{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T15:49:28Z","timestamp":1750261768648,"version":"3.40.5"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T00:00:00Z","timestamp":1679443200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Myelodysplastic syndromes (MDS) encompass a diverse group of myeloid neoplasms for which the diagnosis of low\u2010grade subtypes remains challenging. Erythroblastic islands (EBIs) are highly organized units of erythroid proliferation, differentiation, and enucleation. EBI disruption is frequently observed and is believed to be one of the early changes in MDS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this study, we digitally analyzed bone marrow biopsies dual stained with alpha\u2010hemoglobin stabilizing protein (AHSP) and CD163 to quantitatively study features of EBIs in MDS, among MDS subtypes, as well as those in normal marrows and marrows with other causes of anemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>EBIs in MDS specimens were smaller in size and higher in density compared to both normal and non\u2010MDS anemia specimens. Increased CD163 expression within the EBIs is observed in both MDS and other causes of anemia. A combination of increased EBI density and CD163 expression is seen in association with MDS with high\u2010risk cytogenetics and multiple adverse mutations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>As a proof\u2010of\u2010concept study, we show that EBI features can be relatively easily quantified with AHSP\/CD163 dual immunohistochemistry and open\u2010source imaging analysis software, highlighting those that are unique to MDS, and which may be prognostically relevant. Further studies of the measurable EBI features may provide valuable and novel tools to aid MDS diagnosis and prognostication in the era of digital pathology.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijlh.14001","type":"journal-article","created":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T09:09:10Z","timestamp":1679476150000},"page":"289-296","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Digital image analysis of erythroblastic islands in myelodysplastic syndromes"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0833-5660","authenticated-orcid":false,"given":"Ranran","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Hospital of the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1134-4779","authenticated-orcid":false,"given":"Bradley","family":"Drumheller","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Emory University Hospital  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li\u2010Ping","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Hospital of the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amrom E.","family":"Obstfeld","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine The Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7889-6976","authenticated-orcid":false,"given":"Jonathan I.","family":"Lake","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Hospital of the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Bagg","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Hospital of the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,3,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1904794"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcell.2020.613885"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1431927616000155"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2017.179341"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019000430"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCP8M4QQTAZPGRP"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqx018"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature00803"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/mps3030046"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31825fa501"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102006\u201008\u2010036467"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2018.192518"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.18163"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375\u2010019\u20100532\u20107"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2015.129015"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010017\u201017204\u20105"},{"key":"e_1_2_7_18_1","unstructured":"R Core Team.R: a language and environment for statistical computing.2021.https:\/\/www.r-project.org\/. 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