DOAC plasma levels measured by chromogenic anti-Xa assays and HPLC-UV in apixaban- and rivaroxaban-treated patients from the START-Register.


INTRODUCTION:To measure direct factor Xa inhibitor (apixaban, edoxaban, rivaroxaban) concentrations, dedicated chromogenic anti-Xa assays are recommended as suitable methods to provide rapid drug quantification. Moreover, the high-performance liquid chromatography with ultraviolet detection (HPLC-UV) is reported as a reliable quantitative technique. We investigated seven anti-Xa assays and an HPLC-UV method for measurement of apixaban and rivaroxaban levels in patients enrolled in the START-Register. METHODS:A total of 127 apixaban and 124 rivaroxaban samples were tested by HPLC-UV and the following anti-Xa assays: Biophen DiXaI and Heparin LRT (Hyphen BioMed), Berichrom and Innovance Heparin (Siemens), STA-Liquid Anti-Xa (Stago Diagnostics), Technochrom anti-Xa (Technoclone), and HemosIL Liquid Anti-Xa (Werfen). Each method was performed in one of the participating laboratories: Bologna, Cremona, Florence, and Padua. RESULTS:Our data confirmed the overestimation of apixaban and rivaroxaban levels by the antithrombin-supplemented anti-Xa method (Berichrom). Performances and reproducibility of the six anti-Xa assays not supplemented with antithrombin and the HPLC-UV method were good, with limits of quantification from 8-39 ng/mL (apixaban) and 15-33 ng/mL (rivaroxaban). The six chromogenic methods showed good concordances with the quantitative HPLC-UV [bias: -26.9-22.3 ng/mL (apixaban), -11.3-18.7 ng/mL (rivaroxaban)]. Higher bias and wider range between limits of agreement were observed at higher concentrations [<100 ng/mL: bias -21.3-4.1 ng/mL (apixaban) and -6.2-3.8 ng/mL (rivaroxaban); >200 ng/mL: bias -42.2-36.8 ng/mL (apixaban) and -20.1-68.9 ng/mL (rivaroxaban)]. CONCLUSION:Overall, the anti-Xa assays not supplemented with antithrombin and the HPLC-UV method proved to be suitable for apixaban and rivaroxaban quantification.


Int J Lab Hematol


Cini M,Legnani C,Padrini R,Cosmi B,Dellanoce C,De Rosa G,Marcucci R,Pengo V,Poli D,Testa S,Palareti G




Has Abstract


2020-04-01 00:00:00












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    abstract::Direct international normalized ratio (INR) determination using certified INR plasmas was shown to improve precision and accuracy. We evaluated the utility of a multicalibrator in determining INR. INR values were measured in 493 blood samples from patients subjected to anticoagulation therapy (320) and control subject...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章


    authors: Cha CH,Park CJ,Kim DH,Kim MJ,Cho YU,Jang S,Chi HS

    更新日期:2010-08-01 00:00:00

  • The applicability of multiparameter flow cytometry for the detection of minimal residual disease using different-from-normal panels to predict relapse in patients with acute myeloid leukemia after allogeneic transplantation.

    abstract:BACKGROUND:The MRD status detected using multiparameter flow cytometry (MFC) before allogeneic hematopoietic stem cell transplantation (allo-HSCT) has crucial prognostic value for patients with acute myeloid leukemia (AML) in morphologic complete remission (CR). We designed a novel panel of antibodies to identify aberr...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章


    authors: Wang Z,Guo M,Zhang Y,Xu S,Cheng H,Wu J,Zhang W,Hu X,Yang J,Wang J,Tang G

    更新日期:2019-10-01 00:00:00

  • JAK2V617F mutation in patients with thrombosis: to screen or not to screen?

    abstract:INTRODUCTION:Thrombotic complications are a main concern in patients with myeloproliferative neoplasms. Recently, a gain-of-function mutation of the gene encoding the JAK2 tyrosine kinase that results in a valine-to-phenylalanine substitution at position 617 (V617F) has been described. Since the description of the JAK2...

