title: Usefulness of the delta neutrophil index as an ancillary test in the emergency department for the early diagnosis of suspected acute promyelocytic leukemia.
abstract: The delta neutrophil index (DNI) reflects the fraction of circulating immature granulocytes. We evaluated the usefulness of DNI values in patients with acute myeloid leukemia (AML) to distinguish the acute stage of acute promyelocytic leukemia (APL). We analyzed patients retrospectively who were first diagnosed with AML upon admission to the emergency department (ED). Thirty of the 134 patients (22.4%) were diagnosed with APL on ED admission. The univariate analysis and multivariate logistic regression models revealed that DNI values differed significantly between APL and non-APL AML patients on days 0, 1 and 2. Increased predictability for APL was associated with a DNI greater than 24.2% on ED admission, greater than 23.6% on day 1 and greater than 44% on day 2 in patients with AML. DNI values of patients with AML could discriminate the acute stage of APL from AML for immediate initiation of all-trans retinoic acid therapy.
authors.affiliation: a Department of Emergency Medicine , Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Dong Ryul
authors.identifier: http://orcid.org/0000-0002-3098-2784
authors.initials: DR
authors.lastname: Ko
authors.affiliation: b Division of Hematology, Department of Internal Medicine , Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Ji Eun
authors.identifier: http://orcid.org/0000-0001-8832-1412
authors.initials: JE
authors.lastname: Jang
authors.affiliation: a Department of Emergency Medicine , Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Sung Phil
authors.identifier: http://orcid.org/0000-0002-3074-011X
authors.initials: SP
authors.lastname: Chung
authors.affiliation: c Department of Laboratory Medicine , Jincheon Sungmo Hospital , Jincheon , Republic of Korea.|d Research Institute of Bacterial Resistance , Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Jong Wook
authors.identifier: http://orcid.org/0000-0003-1444-9055
authors.initials: JW
authors.lastname: Lee
authors.affiliation: e Department of Research Affairs, Biostatistics Collaboration Unit , Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Hye Sun
authors.identifier: http://orcid.org/0000-0001-6328-6948
authors.initials: HS
authors.lastname: Lee
authors.affiliation: f Department of Health Insurance Research , National Health Insurance Service Ilsan Hospital , Goyang , Republic of Korea.
authors.forename: Jung Hwa
authors.identifier: http://orcid.org/0000-0003-0321-0751
authors.initials: JH
authors.lastname: Hong
authors.affiliation: a Department of Emergency Medicine , Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Taeyoung
authors.identifier: http://orcid.org/0000-0002-4182-7245
authors.initials: T
authors.lastname: Kong
authors.affiliation: a Department of Emergency Medicine , Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Je Sung
authors.identifier: http://orcid.org/0000-0002-2074-6745
authors.initials: JS
authors.lastname: You
authors.affiliation: a Department of Emergency Medicine , Yonsei University College of Medicine , Seoul , Republic of Korea.
authors.forename: Incheol
authors.identifier: http://orcid.org/0000-0001-7033-766X
authors.initials: I
authors.lastname: Park
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D055088:Early Detection of Cancer; D004636:Emergency Service, Hospital; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000175:diagnosis; D016015:Logistic Models; D009504:Neutrophils; D012189:Retrospective Studies; D014212:Tretinoin / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D014212:Tretinoin
keywords: Acute myeloid leukemia; acute promyelocytic leukemia; delta neutrophil index; diagnosis; disseminated intravascular coagulopathy; predictive value