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All Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Indonesian Journal of Cancer
Donytra Arby Wardhana
1. Integrated Laboratory Installation, Dr. Sardjito General Hospital, Yogyakarta, Indonesia 2. Department Of Clinical Pathology And Laboratory Medicine, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Diagnostic Performance of ESR in Automatic Hematologic Analyzer Mindray BC-760 Compared with CRP to Detect Inflammation in The Adult Population Ratnaningsih, Tri; Donytra Arby Wardhana
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2412

Abstract

C-reactive protein (CRP) is considered a more reliable inflammatory marker than the erythrocyte sedimentation rate (ESR). However, ESR remains widely used in clinical practice. Westergren is the most common method for ESR analysis, although it has limitations, including a long processing time and a requirement for a high blood volume. Currently, an automatic hematologic analyzer has been developed that simultaneously examines ESR. This study aims to evaluate the diagnostic performance of ESR in the automatic hematologic analyzer Mindray BC-760 compared to CRP. A Total of 489 adult participants who were admitted to medical check-ups were recruited in this Cross-sectional observational study. Data were further analyzed using SPSS version 26. The median age was 30 years (range, 24-50 years). The participants were further divided into two groups: those with low CRP (<5 mg/L) and those with high CRP (≥5 mg/L). ESR was significantly elevated in the high CRP group, 14.05 (0.21-48.78) mm/h, compared to the low CRP group, 7.5 (0.27-33.84) mm/h, p <0.001. ESR showed a positive correlation with CRP when Spearman's correlation test was performed (r = 0.338; p <0.001). The diagnostic performance of automatic ESR was further analyzed by referring to Westergren's normal range, which takes into account gender differences (male: <15 mm/h; female: <20 mm/h). In the male group, the AUC was 0.707 (p <0.001), specificity  96.5%, sensitivity 21.1%, likelihood ratio LR +5.95, and LR -0.82. In the female group, the AUC was 0.706 (p <0.001), specificity 83.1%, sensitivity 46.3%, LR +2.73, and LR -0.65. The ESR test using the automatic hematologic analyzer Mindray BC-760 showed moderate diagnostic performance in both the adult male and female groups.
Initial Presentation of Acute Promyelocytic Leukemia as Orbital Myeloid Sarcoma Resembling Neuroblastom Donytra Arby Wardhana; Lydia Friska Malau; Usi Sukorini; Tiarasari Nurjunievi
Indonesian Journal of Cancer Vol. 20 No. 2 (2026): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v20i2.1512

Abstract

Background: Myeloid sarcoma (MS) is a rare extramedullary tumor composed of myeloblasts or immature myeloid cells. It is often associated with acute promyelocytic leukemia (APL), which is a subtype of acute myeloid leukemia (AML), but rarely presents as the initial manifestation of the disease, particularly in children. Diagnosing MS is challenging due to its rarity and clinical resemblance to other malignancies. Early identification and proper diagnostic evaluation are crucial for accurate diagnosis and timely intervention. Case Presentation: We report a 2-year-old girl presenting with a history of a cranial mass and bilateral orbital involvement, initially suspected as neuroblastoma. Laboratory findings revealed anemia, leukocytosis with increased immature granulocytes. Bone marrow aspirate analysis demonstrated 40% promyelocytes, consistent with APL. Fine needle aspiration biopsy (FNAB) of the mandibular lesion showed malignant cells, and immunocytochemical staining was positive for myeloperoxidase (MPO), confirming the diagnosis of MS. The patient was treated with all trans retinoic acid (ATRA) and the chemotherapy agent methotrexate combined with daunorubicin, leading to a favorable response.Conclusions: This case highlights the importance of considering myeloid sarcoma in the differential diagnosis of orbital masses in children, especially when accompanied by hematologic abnormalities. Early recognition and appropriate diagnostic workup, including bone marrow analysis and immunocytochemistry, are essential to establish the diagnosis of APL with extramedullary involvement and to initiate prompt, targeted therapy.
Co-Authors Lydia Friska Malau Tiarasari Nurjunievi Tri Ratnaningsih Usi Sukorini