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Ali U, Knight G, Chopra M, Tsitsikas DA. Reproducibility and stability of the immature platelet fraction using Sysmex XN-10. Scand J Clin Lab Invest 2024; 84:91-96. [PMID: 38420711 DOI: 10.1080/00365513.2024.2321590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/18/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND The Immature Platelet Fraction (IPF) is an indicator of thrombopoiesis which is a useful parameter in thrombocytopenia. It demonstrates compensatory mechanisms in production of platelets, but currently not implemented in routine clinical practice. The aim of this study was to establish the reproducibility and stability of IPF, for both percentage (%-IPF) and absolute (A-IPF) measurements.Material/methods: A total of 71 samples, of which 45 for reproducibility and 26 for stability analysis, were assayed for full blood count using the Sysmex XN-10 analyser at room temperature (RT:19-25 °C). For reproducibility analysis, IPF measurements were analysed 11 times by different appraisers using the same sample, while for stability analysis, IPF was measured over fourteen hourly-intervals up to 24 h (n = 21) and then separately extended beyond the point of stability to 72 h (n = 5). RESULTS Reproducibility analysis of %-IPF and A-IPF (n = 45) showed very reliable results, with the range of mean CV% values between 1.25-8.90% and 1.70-9.96%, respectively. On the other hand, overall, stability analysis of %-IPF and A-IPF (n = 21) at RT over 24 h showed reliable results, with pooled mean CV% values of 1.32% and 1.43%, respectively, with no significant difference between %-IPF and A-IPF (p = 0.767 and p = 0.821). All %-IPF and A-IPF values had exceeded the set acceptance criterion of stability (CV% ≥ 10.0%) before 72 h. CONCLUSIONS Overall, %-IPF and A-IPF reproducibility and storage at RT for 24 h predominantly demonstrates the suitability of their usage for testing on the Sysmex XN-series analysers.
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Affiliation(s)
- Usman Ali
- Department of Haematology, The Royal London Hospital, London, UK
| | - Gavin Knight
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK
| | - Mridula Chopra
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK
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Jornet-Rius O, Mesalles-Naranjo M, Pastor J. Performance of the Sysmex XN-V hematology analyzer in determining the immature platelet fraction in dogs: A preliminary study and reference values. Vet Clin Pathol 2023; 52:433-442. [PMID: 37468992 DOI: 10.1111/vcp.13241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 12/07/2022] [Accepted: 01/13/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Immature platelets (IPs) are newly formed platelets released into circulation that have been demonstrated as good markers of thrombopoiesis. Although many flow cytometric and fully automated-based methods are available, the latest Sysmex XN-V hematology analyzer for veterinary use is equipped with a specific fluorescent platelet channel (PLT-F) that detects platelets using a platelet-specific dye. OBJECTIVES The aims of this study were to evaluate the performance of the Sysmex XSN-1000 V in determining the IPF (immature platelet fraction) and other selected PLT-F channel parameters and to propose IPF reference intervals (RIs) for canine blood samples. METHODS Canine EDTA blood samples were analyzed on the Sysmex XN-1000 V to assess linearity, imprecision, carryover, stability, and the effect of platelet clumping on selected platelet parameters from the PLT-F channel. We also reported the de novo generated RIs for the IPF in dogs. RESULTS Imprecision was acceptable (CV <10%) for all parameters except for the absolute IPF values (IPF#), in which the reproducibility was 12.15% for the normal-low concentration samples. Linearity and carryover were excellent for all variables. Relative IPF values (IPF %) and IPF# remained stable for both storage conditions for up to 48 hours; however, a nonsignificant progressive increase in these parameters was observed from 12 hours at 4°C. We observed a statistical increase in IPF% and IPF# and a statistically significant decrease in PLT-F counts after intentional in vitro platelet aggregation. RIs were generated for all reference samples (n = 69) and for samples with (n = 25) or without (n = 44) platelet clumps. CONCLUSIONS The performance of the new PLT-F channel-derived variables for dogs was excellent. Specific RIs for IPF should be used when platelet aggregates are present.
