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Pseudoneutropenia in lymphangioleiomyomatosis (LAM) patients receiving sirolimus: evaluation in a 100 patient cohort

Vissagan Gopalakrishnan, Amanda M. Jones, Patricia Julien-Williams, Tania Machado, Robert L. Danner, Jeffrey J. Swigris, Robert Paine III, Jay N. Lozier, Joel Moss
ERJ Open Research 2018 4: 00121-2017; DOI: 10.1183/23120541.00121-2017
Vissagan Gopalakrishnan
1Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
2Rush Medical College, Rush University Medical Center, Chicago, IL, USA
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Amanda M. Jones
1Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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Patricia Julien-Williams
1Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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Tania Machado
1Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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Robert L. Danner
3Critical Care Medicine Dept, NIH Clinical Center, Bethesda, MD, USA
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  • ORCID record for Robert L. Danner
Jeffrey J. Swigris
4Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, CO, USA
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Robert Paine III
5Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Dept of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, UT, USA
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Jay N. Lozier
6Dept of Laboratory Medicine, NIH Clinical Center, Bethesda, MD, USA
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Joel Moss
1Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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  • For correspondence: mossj@nhlbi.nih.gov
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    FIGURE 1

    a) White blood cell (WBC) counts for 10 lymphangioleiomyomatosis (LAM) patients (nine on sirolimus, one off sirolimus) experiencing pseudoneutropenia in the morning and during mid-day or afternoon. The dotted line is the lower threshold of the normal range for WBC counts (3.98×103μL−1). b) Neutrophil counts for eight LAM patients (four on sirolimus, four off sirolimus) experiencing pseudoneutropenia in the morning and during mid-day or afternoon. The dotted line is the lower threshold of the normal range for neutrophil counts (1.56×103 μL−1). Comparisons between morning and mid-day/afternoon values were conducted with an unpaired t-test and assessment of treatment interaction was conducted with two-way repeated measures ANOVA.

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    FIGURE 2

    Comparison of absolute counts for a, b) white blood cells (WBC), c, d) neutrophils, e, f) monocytes, and g, h) eosinophils for 100 patients with lymphangioleiomyomatosis (LAM) (44 not receiving sirolimus treatment (a, c, e and g), 55 receiving sirolimus treatment (b, d, f and h)) at three time-points during the day. Box-and-whisker plots show median values, upper and lower quartiles, and highest and lowest values. ANOVA was used to analyse results within and between patients. *: p≤0.05; **: p≤0.01; ***: p≤0.001; ****: p≤0.0001; ns: p>0.05.

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Pseudoneutropenia in lymphangioleiomyomatosis (LAM) patients receiving sirolimus: evaluation in a 100 patient cohort
Vissagan Gopalakrishnan, Amanda M. Jones, Patricia Julien-Williams, Tania Machado, Robert L. Danner, Jeffrey J. Swigris, Robert Paine, Jay N. Lozier, Joel Moss
ERJ Open Research Jan 2018, 4 (1) 00121-2017; DOI: 10.1183/23120541.00121-2017

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Pseudoneutropenia in lymphangioleiomyomatosis (LAM) patients receiving sirolimus: evaluation in a 100 patient cohort
Vissagan Gopalakrishnan, Amanda M. Jones, Patricia Julien-Williams, Tania Machado, Robert L. Danner, Jeffrey J. Swigris, Robert Paine, Jay N. Lozier, Joel Moss
ERJ Open Research Jan 2018, 4 (1) 00121-2017; DOI: 10.1183/23120541.00121-2017
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