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Giuseppe d'Onofrio

Publications and source records attributed to Giuseppe d'Onofrio.

5 recordsLinked to original sources
PubMed2026

Performance of Automated Hematology Analyzer Criteria in Detecting Peripheral Blood Smear Abnormalities: A Systematic Literature Review.

OBJECTIVES: Criteria for visual examination of stained peripheral blood smear (PBS) differ among institutions in the United States and internationally. In an effort to standardize review criteria, the International Consensus Group for Hematology Review (ICGHR) proposed in 2005 a consensus list of rules for CBC findings that should trigger a review of automated cell counter results and potentially lead to further testing or blood smear review. The primary aim of this paper is to report on the published literature in the past 20 years regarding PBS review criteria and their ability to identify relevant peripheral blood abnormalities. METHODS: We performed a systematic review of the published literature from 2005 to 2025 to investigate and summarize PBS review criteria and performance in the context of automated hematology analyzers in clinical laboratories. RESULTS: Of 5351 citations, 68 studies met our search criteria. These studies included 22 countries and all major hematology analyzer manufacturers. Marked variability was observed in study populations, analyzer flagging criteria, details of PBS visual review, definitions of a "positive" smear, and approaches to statistical data analysis. Across studies, the blast flag sensitivity ranged from 18% to 100% while the blast flag specificity ranged from 17% to 100%. Wide ranges in sensitivity/specificity were also seen for atypical and/or abnormal lymphocyte flags across studies. For studies analyzing the same patient population, less striking variation was seen across instruments. CONCLUSIONS: This systematic review provides a 20-year overview of the literature, highlighting significant variability in PBS review criteria, dependence on study design and hematology analyzer, and the importance of developing harmonized evidence-based guidelines.

Humans↗
PubMed2005

Detection of weak D with a fully automated solid-phase red cell adherence system.

BACKGROUND: Microplate agglutination methods (MAMs) and column agglutination technology are widely employed for red cell typing and can be automated. Some tests, however, such as detection of weak D, require manual testing. The possibility of detecting weak D by a solid-phase RBC adherence (SPRCA) test was studied in a fully automated system. STUDY DESIGN AND METHODS: The results of 2609 blood samples, characterized as being D- or with a incomplete agglutination reaction, were analyzed for the presence of the weak D phenotype. The 2609 samples were tested by a weak D tube test (antiglobulin method) and a weak D-test with the new SPRCA method. When weak D was detected, which D epitope was involved and whether it was associated with a partial D phenotype were determined. RESULTS: Weak D was detected in 60 (2.3%) of the 2609 samples. The 60 samples that were weak D by the tube test were also weak D+ with the new automated SPRCA test. The sensitivity and specificity for the new weak D typing method were 100 percent, when compared with the standard weak D manual test. CONCLUSIONS: These results support the possibility of performing weak D detection with a SPRCA fully automated system. These preliminary results are encouraging, showing good sensitivity and specificity of the test. Detection of weak D will permit full automation of blood typing.

Blood Banking↗
PubMed2003

Neural network in hematopoietic malignancies.

