{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T16:11:00Z","timestamp":1778602260810,"version":"3.51.4"},"reference-count":15,"publisher":"Walter de Gruyter GmbH","issue":"7","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_cclm-2025-0115_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>In patients with chronic lymphocytic leukemia (CLL), the white progenitor cell (WPC) channel of the Sysmex XN hematology analyzers typically shows a varying proportion of cells in the upper left field of the scattergram, resembling the shape of shark fins. The underlying mechanism causing this phenomenon has not been elucidated so far. In this study we evaluated biological and\/or genetic features of CLL cells as a potential background of the \u201cshark fins\u201d.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-0115_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Automated blood counts and WPC scattergrams of 95 CLL patients were analyzed. The scattergrams were examined for the presence, count and percentage of cells in the \u201cshark fins\u201d using a flow cytometry software. Potential influencing factors on the occurrence of the \u201cshark fin\u201d cells were statistically tested by Spearman correlation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-0115_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The lymphocyte count was identified as a highly statistically significant predictor of \u201cshark fins\u201d (p&lt;0.0001). Absence of del(17p) (p=0.02), unmutated TP53 (p=0.01), mutated IGHV (p=0.03) and the percentage of smudge cells in peripheral blood smears (p=0.04) showed a statistically significant positive influence on the percentage of cells in the \u201cshark fins\u201d after adjustment for the lymphocyte count. No significant effect was observed for age, sex, del(13q), del(11q), trisomy 12 and treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-0115_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We identified the lymphocyte count, the absence of TP53 mutations and del(17p), a mutated IGHV and the proportion of smudge cells as significant influences on the appearance of \u201cshark fin\u201d cells. Our findings indicate an impact of biological and genetic properties of the leukemic cells on the formation of \u201cshark fins\u201d.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/cclm-2025-0115","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T08:24:16Z","timestamp":1741940656000},"page":"1427-1431","source":"Crossref","is-referenced-by-count":0,"title":["Impact of biological and genetic features of leukemic cells on the occurrence of \u201cshark fins\u201d in the WPC channel scattergrams of the Sysmex XN hematology analyzers in patients with chronic lymphocytic leukemia"],"prefix":"10.1515","volume":"63","author":[{"given":"Margot","family":"Egger","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine , Konventhospital Barmherzige Brueder Linz and Ordensklinikum Linz , Linz , Austria"},{"name":"Medical Faculty , Johannes Kepler University Linz , Linz , Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I-Fei","family":"Fang","sequence":"additional","affiliation":[{"name":"Institute of Laboratory Diagnostics , Hospital of the Brothers of St. John of God Vienna , Vienna , Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franz","family":"Quehenberger","sequence":"additional","affiliation":[{"name":"Institute for Medical Informatics, Statistics and Documentation , Medical University of Graz , Graz , Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Robier","sequence":"additional","affiliation":[{"name":"Institute of Laboratory Diagnostics , Hospital of the Brothers of St. John of God , Graz , Austria"},{"name":"Clinical Institute of Medical and Chemical Laboratory Diagnostics , Medical University of Graz , Graz , Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"2026051215142920725_j_cclm-2025-0115_ref_001","unstructured":"The surveillance, epidemiology, and end results (SEER) program of the national cancer. Available from: https:\/\/seer.cancer.gov\/statfacts\/html\/clyl.html2021."},{"key":"2026051215142920725_j_cclm-2025-0115_ref_002","doi-asserted-by":"crossref","unstructured":"Hallek, M, Cheson, BD, Catovsky, D, Caligaris-Cappio, F, Dighiero, G, D\u00f6hner, H, et al.. iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL. Blood 2018;131:2745\u201360. https:\/\/doi.org\/10.1182\/blood-2017-09-806398.","DOI":"10.1182\/blood-2017-09-806398"},{"key":"2026051215142920725_j_cclm-2025-0115_ref_003","doi-asserted-by":"crossref","unstructured":"Hallek, M, Al-Sawaf, O. Chronic lymphocytic leukemia: 2022 update on diagnostic and therapeutic procedures. Am J Hematol 2021;96:1679\u2013705. https:\/\/doi.org\/10.1002\/ajh.26367.","DOI":"10.1002\/ajh.26367"},{"key":"2026051215142920725_j_cclm-2025-0115_ref_004","doi-asserted-by":"crossref","unstructured":"Schuff-Werner, P, Kohlschein, P, Maroz, A, Linssen, J, Drei\u00dfiger, K, Burstein, C. 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