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    pub_type: 杂志文章,评审


    authors: Xavier SG,Gadelha T,Rezende SM,Zalcberg IR,Spector N

    更新日期:2011-04-01 00:00:00

  • Iron status determination in pregnancy using the Thomas plot.

    abstract:INTRODUCTION:Physiological changes during pregnancy affect routine tests for iron deficiency. The reticulocyte haemoglobin equivalent (RET-He) and serum-soluble transferrin receptor (sTfR) assay are newer diagnostic parameters for the detection of iron deficiency, combined in the Thomas diagnostic plot. We used this pl...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章


    authors: Weyers R,Coetzee MJ,Nel M

    更新日期:2016-04-01 00:00:00

  • The adsorption of dabigatran is as efficient as addition of idarucizumab to neutralize the drug in routine coagulation assays.

    abstract:INTRODUCTION:The direct thrombin inhibitor dabigatran interferes with thrombophilia screening and with the diagnosis of hemostasis disorders that develop during treatment with the anticoagulant. In vitro addition of idarucizumab, a humanized antibody fragment that binds dabigatran, to plasma samples containing dabigatr...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章


    authors: Jacquemin M,Toelen J,Feyen L,Schoeters J,Van Horenbeeck I,Vanlinthout I,Debasse M,Vanassche T,Peerlinck K,Verhamme P

    更新日期:2018-08-01 00:00:00

  • Validation of reflex testing rules and establishment of a new workflow for body fluid cell analysis using a Sysmex XN-550 automatic hematology analyzer.

    abstract:INTRODUCTION:We developed and validated reflex testing rules for the microscopic examination (ME) of body fluids (BFs) on the Sysmex XN-550 (Sysmex Corporation) instrument. METHODS:We assessed the detection limits, precision, linearity, and carryover. To develop the reflex testing rules (derivation arm), we tested 515...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章


    authors: Cho YU,You E,Jang S,Park CJ

    更新日期:2018-06-01 00:00:00

  • Use of Sysmex XN-10 red blood cell parameters for screening of hereditary red blood cell diseases and iron deficiency anaemia.

    abstract:INTRODUCTION:In daily practice in haematology laboratories, red blood cell (RBC) abnormalities are frequent and their management is a real challenge. The aim of this study is to establish a "decision tree" using RBC and reticulocyte parameters from the SYSMEX XN-10 analyser to distinguish between patients with a heredi...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章


    authors: Nivaggioni V,Bouriche L,Coito S,Le Floch AS,Ibrahim-Kosta M,Leonnet C,Arnoux I,Loosveld M

    更新日期:2020-12-01 00:00:00

  • Utility of new mature erythrocyte and reticulocyte indices in screening for iron-deficiency anemia in a pediatric population.

    abstract:INTRODUCTION:Iron-deficient erythropoiesis attributable to nutritional deficiency is the most common cause of anemia in early childhood. Beckman Coulter has proposed new parameters: red blood cell size factor (RSf) and low hemoglobin density (LHD%). [Formula: see text] The aims of the present communication were to esta...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章


    authors: Osta V,Caldirola MS,Fernandez M,Marcone MI,Tissera G,Pennesi S,Ayuso C

    更新日期:2013-08-01 00:00:00

  • The impact of long-haul air travel on variables of the athlete's biological passport.

    abstract:INTRODUCTION:Dehydration, fluid shifts or changes in coagulation occurring during air travel can trigger distinct reactions in the haematological system. Athletes are concerned that these effects might impair sporting performance, increase the risk of thrombosis or cause abnormalities in blood values that might be mist...