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Affiliation(s)
- Oriol Jornet-Rius
- Departament de Medicina i Cirurgia Animal, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Montse Mesalles-Naranjo
- Departament de Medicina i Cirurgia Animal, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Josep Pastor
- Departament de Medicina i Cirurgia Animal, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Bellaterra, Spain
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Kobayashi J, Takezawa Y, Saito S, Kubota N, Sakashita K, Nakazawa Y, Higuchi Y, Tozuka M, Ishida F. Immature Platelet Fraction and Its Kinetics in Neonates. J Pediatr Hematol Oncol 2023; 45:e249-e253. [PMID: 35622986 DOI: 10.1097/mph.0000000000002487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 04/19/2022] [Indexed: 11/25/2022]
Abstract
Thrombocytopenia is a common abnormality encountered in the neonatal period, and immature platelet fraction (IPF) may be an informative indicator of thrombopoiesis; however, data on IPF in neonates are scarce. To define reference intervals (RIs) and factors affecting IPF in neonates, we measured the IPF of 533 consecutive neonates. With a multiple regression analysis of 330 newborns with normal platelet counts at birth, premature delivery, neonatal asphyxia, intrauterine infection, chromosomal abnormalities, and respiratory disorders were identified as independent factors for IPF%. The RIs of IPF% and absolute IPF value in neonates were determined to be 1.3% to 5.7% and 3.2 to 14.5×10 9 /L, respectively. On day 14 after birth, IPF% increased to twice the value at birth and thereafter returned to the previous value on day 28. Reticulocyte counts, in contrast, were the lowest at day 14. IPF% was increased in 16 thrombocytopenic patients with various clinical conditions, especially those with immune-mediated thrombocytopenia. IPF in neonates may be evaluated essentially based on the same RIs as in adults, although some precautions must be taken when evaluating IPF in neonates in the first 2 weeks of life. IPF may be useful for evaluating thrombopoiesis and thrombocytopenia in neonates.
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Affiliation(s)
- Jun Kobayashi
- Department of Medical Sciences, Graduate School of Medicine, Science and Technology, Shinshu University
- Departments of Laboratory Medicine
- Life Science Research Center, Nagano Children's Hospital, Azumino, Nagano Prefecture, Japan
| | - Yuka Takezawa
- Department of Laboratory Medicine, Shinshu University Hospital
| | | | - Noriko Kubota
- Departments of Laboratory Medicine
- Life Science Research Center, Nagano Children's Hospital, Azumino, Nagano Prefecture, Japan
| | - Kazuo Sakashita
- Hematology and Oncology
- Life Science Research Center, Nagano Children's Hospital, Azumino, Nagano Prefecture, Japan
| | | | - Yumiko Higuchi
- Department of Medical Sciences, Graduate School of Medicine, Science and Technology, Shinshu University
- Biomedical Laboratory Sciences, Shinshu University School of Medicine, Matsumoto
| | - Minoru Tozuka
- Departments of Laboratory Medicine
- Life Science Research Center, Nagano Children's Hospital, Azumino, Nagano Prefecture, Japan
| | - Fumihiro Ishida
- Department of Medical Sciences, Graduate School of Medicine, Science and Technology, Shinshu University
- Biomedical Laboratory Sciences, Shinshu University School of Medicine, Matsumoto
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Kuhn A, Weiler K, Gibbs G, Prechtl G, Bauer N, Moritz A. Evaluation of a novel moving threshold gating strategy for assessment of reticulated platelets in dogs using the ADVIA 2120 analyzer. Vet Clin Pathol 2023; 52:11-21. [PMID: 36284074 DOI: 10.1111/vcp.13168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 04/16/2022] [Accepted: 05/16/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND A novel method using a moving threshold (r-PLTmt) to determine canine r-PLTs (reticulated platelets) has been introduced for ADVIA 2120 software v6.11.7. OBJECTIVES We aimed to evaluate absolute (ar-PLTmt) and percent (%r-PLTmt) prior to and after visual inspection of scattergrams (ar-PLTmtv, %rPLTmtv) compared with flow cytometry (flow) and to determine reference intervals (RIs) in 120 dogs. METHODS For method comparison, 42 blood samples of healthy and thrombocytopenic dogs were included. Calculation of Spearman's rho, Bland-Altman, and Passing-Bablok analysis was performed. Coefficients of variation (CVs) were determined for three concentration levels. RESULTS Moderate correlations between %r-PLTmt and %r-PLTmtv (rs 0.75-0.76) were seen compared with flow cytometry. The CV for medium %r-PLTs counts assessed with flow cytometry was 12.9%. Comparable CVs were obtained for ar-PLTmt (14.4%) and %r-PLTmt (15.7%), and ar-PLTmtv and %r-PLTmtv (10.9% and 12.9%, respectively). At low and high concentration levels, CVs for % and absolute r-PLTmt/rPLTmtv ranged between 23%-30% and 15%-20%. In patients with microcytic hypochromic erythrocytes, CVs for ar-PLTmt and %r-PLTmt were 36%-66%. Visual inspection of scattergrams resulted in a marked decrease in CV ranging between 15% and 20%. A proportional bias of 10.8% between %r-PLTmt and flow cytometry became lower (9.7%) after visual validation of scattergrams. Passing-Bablok analysis showed proportional and constant error. RIs for r-PLTmt and r-PLTmtv were 0.2%-3.8% and 0.6-10.2 × 109 /L and 0.3%-4.5% and 1.1-10.3 × 109 /L, respectively. Median values for %r-PLTmtv were higher in young adults (≤2 years) than in older dogs (P = 0.03). CONCLUSIONS r-PLTmt and r-PLTmtv were moderately correlated with flow cytometry. Visual inspection of scattergrams is recommended.
