{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:17:46Z","timestamp":1788337066331,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T00:00:00Z","timestamp":1712188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5T32HL139443\u201003"],"award-info":[{"award-number":["5T32HL139443\u201003"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HL140589"],"award-info":[{"award-number":["R01HL140589"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R35HL145000"],"award-info":[{"award-number":["R35HL145000"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Hyperleukocytosis is an emergency of acute leukemia leading to blood hyperviscosity, potentially resulting in life\u2010threatening microvascular obstruction, or leukostasis. Due to the high number of red cells in the circulation, hematocrit\/hemoglobin levels (Hct\/Hgb) are major drivers of blood viscosity, but how Hct\/Hgb mediates hyperviscosity in acute leukemia remains unknown. In vivo hemorheological studies are difficult to conduct and interpret due to issues related to visualizing and manipulating the microvasculature. To that end, a multi\u2010vessel microfluidic device recapitulating the size\u2010scale and geometry of the microvasculature was designed to investigate how Hct\/Hgb interacts with acute leukemia to induce \u201cin vitro\u201d leukostasis. Using patient samples and cell lines, the degree of leukostasis was different among leukemia immunophenotypes with respect to white blood cell (WBC) count and Hct\/Hgb. Among lymphoid immunophenotypes, severe anemia is protective against in vitro leukostasis and Hct\/Hgb thresholds became apparent above which in vitro leukostasis significantly increased, to a greater extent with B\u2010cell acute lymphoblastic leukemia (ALL) versus T\u2010cell ALL. In vitro leukostasis in acute myeloid leukemia was primarily driven by WBC with little interaction with Hct\/Hgb. This sets the stage for prospective clinical studies assessing how red cell transfusion may affect leukostasis risk in immunophenotypically different acute leukemia patients.<\/jats:p>","DOI":"10.1002\/ajh.27308","type":"journal-article","created":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T09:11:11Z","timestamp":1712221871000},"page":"1103-1107","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Redefining hyperviscosity in acute leukemia: Potential implications for red cell transfusions in the microvasculature"],"prefix":"10.1002","volume":"99","author":[{"given":"Jamie O.","family":"Musick","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3400-2237","authenticated-orcid":false,"given":"Evelyn K.","family":"Williams","sequence":"additional","affiliation":[{"name":"Wallace H. Coulter Department of Biomedical Engineering Georgia Institute of Technology and Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirby S.","family":"Fibben","sequence":"additional","affiliation":[{"name":"Wallace H. Coulter Department of Biomedical Engineering Georgia Institute of Technology and Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3072-5806","authenticated-orcid":false,"given":"Dan Y.","family":"Zhang","sequence":"additional","affiliation":[{"name":"George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Caruso","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumiko","family":"Sakurai","sequence":"additional","affiliation":[{"name":"Wallace H. Coulter Department of Biomedical Engineering Georgia Institute of Technology and Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reginald","family":"Tran","sequence":"additional","affiliation":[{"name":"Wallace H. Coulter Department of Biomedical Engineering Georgia Institute of Technology and Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa L.","family":"Kemp","sequence":"additional","affiliation":[{"name":"Wallace H. Coulter Department of Biomedical Engineering Georgia Institute of Technology and Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilbur A.","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta Emory University School of Medicine  Atlanta Georgia USA"},{"name":"Wallace H. Coulter Department of Biomedical Engineering Georgia Institute of Technology and Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2012.01.003"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2017.1270754"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V60.2.279.279"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-10-551507"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI107191"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2018.02.006"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-06-846816"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11864-015-0387-8"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019001142"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1987.27387235626.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-bioeng-091520-025358"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0887-7963(03)00037-3"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.115.306824"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addr.2012.09.011"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/10739680590894966"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.67.4.826"}],"container-title":["American Journal of Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.27308","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T11:55:50Z","timestamp":1715774150000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.27308"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,4]]},"references-count":16,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1002\/ajh.27308"],"URL":"https:\/\/doi.org\/10.1002\/ajh.27308","archive":["Portico"],"relation":{},"ISSN":["0361-8609","1096-8652"],"issn-type":[{"value":"0361-8609","type":"print"},{"value":"1096-8652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,4]]},"assertion":[{"value":"2023-12-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}