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    pub_type: 杂志文章


    authors: Schumacher YO,Klodt F,Nonis D,Pottgiesser T,Alsayrafi M,Bourdon PC,Voss SC

    更新日期:2012-12-01 00:00:00

  • Clinical and hematological characteristics of 88 patients with COVID-19.

    abstract:INTRODUCTION:To retrospectively analyze epidemiological, clinical and hematological characteristics of COVID-19 patients. METHODS:The demographic, symptoms, and physiological parameters of 88 patients were collected and analyzed. The performance of complete blood count (CBC) indexes for monitoring and predicting the s...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章


    authors: Zhang H,Cao X,Kong M,Mao X,Huang L,He P,Pan S,Li J,Lu Z

    更新日期:2020-12-01 00:00:00

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    abstract::Advances in lab-on-a-chip technologies enabled programmable, reconfigurable, and scalable manipulation of a variety of laboratory procedures. Samples, reagents, and fluids can be precisely controlled; buffer temperature, pH, and concentration control systems as well as a variety of detection systems can be integrated ...

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    pub_type: 杂志文章,评审


    authors: Park S,Moon HS,Lee DS,Kim HC,Chun H

    更新日期:2013-10-01 00:00:00

  • MFI ratio estimation of ZAP-70 in B-CLL by flow cytometry can be improved by considering the isotype-matched antibody signal.

    abstract:INTRODUCTION:The IgV(H) mutational status of B-cell chronic lymphocytic leukemia (B-CLL) is of prognostic value. Expression of ZAP-70 in B-CLL is a surrogate marker for IgV(H) unmutated (UM). As determination of IgV(H) mutational status involves a methodology currently unavailable for most clinical laboratories, it is ...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章


    authors: Marquez ME,Deglesne PA,Suarez G,Romano E

    更新日期:2011-04-01 00:00:00

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    abstract:INTRODUCTION:The Sysmex XP-300(®) (XP-300) is a new, fully automated hematology analyzer, designed to generate complete blood counts (CBC) with 3-part differential. In our study, the XP-300 was evaluated as a point-of-care (POC) analyzer in an oncology setting. In which blood samples from patients with different pathol...

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    pub_type: 杂志文章,随机对照试验


    authors: van Dievoet MA,Louagie H,Ghys T

    更新日期:2016-10-01 00:00:00

  • Red cell membrane disorders.

    abstract::Significant advances have been made in our understanding of the structural basis for altered cell function in various inherited red cell membrane disorders with reduced red cell survival and resulting hemolytic anemia. The current review summarizes these advances as they relate to defining the molecular and structural...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章,评审


    authors: Narla J,Mohandas N

    更新日期:2017-05-01 00:00:00

  • Limitation of the activated partial thromboplastin time as a monitoring method of the direct thrombin inhibitor argatroban.

    abstract:BACKGROUND:Argatroban is licensed for patients with heparin-induced thrombocytopenia and monitoring is conventionally by activated partial thromboplastin time (APTT) ratio with a target of 1.5-3.0 and not exceeding 100 s. The APTT may be influenced by coagulopathies, lupus anticoagulant and raised FVIII levels. Variabl...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章


    authors: Guy S,Kitchen S,Maclean R,Van Veen JJ

    更新日期:2015-12-01 00:00:00

  • IgG subclasses of FVIII inhibitors in an argentine cohort of severe hemophilia A patients: Analysis by flow cytometry.

    abstract:INTRODUCTION:FVIII inhibitors consist of a polyclonal population of antibodies. Previous studies have demonstrated different distribution of IgG subclasses. IgG4 was associated to high level of FVIII inhibitors and failure of immune tolerance induction (ITI) treatment. This study monitored the relative distribution of ...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章


    authors: Irigoyen MB,Primiani L,Felippo M,Candela M,de Bracco MME,Galassi NV

    更新日期:2017-12-01 00:00:00

  • CD34, RAB20, PU.1 and GFI1 mRNA expression in myelodysplastic syndrome.

    abstract::Myelodysplastic syndrome (MDS) with hypocellular bone marrow (BM) is often difficult to distinguish from aplastic anemia (AA). Furthermore, the diagnosis of MDS with low blast counts and normal karyotype may be problematic. These issues highlight the need for a reliable marker for the diagnosis of MDS. This study was ...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章


    authors: Huh HJ,Chae SL,Lee M,Hong KS,Mun YC,Seong CM,Chung WS,Huh JW

    更新日期:2009-06-01 00:00:00

  • Evaluation of automated capillary complete blood counts for routine clinical decision making in a large cohort of hematological patients, using Mindray BC-3000 Plus Auto and Sysmex XE-5000 hematology analyzers.

    abstract:INTRODUCTION:Venous blood (VB) sampling for complete blood count (CBC) via venipuncture is the basic method for the daily evaluation of hematological patients. However, several issues during this process, such as venipuncture difficulty and repetitive attempts, may cause pain, phlebitis, hematomas, inadequate sampling,...