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Affiliation(s)
- Anja Kuhn
- Clinic for Small Animals, Internal Medicine, Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, Justus Liebig University, Giessen, Germany
| | - Kristina Weiler
- Clinical Pathophysiology and Clinical Pathology, Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, Justus Liebig University, Giessen, Germany
| | - Graham Gibbs
- Siemens Healthcare Laboratory Diagnostics, Sudbury, UK
| | | | - Natali Bauer
- Clinical Pathophysiology and Clinical Pathology, Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, Justus Liebig University, Giessen, Germany
| | - Andreas Moritz
- Clinic for Small Animals, Internal Medicine, Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, Justus Liebig University, Giessen, Germany.,Clinical Pathophysiology and Clinical Pathology, Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, Justus Liebig University, Giessen, Germany
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Harrison TE, Bowler J, Levins TN, Reeves KD. PRPCalc2: An App for Platelet-Rich Plasma Preparation. Cureus 2023; 15:e36099. [PMID: 36937123 PMCID: PMC10016811 DOI: 10.7759/cureus.36099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 03/16/2023] Open
Abstract
Platelet-rich plasma (PRP), an inexpensive yet powerful treatment modality, is widely used but poorly understood. Three areas of unmet need are the ability to compare results using differing centrifuges and methods; translating a study result into a specific practice; and estimating yield and dosage without the benefit of an in-office hematology analyzer. PRPCalc2 is a set of software tools that facilitates these goals. The app consists of software tools that (1) calculate the appropriate radius for centrifugation, (2) calculate the correct revolutions per minute (RPM) for the centrifuge, (3) calculate the mean yield for the method and its confidence interval, and (4) calculate platelet dosage. Using these tools, a practitioner with any centrifuge can create and validate their own PRP preparation method and then use it to create a standardized PRP.
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Affiliation(s)
| | | | - Todd N Levins
- Regenerative Medicine, Private Practice, Victoria, CAN
| | - K Dean Reeves
- Rehabilitation Medicine, Private Practice, Kansas City, USA
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Soulard M, Croix P, Cohen P. Comparison of platelet count results on the Sysmex XN between citrate or MgSO 4 and K2 EDTA anticoagulants. Int J Lab Hematol 2023; 45:20-28. [PMID: 36093831 PMCID: PMC10087425 DOI: 10.1111/ijlh.13966] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/13/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The aim of this study performed on Sysmex XN is to compare platelet values on citrate and MgSO4 (TBX) in patients with K2EDTA-induced platelet clusters and to identify platelet biases of these matrices compared to K2EDTA. METHODS Sixty patients with K2EDTA-induced platelet clusters were re-sampled with K2EDTA, citrate and TBX. Platelet results were then compared, and smears were analysed for clumping. Platelet results from 120 patients without K2EDTA-induced platelet clusters were compared between K2 EDTA, citrate, and MgSO4 with impedance and fluorescence modes. Biases from regressions were analysed. RESULTS Out of the 60 patients with K2EDTA-induced platelet clusters, none showed platelet clusters with MgSO4 whereas 50% still showed clusters with citrate. Among those without platelet clusters on citrate, the mean relative difference between (citrate- MgSO4 )/MgSO4 was -12.7% in impedance and -9.8% in fluorescence. Among the 120 patients without K2EDTA-induced platelet clusters, in fluorescence the mean relative bias with respect to K2EDTA was -2.06% for MgSO4 and -10.3% for Citrate. For the MgSO4 versus K2 EDTA regressions, the maximum absolute values of the 95% CI of the relative biases at 150 × 109 /L (5.45%) and 450 × 109 /L (3.56%) were below the desirable analytical objectives of the EFLM. CONCLUSION In patients with K2EDTA-induced platelet clusters, MgSO4 is preferable to citrate. MgSO4 provides a bias with XN in fluorescence when compared to EDTA which is within analytical tolerance.
