Evaluation of low platelet counts by optical, impedance, and CD61-immunoplatelet methods: estimation of possible inappropriate platelet transfusion.

Background: The Cell-Dyn Sapphire (Abbott Diagnostics) detects platelets (PLTs) with a CD61 monoclonal antibody directed against glycoprotein IIIa as well as impedance (IMP) and optical (OPT) technology. We decided to evaluate low PLT counts produced by IMP and OPT methods and to compare them with the CD61 method. We also examined the possibility of inappropriate PLT transfusion resulting from an inaccurate PLT count.

Progressive multifocal leukoencephalopathy in chronic lymphocytic leukemia after treatment with fludarabine.

A 65-year-old man with chronic lymphocytic leukemia (CLL) diagnosed 11 years ago and treated with standard dose of fludarabine developed a rapidly fatal progressive neurological syndrome. Differential diagnoses included brain infiltration by CLL as opposed to progressive multifocal leukoencephalopathy (PML). A magnetic resonance imaging (MRI) scan showed a hyperintense T2-weighted signal in the left frontal region.