2023
Uncovering Primary Extranodal Diffuse Large B Cell Lymphoma in the Adrenal and Thyroid Glands
Li J, Balbuena-Merle R, Hrones M, Gibson C. Uncovering Primary Extranodal Diffuse Large B Cell Lymphoma in the Adrenal and Thyroid Glands. American Journal Of Case Reports 2023, 25: e942659. PMID: 38287660, PMCID: PMC10838563, DOI: 10.12659/ajcr.942659.Peer-Reviewed Original ResearchPROSER: A Web-Based Peripheral Blood Smear Interpretation Support Tool Utilizing Electronic Health Record Data
Iscoe M, Loza A, Turbiville D, Campbell S, Peaper D, Balbuena-Merle R, Hauser R. PROSER: A Web-Based Peripheral Blood Smear Interpretation Support Tool Utilizing Electronic Health Record Data. American Journal Of Clinical Pathology 2023, 160: 98-105. PMID: 37026746, DOI: 10.1093/ajcp/aqad024.Peer-Reviewed Original ResearchConceptsQuality improvement studyElectronic health recordsLaboratory valuesWeb-based clinical decision support toolClinical decision support toolElectronic health record dataHealth record dataImprovement studyResident trainingBlood smear interpretationClinical outcomesMorphologic findingsAcademic hospitalCorresponding reference rangesMedication informationReference rangeMicroscopy findingsCDS toolsIntervention effectsPathology practiceSmear interpretationHealth recordsRecord dataPathologistsPatients
2021
Potential Implications of a Type 1 Interferon Gene Signature on COVID-19 Severity and Chronic Inflammation in Sickle Cell Disease
Madany E, Okwan-Duodu D, Balbuena-Merle R, Hendrickson JE, Gibb DR. Potential Implications of a Type 1 Interferon Gene Signature on COVID-19 Severity and Chronic Inflammation in Sickle Cell Disease. Frontiers In Medicine 2021, 8: 679030. PMID: 34368185, PMCID: PMC8339405, DOI: 10.3389/fmed.2021.679030.Peer-Reviewed Original ResearchSickle cell diseaseCOVID-19 severityIFNα/βType 1 interferonCell diseaseSARS-CoV-2 infectionType 1 interferon responseCorona Virus Disease-19 (COVID-19) pandemicCohort of patientsMajority of patientsInterferon gene signatureIFNα/β productionRace-matched controlsDisease-19 pandemicCOVID-19Express elevated levelsMajority of evidenceSCD diseaseSevere sequelaeChronic inflammationFavorable outcomeVariable progressionClinical consequencesGeneral populationPatients
2020
Monocytic Acute Myeloid Leukemias with KM2TA Translocations to Chromosome 17q that May Clinically Mimic Acute Promyelocytic Leukemia
Balbuena-Merle RI, Tormey CA, DiAdamo A, Rinder HM, Siddon AJ. Monocytic Acute Myeloid Leukemias with KM2TA Translocations to Chromosome 17q that May Clinically Mimic Acute Promyelocytic Leukemia. Lab Medicine 2020, 52: 290-296. PMID: 32984885, DOI: 10.1093/labmed/lmaa078.Peer-Reviewed Original ResearchConceptsAcute promyelocytic leukemiaAcute myeloid leukemiaMyeloid leukemiaPromyelocytic leukemiaMonocytic acute myeloid leukemiaTrans retinoic acidClinical presentationPrognostic implicationsPrognostic significanceLaboratory pictureCorrect diagnosisDistinct chemotherapyLeukemiaLeukemic entitiesRetinoic acidGene translocationMonocytic differentiationChromosome 17qTranslocationChemotherapyDiagnosisImmunohematologic aspects of alloimmunization and alloantibody detection: A focus on pregnancy and hemolytic disease of the fetus and newborn
