Monocytosis is associated with hemolysis in sickle cell disease

Naritsara Wongtong, Susan Jones, Yu Deng, Jianwen Cai, Kenneth Ataga

Research output: Contribution to journalArticle

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Abstract

Background: The clinical relevance of monocytosis in sickle cell disease (SCD) is uncertain. The purpose of this study was to explore the association of monocyte counts with clinical and laboratory variables in SCD. Design and methods: This cross-sectional study was performed using a cohort of adult patients with SCD and control subjects without SCD. Complete blood counts, markers of hemolysis, coagulation activation, endothelial injury, and other laboratory studies were obtained in patients with SCD. Clinical complications were ascertained at the time of evaluation and tricuspid regurgitant jet velocity was determined by Doppler echocardiography. Results: One hundred and fifty-seven patients with SCD and 24 healthy, African-American, control subjects were evaluated. The absolute monocyte count was increased in SCD patients compared with healthy controls (0.6 × 10 9 /l vs. 0.4 × 10 9 /l, P = 0.0025), with higher counts in HbSS/HbSβ 0 thalassemia compared with HbSC/HbSβ+ thalassemia. In univariate analyses, absolute monocyte count was correlated with reticulocyte count, absolute neutrophil count, indirect bilirubin, lactate dehydrogenase, and inversely correlated with hemoglobin in SCD patients. Furthermore, monocyte count was correlated with soluble vascular cell adhesion molecule-1 (VCAM-1) in HbSS/HbSβ 0 thalassemia patients. No significant associations were observed between absolute monocyte count and evaluated clinical complications. In multivariable analyses, reticulocyte count and absolute neutrophil count were significantly associated with absolute monocyte count. Conclusions: Monocytosis is associated with hemolysis and inflammation in SCD. We suggest that hemolysis and the resultant erythropoietic response contribute to monocyte activation.

Original languageEnglish (US)
Pages (from-to)593-597
Number of pages5
JournalHematology
Volume20
Issue number10
DOIs
StatePublished - Dec 1 2015

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Sickle Cell Anemia
Hemolysis
Monocytes
Thalassemia
Reticulocyte Count
Neutrophils
Blood Cell Count
Vascular Cell Adhesion Molecule-1
Doppler Echocardiography
L-Lactate Dehydrogenase
Bilirubin
African Americans
Hemoglobins
Cross-Sectional Studies
Inflammation
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Hematology

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Monocytosis is associated with hemolysis in sickle cell disease. / Wongtong, Naritsara; Jones, Susan; Deng, Yu; Cai, Jianwen; Ataga, Kenneth.

In: Hematology, Vol. 20, No. 10, 01.12.2015, p. 593-597.

Research output: Contribution to journalArticle

Wongtong, Naritsara ; Jones, Susan ; Deng, Yu ; Cai, Jianwen ; Ataga, Kenneth. / Monocytosis is associated with hemolysis in sickle cell disease. In: Hematology. 2015 ; Vol. 20, No. 10. pp. 593-597.
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abstract = "Background: The clinical relevance of monocytosis in sickle cell disease (SCD) is uncertain. The purpose of this study was to explore the association of monocyte counts with clinical and laboratory variables in SCD. Design and methods: This cross-sectional study was performed using a cohort of adult patients with SCD and control subjects without SCD. Complete blood counts, markers of hemolysis, coagulation activation, endothelial injury, and other laboratory studies were obtained in patients with SCD. Clinical complications were ascertained at the time of evaluation and tricuspid regurgitant jet velocity was determined by Doppler echocardiography. Results: One hundred and fifty-seven patients with SCD and 24 healthy, African-American, control subjects were evaluated. The absolute monocyte count was increased in SCD patients compared with healthy controls (0.6 × 10 9 /l vs. 0.4 × 10 9 /l, P = 0.0025), with higher counts in HbSS/HbSβ 0 thalassemia compared with HbSC/HbSβ+ thalassemia. In univariate analyses, absolute monocyte count was correlated with reticulocyte count, absolute neutrophil count, indirect bilirubin, lactate dehydrogenase, and inversely correlated with hemoglobin in SCD patients. Furthermore, monocyte count was correlated with soluble vascular cell adhesion molecule-1 (VCAM-1) in HbSS/HbSβ 0 thalassemia patients. No significant associations were observed between absolute monocyte count and evaluated clinical complications. In multivariable analyses, reticulocyte count and absolute neutrophil count were significantly associated with absolute monocyte count. Conclusions: Monocytosis is associated with hemolysis and inflammation in SCD. We suggest that hemolysis and the resultant erythropoietic response contribute to monocyte activation.",
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AB - Background: The clinical relevance of monocytosis in sickle cell disease (SCD) is uncertain. The purpose of this study was to explore the association of monocyte counts with clinical and laboratory variables in SCD. Design and methods: This cross-sectional study was performed using a cohort of adult patients with SCD and control subjects without SCD. Complete blood counts, markers of hemolysis, coagulation activation, endothelial injury, and other laboratory studies were obtained in patients with SCD. Clinical complications were ascertained at the time of evaluation and tricuspid regurgitant jet velocity was determined by Doppler echocardiography. Results: One hundred and fifty-seven patients with SCD and 24 healthy, African-American, control subjects were evaluated. The absolute monocyte count was increased in SCD patients compared with healthy controls (0.6 × 10 9 /l vs. 0.4 × 10 9 /l, P = 0.0025), with higher counts in HbSS/HbSβ 0 thalassemia compared with HbSC/HbSβ+ thalassemia. In univariate analyses, absolute monocyte count was correlated with reticulocyte count, absolute neutrophil count, indirect bilirubin, lactate dehydrogenase, and inversely correlated with hemoglobin in SCD patients. Furthermore, monocyte count was correlated with soluble vascular cell adhesion molecule-1 (VCAM-1) in HbSS/HbSβ 0 thalassemia patients. No significant associations were observed between absolute monocyte count and evaluated clinical complications. In multivariable analyses, reticulocyte count and absolute neutrophil count were significantly associated with absolute monocyte count. Conclusions: Monocytosis is associated with hemolysis and inflammation in SCD. We suggest that hemolysis and the resultant erythropoietic response contribute to monocyte activation.

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