Background The unresolved COVID‐19 pandemic considerably impacts the health services in Iraq and worldwide. Consecutive waves of mutated virus increased virus spread and further constrained health systems. Although molecular identification of the virus by polymerase chain reaction is the only recommended method in diagnosing COVID‐19 infection, radiological, biochemical, and hematological studies are substantially important in risk stratification, patient follow‐up, and outcome prediction. Aim This narrative review summarized the hematological changes including the blood indices, coagulative indicators, and other associated biochemical laboratory markers in different stages of COVID‐19 infection, highlighting the diagnostic and prognostic significance. Methods Literature search was conducted for multiple combinations of different hematological tests and manifestations with novel COVID‐19 using the following key words: “hematological,” “complete blood count,” “lymphopenia,” “blood indices,” “markers” "platelet" OR "thrombocytopenia" AND "COVID‐19," "coronavirus2019," "2019‐nCoV," OR "SARS‐CoV‐2." Articles written in the English language and conducted on human samples between December 2019 and January 2021 were included. Results Hematological changes are not reported in asymptomatic or presymptomatic COVID‐19 patients. In nonsevere cases, hematological changes are subtle, included mainly lymphocytopenia (80.4%). In severe, critically ill patients and those with cytokine storm, neutrophilia, lymphocytopenia, elevated D‐dimer, prolonged PT, and reduced fibrinogen are predictors of disease progression and adverse outcome. Conclusion Monitoring hematological changes in patients with COVID‐19 can predict patients needing additional care and stratify the risk for severe course of the disease. More studies are required in Iraq to reflect the hematological changes in COVID‐19 as compared to global data.

Background: Acute leukemias (ALs) are a heterogeneous group of malignancies with various clinical, morphological, immunophenotypic, and molecular characteristics. Distinguishing between lymphoid and myeloid leukemia is often performed by flow cytometry. This study aimed to evaluate the immunophenotypic characterization and expression of immuno-markers in both acute myeloid leukemia (AML-M0) and acute T-cell lymphoblastic leukemia (T-ALL). Methods: A retrospective cross-sectional study was conducted in the Pathology Department/Teaching Laboratories/Medical City/Iraq and included all patients newly diagnosed with AL from 5 January to 10 December 2018. Immunophenotypic analysis was performed on bone marrow samples, freshly collected in EDTA tubes. Flow cytometry (Canto-2 BD) was used, with laser excitation of blue and red wavelengths. A panel of monoclonal antibodies (MoAbs) was used for diagnosis, using a SSC/CD45 gating strategy. Results: The study showed 41.6% of AML-M0 patients had no aberrant antigen expression, while 33.3%, 16.6%,  8.3%, and 8.3% had aberrant CD7, CD56, CD2, and CD19, respectively. In 16.6% of AML-M0 cases more than one aberrant antigen was expressed. With regard to T-ALL, 7.0% were pro-T type, 58.0% were pre-T, 13.0% were cortical, and 22.0% were mature-T type. In 55.5% of patients with T-ALL there was no aberrant antigen expression. Conclusion: We concluded that most patients with AML-M0 have no aberrant antigen expression. In patients with T-ALL, the pre-T type is most common, according to the European Group for the Immunological Classification of Leukemias (EGIL) classification. Patients with T-ALL also generally lack aberrant antigen expression.

AIM: The aim of this study was to measure the prevalence of myeloproliferative disorders in a sample of Iraqi patients and to measure the changes in patients’ blood parameters. BACKGROUND: Myeloproliferative disorders are a group of neoplasms affecting the bone marrow progenitor cells characterized by excess cells with a risk of transforming to acute leukemia. There is a gap in knowledge about the prevalence of Iraqi population. Thus, we investigated the prevalence and distribution of different types of myeloproliferative disorders in a sample of Iraqi patients. MATERIALS AND METHODS: Cross-sectional study is done at the National Center of Hematology from November 2019 till March 2020 on 75 patients who were diagnosed by a specialist hematopathologist to have one subtype of myeloproliferative disorders (MPDs). Blood samples were taken from them and analyzed to get complete blood count, blood film, bone marrow aspirate, and biopsy that were analyzed for each patient. Blood samples were taken from them and analyzed in terms of blood indices, which include red blood cells, white blood cells, and platelets. RESULTS: The 75 patients were found to be comprising 35 chronic myelogenous leukemia (CML) patients (46.7%), myelofibrosis 22 patients (29.3%), essential thrombocythemia (ET) 9 patients (12%), and polycythemia vera (PV) 9 patients (12%). In terms of male/female ratios, they were as follows: Myeloproliferative neoplasms (MPNs) male-to-female ratio is 1.2, CML= 0.94, myelofibrosis= 2.14 and ET= 0.5 and PV male-to-female ratio is 2. CONCLUSIONS : MPN male-to-female ratio in Iraq, which is 1.2, CML is the most common subtype. Regarding myelofibrosis, in our study, the male-to-female ratio is 2.14, which is much higher other countries. This could be attributed to high exposure to benzene and toluene which are well known to be causative agents for myelofibrosis. Regarding ET or PV, the male-to-female ratios were compatible with other countries.

Background: There is a great risk of cardiovascular disease (CVD) and vascular thrombosis in patients with End-Stage Renal Disease (ESRD). These patients exhibit numerous abnormalities in coagulation, fibrinolytic, inhibitory protein abnormalities in multiple levels. Aim:To assess hypercoagulable changes by measuring the levels of Antithrombin, plasma fibrinogen and FXII activity in patients with ESRD, and to found correlation between and hematological parameters including: Hb level, WBC count, reticulocyte percentage and platelet count.Method: A case control study conducted at Al-Hayat center, Al Karama teaching hospital during the period from the 1 of February to the 30 of October 2014 and 50 patients aged < 60 years of both genders with (ESRD) in addition to 20 apparently healthy controls were included in this study.Results: Patients and controls were matched for age and gender. The mean hemoglobin level, total WBC count, absolute neutrophil count, reticulocyte percentage and platelets count were significantly lower in ESRD patients than controls, P<0.05. The mean values of the coagulation parameters, ProthrombinTtime (PT), Activated Partial Thromboplastin Time (APTT), Plasma Fibrinogen and Factor XII activity were significantly higher in patients than controls. Anti-thrombin activity was significantly lower in patients group than controls, (P<0.001). Cardiovascular complications and vascular thrombosis included Deep Venous Thrombosis( DVT), Cerebro-Vascular-Accident (CVA), Myocardial Infarction (MI), angina or heart failure reported in 62% of the patients. Patients with cardiovascular complication and vascular thrombosis had significantly higher PT, APTT, and factor XII activity, lower anti-thrombin activity as compared to those without cardiovascular complication and vascular thrombosis. Conclusion: (ESRD)patients had coagulation abnormalities render them more liable to have cardiovascular complications and vascular thrombosis.