Gupta GK, Balbuena-Merle R, Hendrickson JE, Tormey CA. Immunohematologic aspects of alloimmunization and alloantibody detection: A focus on pregnancy and hemolytic disease of the fetus and newborn. Transfusion And Apheresis Science 2020, 59: 102946. PMID: 32962917, DOI: 10.1016/j.transci.2020.102946.Peer-Reviewed Original ResearchConceptsRed blood cellsHemolytic diseaseCurrent pathophysiologic mechanismsSetting of pregnancyPeri-partum periodPregnant patientsRBC alloantibodiesPathophysiologic mechanismsTransfusion practiceAlloantibody detectionTransfusion therapyClinical impactAlloimmunizationTransfusion communityBlood bankPregnancyDeadliest formBlood cellsAlloantibodiesFetusesDiseaseLaboratory toolPatientsTherapySettingCharacterization of circulating and cultured Tfh-like cells in sickle cell disease in relation to red blood cell alloimmunization status
Balbuena-Merle R, Santhanakrishnan M, Devine L, Gibb DR, Tormey CA, Siddon AJ, Curtis SA, Gallagher PG, Weinstein JS, Hendrickson JE. Characterization of circulating and cultured Tfh-like cells in sickle cell disease in relation to red blood cell alloimmunization status. Transfusion And Apheresis Science 2020, 59: 102778. PMID: 32439490, PMCID: PMC7483805, DOI: 10.1016/j.transci.2020.102778.Peer-Reviewed Original ResearchConceptsTfh-like cellsNaïve CD4 T cellsSickle cell diseaseCD4 T cellsCD4 T cell subsetsT cell subsetsT cellsCell diseaseRed blood cell alloimmunizationPeripheral blood mononuclear cellsBlood mononuclear cellsCD3/CD28Electronic medical recordsAlloimmunization statusHLA alloantibodiesRBC autoantibodiesRBC alloantibodiesFollicular helperIL-12Mononuclear cellsMedical recordsIL-7Antigen specificityB cellsAlloantibodiesPassive anti‐C acquired in the setting of Rh immune globulin administration following Rh mismatched apheresis platelet transfusion: A case series
Sostin N, Ross R, Balbuena‐Merle R, Hendrickson JE, Tormey CA. Passive anti‐C acquired in the setting of Rh immune globulin administration following Rh mismatched apheresis platelet transfusion: A case series. Journal Of Clinical Apheresis 2020, 35: 224-226. PMID: 32110829, DOI: 10.1002/jca.21773.Peer-Reviewed Original ResearchConceptsPlatelet transfusionsRh immune globulin administrationRisk/benefit ratioApheresis platelet transfusionImmune globulin administrationRhIG immunoprophylaxisImmune globulinTransfusion supportAlloantibody formationCase seriesNegative recipientsAlloimmunization riskRhIG administrationReproductive agePassive transferPLT transfusionsTransfusionBlood bankBenefit ratioRhIGApheresis PLTsAdministrationImmunoprophylaxisPatientsSettingThe evanescence and persistence of RBC alloantibodies in blood donors
Hauser RG, Esserman D, Karafin MS, Tan S, Balbuena‐Merle R, Spencer BR, Roubinian NH, Wu Y, Triulzi DJ, Kleinman S, Gottschall JL, Hendrickson JE, Tormey CA, ). The evanescence and persistence of RBC alloantibodies in blood donors. Transfusion 2020, 60: 831-839. PMID: 32061102, DOI: 10.1111/trf.15718.Peer-Reviewed Original ResearchConceptsBlood donorsAntibody persistenceAntibody screenDonor Evaluation Study-IIIHistory of transfusionUS blood centersFit inclusion criteriaPresence of alloantibodiesRecipient EpidemiologyRBC alloantibodiesBlood productsInclusion criteriaSignificant antibodiesBiologic factorsHealthy populationAntibody detectionAntibody identificationAlloantibodiesBlood centersMultiple antibodiesFirst donationAntibody specificityStudy IIIAntibodiesCenter policies
2019
