiles during PBSCT. This transition addresses the limitations of the FC technique, which encompass high expenses, complexity, the demand for specialized personnel, substantial sample sizes, timeintensive procedures, and restricted availability. MM patients representing males (n=23) and females (n=22) at the age of 40-65 years, admitted to the Bone Marrow Transplant Unit (BMTU) in Apeksha Hospital, Maharagama, Sri Lanka were selected for the study (n=45). The ninth day from the mobilization of the bone marrow cells was considered as the day of harvesting. The Sysmax-1000 AHA was used to enumerate HPC_PB and, V_CD34_PB was enumerated by flow cytometer (FC) BDACS Lytic TM using already collected samples for routine testing. First, the data were separately tested for normalization, followed by correlation bivariate analysis and, Receiver Operating Characteristic (ROC) curve analysis to establish relationships and cutoff values for HPC_PB respectively. In the ROC analysis, the two groups of V_CD34_PB were defined as; Group 1 =90 cells/µL.In the statistical analysis, the HPC_PB_AHA showed normal distribution while V_CD34_PB_FC did not follow it. HPC_PB possessed a significant (p=0.000) strong positive Spearman bivariate correlation (r = 0.930) with the V_CD34_PB. The cutoff value obtained for the HPC_PB is 89 cells/µL, at V_CD34_PB of 90 cells/µL with sensitivity (97.1%), specificity (99.9%), and area under the curve of 0.978 with statistically significant (p=0.022
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    Studying the associations between myeloperoxidase levels in neutrophils and mean cell haemoglobin concentration in varying haemoglobin concentrations of patients attending haematology clinic, Colombo North teaching hospital,
    (Faculty of Science, University of Kelaniya Sri Lanka, 2023) Peiris, M. U. A.; Wickramasinghe, P. W. W. M. S. D.; Tudugala, R.; Costa, Y.; Kottahachchi, D. U.
    Myeloperoxidase (MPO), a heme-containing peroxidase mostly found in the lysosomal azurophilic granules in neutrophils. Since the MPO directly associates with the neutrophil phagocytic system, diseases that associate with bacterial infection or inflammation may directly link with its levels in neutrophils. Since serum iron levels regulate the levels of MPO in neutrophils, it may directly or indirectly be correlated with the plasma hemoglobin (HB) and intrared cell HB concentration;MCHC, especially in anemic conditions. In such a situation, finding associations between MCHC, HB with MPO would facilitate MPO to be used as a new diagnostic tool for anemia. Present study was focused on understanding the correlations between MPO in peripheral blood neutrophils and Mean Cell Hemoglobin Concentration (MCHC) in varying hemoglobin concentrations. Total of 180 patients with varying hemoglobin concentrations who attended Haematology Clinic at Colombo North Teaching Hospital, Ragama, Sri Lanka were selected and peripheral blood smears of them were stained and quantified according to Mahjoub et al. (2015) with a few modifications. Mean Cell Hemoglobin Concentration (MCHC) was measured using a Hematology analyzer (Mindray BC-6800). Results were further categorized according to the subgroups of HB; Group1: 8.0 g/dL= 12.0 g/dL. The statistical analysis was performed using IBM SPSS_V26. First, the data was tested for normalization, followed by the Mann-Whitney Test. The total study population was 180 that included females (70%) and males (30%). The mean values of HB, Total MPO score, MCHC are 9.77 ±3.21, 50.85±30.29, 32.98±3.59 g/dL respectively. None of the parameters followed a normal distribution. In the Spearman’s correlation bivariate analysis, the MCHC showed significant weak negative correlation (p=0.025; r=.167) with the MPO. However, there was no reliable correlation between MPO and HB. MPO did not show any significant differences between HB subgroups. However, MPO and MCHC separately showed a significant (p<0.01) increase in their mean difference among all the HB subgroups. Our results revealed that the MCHC possesses a moderate to weak correlation with MPO in neutrophils. Further, the MPO did not provide reliable correlations with HB in the whole group or in subgroups. However, MCHC values tend to decrease with the increasing levels of MPO in the mild anemic group (10.0 g/dL=