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    pub_type: 杂志文章


    authors: Oudatzis G,Tsagarakis NJ,Paterakis G,Vasileiou P,Xenou E,Maraki P,Pangrati T,Angelopoulou MK,Vassilakopoulos TP,Konstantopoulos K

    更新日期:2020-10-01 00:00:00

  • Paediatric reference intervals for common coagulation assays in Chinese children as performed on the STA-R coagulation analyzer.

    abstract:INTRODUCTION:In order to correctly manage the paediatric patients affected with haemostatic disorders, age-appropriate reference intervals should be used. The purpose of this study was to establish age-specific reference intervals for prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (aPT...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章


    authors: Liu J,Dai Y,Yuan E,Li Y,Wang Q,Wang L,Su Y

    更新日期:2019-10-01 00:00:00

  • Real-world assay variability between laboratories in monitoring of recombinant factor IX Fc fusion protein activity in plasma samples.

    abstract:INTRODUCTION:Monitoring of factor IX (FIX) replacement therapy in haemophilia B relies on accurate coagulation assays. However, considerable interlaboratory variability has been reported for one-stage clotting (OSC) assays. This study aimed to evaluate the real-world, interlaboratory variability of routine FIX activity...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章,多中心研究


    authors: Sommer JM,Sadeghi-Khomami A,Barnowski C,Wikén M,Willemze AJ

    更新日期:2020-06-01 00:00:00

  • Gene expression risk signatures maintain prognostic power in multiple myeloma despite microarray probe set translation.

    abstract:INTRODUCTION:Gene expression profiling (GEP) risk models in multiple myeloma are based on 3'-end microarrays. We hypothesized that GEP risk signatures could retain prognostic power despite being translated and applied to whole-transcript microarray data. METHODS:We studied CD138-positive bone marrow plasma cells in a ...

    journal_title:International journal of laboratory hematology

    pub_type: 临床试验,杂志文章,多中心研究


    authors: Hermansen NE,Borup R,Andersen MK,Vangsted AJ,Clausen NT,Kristensen DL,Nielsen FC,Gimsing P

    更新日期:2016-06-01 00:00:00

  • ICSH guidelines for the standardization of bone marrow specimens and reports.

    abstract::The bone marrow examination is an essential investigation for the diagnosis and management of many disorders of the blood and bone marrow. The aspirate and trephine biopsy specimens are complementary and when both are obtained, they provide a comprehensive evaluation of the bone marrow. The final interpretation requir...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章,实务指引


    authors: Lee SH,Erber WN,Porwit A,Tomonaga M,Peterson LC,International Council for Standardization In Hematology.

    更新日期:2008-10-01 00:00:00

  • Analytical comparison between two hematological analyzer systems: CAL-8000 vs. XN-9000.

    abstract:INTRODUCTION:This study was aimed to compare the analytical performance of traditional and new parameters and morphological flags of CAL-8000 and XN-9000. The automated differential leukocyte count (DIFF profile) and morphological flags were compared with optical microscopy (OM). METHODS:A total of 1025 peripheral blo...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章


    authors: Buoro S,Mecca T,Seghezzi M,Manenti B,Azzarà G,Dominoni P,Crippa A,Ottomano C,Lippi G

    更新日期:2017-04-01 00:00:00

  • Osmotic gradient ektacytometry: A valuable screening test for hereditary spherocytosis and other red blood cell membrane disorders.