The Presence and Persistence of Pregnancy-Associated Red Blood Cell Alloantibodies in Blood Donors
Balbuena-Merle R, Hauser R, Karafin M, Tan S, Spencer B, Roubinian N, Wu Y, Triulzi D, Kleinman S, Gottschall J, Tormey C, Hendrickson J. The Presence and Persistence of Pregnancy-Associated Red Blood Cell Alloantibodies in Blood Donors. Blood 2019, 134: 2452. DOI: 10.1182/blood-2019-121388.Peer-Reviewed Original ResearchRBC alloantibodiesTransfusion historyBlood donorsBlood donor databasePregnant femalesPersistent antibodiesPrior transfusionsPrior pregnancyAntibody screenMean durationPregnancy historyFemale healthy blood donorsRed blood cell alloantibodiesDonor databaseMean timeAntibody screen resultsHealthy blood donorsUS blood centersSubsequent donationsMajority of donorsSubsequent blood donationsAlloantibody specificitiesRBC alloimmunizationCell microchimerismAntigen exposureRed Blood Cell Alloimmunization in Pediatric Sickle Cell Disease Population of Puerto Rico: An Observational Study
Balbuena-Merle RI, Nazario-Delgado CM, Rosario-Rosado RV, Millán-Tapia D, Climent-Peris C. Red Blood Cell Alloimmunization in Pediatric Sickle Cell Disease Population of Puerto Rico: An Observational Study. Annals Of Laboratory Medicine 2019, 40: 187-189. PMID: 31650739, PMCID: PMC6822008, DOI: 10.3343/alm.2020.40.2.187.Peer-Reviewed Original ResearchRed blood cell alloimmunization is associated with lower expression of FcγR1 on monocyte subsets in patients with sickle cell disease
Balbuena‐Merle R, Curtis SA, Devine L, Gibb DR, Karafin MS, Luckey CJ, Tormey CA, Siddon AJ, Roberts JD, Hendrickson JE. Red blood cell alloimmunization is associated with lower expression of FcγR1 on monocyte subsets in patients with sickle cell disease. Transfusion 2019, 59: 3219-3227. PMID: 31355970, PMCID: PMC7075520, DOI: 10.1111/trf.15463.Peer-Reviewed Original ResearchConceptsSickle cell diseaseMonocyte subsetsTotal monocytesCell diseaseComplications of SCDRed blood cell alloimmunizationRed blood cell alloantibodiesElectronic medical recordsTransfusion exposureSerum cytokinesIntermediate monocytesRBC alloantibodiesInflammatory milieuCD64 expressionClassical monocytesPeripheral bloodInflammatory functionsMedical recordsAntibody formationClinical significancePatientsMonocytesFlow cytometryLow expressionRespondersFatal acute hemolytic transfusion reaction due to anti‐B from a platelet apheresis unit stored in platelet additive solution
Balbuena‐Merle R, West FB, Tormey CA, Hendrickson JE. Fatal acute hemolytic transfusion reaction due to anti‐B from a platelet apheresis unit stored in platelet additive solution. Transfusion 2019, 59: 1911-1915. PMID: 30865314, DOI: 10.1111/trf.15240.Peer-Reviewed Original ResearchConceptsGroup B patientsHemolytic transfusion reactionsDirect antiglobulin testB patientsTransfusion reactionsApheresis unitsBlood group B patientsRelapsed acute myeloid leukemiaAcute hemolytic transfusion reactionAnti-human globulin phaseHigh lactate dehydrogenaseAnti-human globulinAcute myeloid leukemiaRecipient testingDonor testingRecipient variablesExtravascular hemolysisPlatelet transfusionsTransfusion recipientsAntibody screenHigh bilirubinPLT transfusionsAntiglobulin testBlood productsMyeloid leukemiaLeptomeningeal Carcinomatosis as the Initial Manifestation of Metastatic Disease diagnosed in Postmortem Examination: A Case Series.
