[Evaluation of the performances of the UF-1000i(®) automated urine analyzer]. / Évaluation des performances de l'automate d'analyse urinaire UF-1000i(®).

The purpose of this study was the evaluation of the UF 1000i(®) automated urine analyzer (bioMérieux(©)).The coefficients of variation (CV) for the repeatability of the red blood cell (RBC), white blood cell (WBC) and bacteria counts were overall concordant with those announced by the supplier. However, for low concentrations, the CV for the repeatability for concentrations of 10(3) RBC/mL, 10(3) WBC/mL and 5×10(3) UA/mL were respectively of 26, 18 and 36% and thus higher than the CV (10%) reported for each of the three parameters by the supplier. Reproducibility results agreed with those given by the supplier (10%). The linearity range was different from that reported by the supplier and was shifted by a factor 10 for WBC and bacteria high concentrations. Cross contamination between samples was prevented by using the washing program recommended by the supplier which however led to a lower analysis frequency (80 samples per hour). Detection limits were of 5,7×10(1) RBC/mL, 5,7×10(1) WBC/mL and 1,6×10(4) UA/mL respectively for the RBC, WBC and bacteria. Quantification limits found in this study were of 1,3×10(3) RBC/mL, 1,7×10(3) WBC/mL, 5,1×10(3) UA/mL. An overestimation of the RBC count was observed within the range of 5×10(3) to 2×10(4) RBC/mL. Beyond this concentration range, the concordance is good. The correlation is poor within this range and good for higher concentrations. For WBC, concordance and correlation were satisfactory over the whole range tested.

[Preservation of urine samples for UF 1000i (bioMérieux©) analysis]. / Évaluation de la conservation des échantillons urinaires en vue d'une étude sur l'automate d'analyse urinaire UF 1000i (bioMérieux©).

With the general tendency that's to say the grouping of laboratories as technical divisions and the accreditation's obligation, the handling of urinary sample preservation's conditions is a major concern. Urinary sample preservation, with or without boric acid, for UF 1000i urinalysis was the purpose of this study. No significant modification was found in red blood cells and white blood cells concentration on a 48  h period with or without boric acid. Preservation's quality of the red blood cells is lower, but the presence of preservative is ineffectual. Thus, for those elements, even if a fast analyse is obviously preferred, these parameters seem to be stable enough to allow a 24  to 48  h delayed urinalysis. Results are totally different for bacteria, which grow if no preservative is added, in a period of time based on the size of the initial bacteria's inoculum. Efficiency of the boric acid as a preservative is shown by the curves, which put into perspective the concentration of acid boric. Finally, boric acid doesn't interfere with the erythrocyte, leucocyte or bacteria's count on UF 1000i and his use is totally suitable for the preservation of urine samples for UF 1000i analysis.

[Modifying cutoff values of the UF 1000i(®) automated urine analyzer to predict urinary tract infection]. / Faut-il modifier le seuil de prédiction de l'infection urinaire de l'automate d'analyse urinaire UF 1000i(® )?

The fundamental advantage of using automated urine analyzers lies in the current grouping of laboratories as technical divisions. The UF1000i(®) Biomérieux is a 2(nd) generation automated urine analyzer which uses fluorescence flow cytometry to count the particles and bacteria present in urine. It also provides a prediction indicator for the urinary tract infection, based on the leukocyte and bacteria count. The indicator is an alarm (UTI) which triggers according to the cut off values set by the supplier (bacteria count (B): 100000 arbitrary units (AU)/mL, and leukocyte count (L): 25000/mL). Different cut off values of bacteria and leukocytes were evaluated to give the best discrimination, compared with conventional cytobacteriological examination based on the REMIC recommendations of 2010. Our study highlighted two cut off pairs with distinctive performances: L = 15000/mL and B = 100000 AU/mL ; L = 15000/mL and B = 150000 AU/mL. For these cut off values, the negative predictive values is respectively 1 and 0.99. Thus, UF 1000i gives a fairly good indicator for the probable absence of urinary tract infection.

PICALM-MLLT10 acute myeloid leukemia: a French cohort of 18 patients.

The PICALM-MLLT10 fusion gene, generated by the t(10;11)(p12-13;q14-21) translocation, is a rare but recurrent event in acute leukemias. In this study, we assessed the characteristics and outcome of 18 PICALM-MLLT10 AML patients. As compared with non PICALM-MLLT10 patients (n=72), PICALM-MLLT10 AML were characterized by more frequent extramedullary diseases, CD7 expression and higher platelet counts. Three out of four therapy-related PICALM-MLLT10 AMLs had been previously treated for diffuse large B-cell lymphoma. The complete response rate was 71% after intensive chemotherapy. PICALM-MLLT10 patients had a shorter median overall survival than patients with favorable cytogenetics (12 months vs. not reached, p=0.07) but not significantly different from those of intermediate (26 months, p=0.32) or unfavorable cytogenetic groups (8 months, p=0.13). Long term responses were achieved in a subset of patients after allogeneic stem-cell transplantation but also after high-dose cytarabine.

Acute monocytic leukemia with coexpression of minor BCR-ABL1 and PICALM-MLLT10 fusion genes along with overexpression of HOXA9.

The t(9;22)(q34;q11) translocation occurs in chronic myeloid leukemia (CML) and adult B-cell acute lymphoblastic leukemia (ALL), leading to fusion of BCR to ABL1 and constitutive activation of ABL1 tyrosine kinase activity. The main BCR-ABL1 breakpoints result in P190 BCR-ABL1 or P210 BCR-ABL1 fusion proteins. The latter is found in almost all cases of CML and in one third of the cases of t(9;22)-positive adult B-ALL. P190 BCR-ABL1 is found in the remaining two thirds of t(9;22)-positive adult B-ALL cases but only exceptionally in CML. We describe here the first case of t(9;22)(q34;q11) associated with t(10;11)(p13;q14) in acute monocytic leukemia. The recurrent t(10;11)(p13;q14) translocation, usually found in acute myeloid leukemia (AML) and T-ALL, merges PICALM to MLLT10. RT-PCR enabled identification of PICALM-MLLT10 and BCR-ABL1 e1-a2 fusion transcripts; in the context of chronic and acute myeloid leukemia, the latter usually has a monocytic presentation. We also identified overexpression of HOXA9, a gene essential to myeloid differentiation that is expressed in PICALM-MLLT10 and MLL-rearranged acute leukemias. This case fits with and extends a recently proposed multistage AML model in which constitutive activation of tyrosine kinases by mutations (BCR-ABL1) are associated with deregulation of transcription factors central to myeloid differentiation (HOXA9 secondary to PICALM-MLLT10).