    abstract:INTRODUCTION:New generation osmotic gradient ektacytometry has become a powerful procedure for measuring red blood cell deformability and therefore for the diagnosis of red blood cell membrane disorders. In this study, we aim to provide further support to the usefulness of osmotic gradient ektacytometry for the differe...

    journal_title:International journal of laboratory hematology

    pub_type: 临床试验,杂志文章


    authors: Llaudet-Planas E,Vives-Corrons JL,Rizzuto V,Gómez-Ramírez P,Sevilla Navarro J,Coll Sibina MT,García-Bernal M,Ruiz Llobet A,Badell I,Velasco-Puyó P,Dapena JL,Mañú-Pereira MM

    更新日期:2018-02-01 00:00:00

  • Inappropriate use of protein C, protein S, and antithrombin testing for hereditary thrombophilia screening: an experience from a large university hospital.

    abstract:INTRODUCTION:Deficiencies of protein C, protein S, and antithrombin are the main inherited risk factors in Thai patients with venous thromboembolism, although the prevalence is not high. METHODS:To evaluate the appropriate use of the testing for these proteins, the test orders of 503 patients were retrospectively revi...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章


    authors: Tientadakul P,Chinthammitr Y,Sanpakit K,Wongwanit C,Nilanont Y

    更新日期:2011-12-01 00:00:00

  • Diagnostic and prognostic utility of WBC counts and cell population data in patients with COVID-19.

    abstract:INTRODUCTION:Early diagnosis and identification of potential critical cases for timely treatment are crucial for COVID-19 patients. The aim of this study was to analyze the diagnostic and prognostic implications of WBC and cell population data (CPD) abnormalities related to COVID-19 at disease onset. METHODS:Baseline ...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章


    authors: Naoum FA,Ruiz ALZ,Martin FHO,Brito THG,Hassem V,Oliveira MGL

    更新日期:2020-11-15 00:00:00

  • An investigation of the protective effect of alpha+-thalassaemia against severe Plasmodium falciparum amongst children in Kumasi, Ghana.

    abstract:INTRODUCTION:Several factors influence the severity of Plasmodium falciparum; here, we investigate the impact of alpha+-thalassaemia genotype on P. falciparum parasitemia and prevalence of severe anaemia amongst microcytic children from Kumasi, Ghana. METHODS:Seven hundred and thirty-two children (≤10 years) with P. f...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章


    authors: Opoku-Okrah C,Gordge M,Kweku Nakua E,Abgenyega T,Parry M,Robertson C,Smith CL

    更新日期:2014-02-01 00:00:00

  • The clinical utility of new reticulocyte and erythrocyte parameters on the Sysmex XN 9000 for iron deficiency in pregnant patients.

    abstract:INTRODUCTION:Iron deficiency (ID) is a major cause of morbidity in pregnancy. Antenatal clinics use a hemoglobin to screen for ID, which delays the diagnosis of subclinical ID. The aim of this study was to investigate the clinical utility of the percentage of microcytic red cells (%Micro-R), percentage of hypochromic r...

    journal_title:International journal of laboratory hematology

    pub_type: 临床试验,杂志文章


    authors: Levy S,Schapkaitz E

    更新日期:2018-12-01 00:00:00

  • The HemoScreen hematology point-of-care device is suitable for rapid evaluation of acute leukemia patients.

    abstract:BACKGROUND:Hematological patients, receiving intensive chemotherapy (predominantly acute leukemia patients), have repeated postchemotherapy periods with severe bone marrow suppression. As a result, these patients require regular monitoring of the complete blood counts (CBC) for optimal patient care. To reduce the strai...

    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章


    authors: Kristian Kur D,Thøgersen D,Kjeldsen L,Friis-Hansen L

    更新日期:2021-02-01 00:00:00

  • Performance evaluation of the new hematology analyzer Sysmex XN-series.

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    journal_title:International journal of laboratory hematology

    pub_type: 杂志文章


    authors: Seo JY,Lee ST,Kim SH

    更新日期:2015-04-01 00:00:00