Clin Pediatr Hematol Oncol.
2018 Oct;25(2):128-135. 10.15264/cpho.2018.25.2.128.
Delta Neutrophil Index as an Early Marker for Distinguishing Myeloid from Childhood Acute Leukemia
- Affiliations
-
- 1Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
- 2Division of Pediatric Emergency Medicine, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea. MKIM@yuhs.ac
- 3Division of Pediatric Hematology and Oncology, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea.
- KMID: 2435404
- DOI: http://doi.org/10.15264/cpho.2018.25.2.128
Abstract
- BACKGROUND
The accurate and early diagnosis of acute myeloid leukemia (AML) is important to choose proper treatment option depending on the risk stratification. The delta neutrophil index (DNI) is a relatively new blood marker that indicates the proportion of immature granulocytes in peripheral blood circulation. This study aimed to evaluate the diagnostic value of the DNI for detecting AML in the early phase of acute leukemia.
METHODS
We retrospectively analyzed laboratory tests and bone marrow study results of 163 pediatric patients with acute leukemia admitted to the emergency department, who were diagnosed with acute leukemia. An automatic analyzer (ADVIA 2120 Hematology System; Siemens Healthcare Diagnostics, Forchheim, Germany) was used to measure the DNI in the peripheral blood of each patient.
RESULTS
The mean DNI was significantly different between the AML (N=39) and non-AML (N=124) groups (P < 0.05), and the DNI was the only significant marker for predicting AML in patients with acute leukemia (odds ratio, 1.328; P < 0.05). The DNI more than 4.4% has the highest predictability for distinguishing the patients with AML from the patients with acute leukemia. The mean DNI of the acute promyelocytic leukemia (APL, N=8) group was statistically higher than that of the non-APL group (N=31, P=0.019), but the DNI was not significant in the univariate logistic regression analysis.
CONCLUSION
The DNI might be a promising peripheral blood marker for predicting AML in the early work-up of patients with acute leukemia.
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