Balbuena-Merle RI, Santé-Pérez M, Pérez-Berenguer J, Velez-Rosario R, Correa-Rivas M, Jiménez A. Leptomeningeal Carcinomatosis as the Initial Manifestation of Metastatic Disease diagnosed in Postmortem Examination: A Case Series. Puerto Rico Health Sciences Journal 2019, 38: 64-67. PMID: 30924918.Peer-Reviewed Original ResearchConceptsLeptomeningeal carcinomatosisYear old womanPostmortem examinationOlder womenMalignant cellsStatus post resectionCerebrospinal fluid examinationYear old maleInitial manifestationClinical suspicionMetastatic diseaseNeurologic symptomatologyFluid examinationCase seriesNeurological presentationUnknown malignancyPost resectionUnknown etiologyBreast cancerSerial examinationsPia-arachnoidOld maleClinical diagnosisNeurological imagingMultidisciplinary approachRed blood cell alloimmunization and delayed hemolytic transfusion reactions in patients with sickle cell disease
Balbuena-Merle R, Hendrickson JE. Red blood cell alloimmunization and delayed hemolytic transfusion reactions in patients with sickle cell disease. Transfusion Clinique Et Biologique 2019, 26: 112-115. PMID: 30857806, DOI: 10.1016/j.tracli.2019.02.003.Peer-Reviewed Original ResearchConceptsHemolytic transfusion reactionsSickle cell diseaseRed blood cell alloimmunizationRBC alloantibodiesTransfusion reactionsRBC alloimmunizationCell diseaseLife-threatening hemolytic transfusion reactionsSubset of patientsBlood bank testingCurrent screening practicesAlternative complement pathwayRBC autoantibodiesTransfusion burdenInflammatory statusPatient populationCase reportRBC exposureBlood donorsScreening practicesHigh prevalenceChronic hemolysisAlloantibodiesBystander hemolysisPatients
2018
Elevated Levels of CD64 MFI on Monocyte Subsets Are Associated with a History of Stroke in Sickle Cell Disease
Curtis S, Balbuena-Merle R, Devine L, Zelterman D, Roberts J, Dearborn-Tomazos J, Sansing L, Hendrickson J. Elevated Levels of CD64 MFI on Monocyte Subsets Are Associated with a History of Stroke in Sickle Cell Disease. Blood 2018, 132: 1093. DOI: 10.1182/blood-2018-99-117504.Peer-Reviewed Original ResearchHistory of strokeSickle cell diseaseRole of monocytesIschemic strokeTotal neutrophil countComplete blood countMonocyte subsetsStroke historyNeutrophil countIntermediate monocytesMonocyte subtypesBlood countClassical monocytesCell diseaseFuture stroke riskIschemic stroke historyVaso-occlusive crisisPro-inflammatory monocytesPathophysiology of strokeCause of morbidityMultivariate logistic regressionNon-classical monocytesT-testHigh-affinity receptorStudent's t-testBullous hemorrhagic dermatosis is an under-recognized side effect of full dose low-molecular weight heparin: a case report and review of the literature
Russo A, Curtis S, Balbuena-Merle R, Wadia R, Wong E, Chao HH. Bullous hemorrhagic dermatosis is an under-recognized side effect of full dose low-molecular weight heparin: a case report and review of the literature. Experimental Hematology & Oncology 2018, 7: 15. PMID: 29989046, PMCID: PMC6035443, DOI: 10.1186/s40164-018-0108-7.BooksLow molecular weight heparinBullous hemorrhagic dermatosisWeight heparinCoagulation testingFull-dose low molecular weight heparinMajority of patientsSmall case seriesMolecular weight heparinDays of administrationSearch of PubMedSite of injectionCase seriesIntracranial hemorrhageOvid EmbaseCase reportElderly menLate diagnosisTherapeutic rangeOvid MEDLINEAnticoagulationSide effectsPatientsTherapeutic interventionsNew casesDifferent anticoagulants
2014
Mantle Cell Lymphoma Mimicking B-Cell Prolymphocytic Leukemia
Balbuena-Merle R, Velez-Rosario R. Mantle Cell Lymphoma Mimicking B-Cell Prolymphocytic Leukemia. American Journal Of Clinical Pathology 2014, 142: a049-a049. DOI: 10.1093/ajcp/142.suppl1.049.Peer-Reviewed Original Research