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Leuk Lymphoma. 2017 Oct;58(10):2387-2394. doi: 10.1080/10428194.2017.1296142. Epub 2017 Mar 2.

Usefulness of the delta neutrophil index as an ancillary test in the emergency department for the early diagnosis of suspected acute promyelocytic leukemia.

Author information

1
a Department of Emergency Medicine , Yonsei University College of Medicine , Seoul , Republic of Korea.
2
b Division of Hematology, Department of Internal Medicine , Yonsei University College of Medicine , Seoul , Republic of Korea.
3
c Department of Laboratory Medicine , Jincheon Sungmo Hospital , Jincheon , Republic of Korea.
4
d Research Institute of Bacterial Resistance , Yonsei University College of Medicine , Seoul , Republic of Korea.
5
e Department of Research Affairs, Biostatistics Collaboration Unit , Yonsei University College of Medicine , Seoul , Republic of Korea.
6
f Department of Health Insurance Research , National Health Insurance Service Ilsan Hospital , Goyang , Republic of Korea.

Abstract

The delta neutrophil index (DNI) reflects the fraction of circulating immature granulocytes. We evaluated the usefulness of DNI values in patients with acute myeloid leukemia (AML) to distinguish the acute stage of acute promyelocytic leukemia (APL). We analyzed patients retrospectively who were first diagnosed with AML upon admission to the emergency department (ED). Thirty of the 134 patients (22.4%) were diagnosed with APL on ED admission. The univariate analysis and multivariate logistic regression models revealed that DNI values differed significantly between APL and non-APL AML patients on days 0, 1 and 2. Increased predictability for APL was associated with a DNI greater than 24.2% on ED admission, greater than 23.6% on day 1 and greater than 44% on day 2 in patients with AML. DNI values of patients with AML could discriminate the acute stage of APL from AML for immediate initiation of all-trans retinoic acid therapy.

KEYWORDS:

Acute myeloid leukemia; acute promyelocytic leukemia; delta neutrophil index; diagnosis; disseminated intravascular coagulopathy; predictive value

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