BACKGROUND: In the last 30 years, the automatization of the hematology laboratory has led to a high increase in the number of full blood counts (FBC) performed daily as well as a very high degree in the quality assessment in terms of accuracy and precision. Moreover, the produced data are so many that their full interpretation needs an expert; often these new parameters are not exploited. The new challenge of the hematology laboratory consists in the translation of numerical data and new parameters into clinical meaningful information also offering, when possible, a pre-diagnostic guideline, maintaining similar high quality level also in these new aspects. METHODS: Since the first development of automated cytochemistry for leukocyte differential count, a new efficient pre-microscopic approach to leukemia diagnosis and classification, was made possible at the time of the automated blood cell count. This original method, used by the Bayer hematological H* series and ADVIA120 analyzers, is based on a light assessment of basic cell properties: volume and peroxidase activity (P) in the Perox channel, which is used to differentiate the main leukocyte types according to the different enzyme content and Nuclear density (ND) in the basophil channel, which is used to count basophils and blast cells according the chromatin pattern and to flag the presence of abnormal or immature cells. The simple observation of P and ND two-dimensional cytograms can be used to include any single case in a separate and distinct diagnostic category correlated to FAB and WHO classifications of hematological malignancies. Moreover, on the RBC map, it is possible to obtain some information about the pathological cluster. The simultaneous observation of these three cytograms and the introduction of a simple and quick score provide objective informations on blast lineage, level of myeloid differentiation, chronic versus acute leukemias. Using a simple visual score system, we have reached in a previous study a pre-diagnostic efficiency in 91% of the analyzed samples. ADVIA120 provides cytogram cell distribution at the end of the analytical processes that include the evaluation of 492 signals, the so-called raw data. The working hypothesis is to create a knowledge-based system, an Artificial Neural Network able to directly handle these raw-data for producing classes of diagnostic probability with a high level of efficiency. The Bayer R&D team in Tarrytown has created an ANN software for connecting a set of input data to output through weighted "hidden layers" (i) assessing the 84 ADVIA120 parameter sets to be used, (ii) defining the interim analysis tool for fitting to standard "normal archetypes", (iii) finding a discriminant function normal vs. pathological. We have collected from 22 Italian hematological centers data from peripheral blood of 1000 patients having mainly hematopoietic disorders at diagnosis. RESULTS AND CONCLUSIONS: The ANN has been trained with labeled samples. Same analysis has been performed for constructing the "pathological archetypes". Finally, we have tested the ANN model with a small selected set of the collected pathological samples. The preliminary encouraging results show the high capability of this ANN of clustering signals according to the pre-defined normal as well as pathological archetypes. The next big step is to create an application for discriminating different types of anemia, simply using data from patient's peripheral blood.

Hematologic Neoplasms↗
PubMed2002

Role for granulocyte colony-stimulating factor in the generation of human T regulatory type 1 cells.

Granulocyte colony-stimulating factor (G-CSF) may affect T-cell homeostasis by multiple mechanisms, inducing polarization of cytokine secretion, inhibition of T-cell proliferation, and enhancement of T-cell apoptosis. We analyzed the production of interleukin-10 (IL-10) and transforming growth factor-beta1 (TGF-beta1) by T cells from healthy volunteer donors treated with recombinant human G-CSF. Highly purified CD4(+) T cells obtained before and after G-CSF administration (pre-G and post-G, respectively) were activated using the allogeneic mixed leukocyte reaction. Post-G CD4(+) T cells produced high levels of IL-10 but undetectable levels of IL-2 and IL-4, whereas the level of TGF-beta1 release was comparable to that of pre-G CD4(+) T cells. Notably, post-G CD4(+) T cells proliferated poorly in response to alloantigens and to recall antigens and suppressed the proliferation of autologous CD4(+) T cells in a cell contact-independent and an antigen-nonspecific manner. TGF-beta1 and IL-10 were not dispensable for post-G CD4(+) T cells to mediate suppression, as shown by neutralization studies. Compared with pre-G CD4(+) T cells, alloantigen-activated post-G CD4(+) T cells preferentially expressed markers associated with memory T cells, in conjunction with reduced levels of CD28 and CD62L. Collectively, these data demonstrate that CD4(+) T cells exposed to G-CSF in vivo acquire the properties of T regulatory (Tr) cells once triggered in vitro through the T-cell receptor, including a peculiar cytokine production profile (IL-10(++)TGF-beta1(+)IL-2(low/-)IL-4(low/-)), an intrinsic low proliferative capacity, and a contact-independent suppression of antigen-driven proliferation. Tr cells generated ex vivo after exposure to G-CSF might be clinically relevant for transplantation medicine and for the treatment of human immune-mediated diseases.

Adult↗