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Affiliation(s)
- Michel Soulard
- Biogroup Hematology LaboratoryLa ChocolaterieLevallois PerretFrance
| | - Pascale Croix
- Biogroup Hematology LaboratoryLa ChocolaterieLevallois PerretFrance
| | - Patrick Cohen
- Division of Laboratory Medicine, Diagnostic DepartmentGeneva University Hospitals and Faculty of MedicineGenevaSwitzerland
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Sandberg S, Carobene A, Bartlett B, Coskun A, Fernandez-Calle P, Jonker N, Díaz-Garzón J, Aarsand AK. Biological variation: recent development and future challenges. Clin Chem Lab Med 2022; 61:741-750. [PMID: 36537071 DOI: 10.1515/cclm-2022-1255] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 02/18/2023]
Abstract
Abstract
Biological variation (BV) data have many applications in laboratory medicine. However, these depend on the availability of relevant and robust BV data fit for purpose. BV data can be obtained through different study designs, both by experimental studies and studies utilizing previously analysed routine results derived from laboratory databases. The different BV applications include using BV data for setting analytical performance specifications, to calculate reference change values, to define the index of individuality and to establish personalized reference intervals. In this review, major achievements in the area of BV from last decade will be presented and discussed. These range from new models and approaches to derive BV data, the delivery of high-quality BV data by the highly powered European Biological Variation Study (EuBIVAS), the Biological Variation Data Critical Appraisal Checklist (BIVAC) and other standards for deriving and reporting BV data, the EFLM Biological Variation Database and new applications of BV data including personalized reference intervals and measurement uncertainty.
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Affiliation(s)
- Sverre Sandberg
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital , Bergen , Norway
- Department of Medical Biochemistry and Pharmacology , Norwegian Porphyria Centre, Haukeland University Hospital , Bergen , Norway
- Department of Global Public Health and Primary Care , University of Bergen , Bergen , Norway
| | - Anna Carobene
- Laboratory Medicine, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Bill Bartlett
- School of Science and Engineering, University of Dundee , Dundee , Scotland
| | - Abdurrahman Coskun
- Acibadem Mehmet Ali Aydınlar University, School of Medicine , Istanbul , Türkiye
| | - Pilar Fernandez-Calle
- Hospital Universitario La Paz, Quality Analytical Commission of Spanish Society of Clinical Chemistry (SEQC) , Madrid , Spain
| | - Niels Jonker
- Certe, Wilhelmina Ziekenhuis Assen , Assen , The Netherlands
| | - Jorge Díaz-Garzón
- Hospital Universitario La Paz, Quality Analytical Commission of Spanish Society of Clinical Chemistry (SEQC) , Madrid , Spain
| | - Aasne K. Aarsand
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital , Bergen , Norway
- Department of Medical Biochemistry and Pharmacology , Norwegian Porphyria Centre, Haukeland University Hospital , Bergen , Norway
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Walle M, Asrie F, Gelaw Y, Getaneh Z. The role of platelet parameters for the diagnosis of preeclampsia among pregnant women attending at the University of Gondar Comprehensive Specialized Hospital antenatal care unit, Gondar, Ethiopia. J Clin Lab Anal 2022; 36:e24305. [PMID: 35202493 PMCID: PMC8993625 DOI: 10.1002/jcla.24305] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/22/2022] [Accepted: 02/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background Preeclampsia (PE) is a pregnancy‐related illness characterized by high blood pressure (BP) and proteinuria after the 20th gestational week (GW). Platelet (PLT) parameter changes are the common hematological abnormalities observed in PE patients. The main aim of this study was to assess the role of PLT parameters for PE diagnosis among pregnant women. Methods A comparative cross‐sectional study was conducted at the University of Gondar Specialized Hospital. A total of 126 pregnant women (63 normotensive [NT] and 63 PE) were recruited using a convenient sampling method. Three milliliter blood was collected from each participant, and PLT parameters were determined using Sysmex XS‐500i analyzer. An independent t‐test supplemented with receiver‐operating characteristics (ROC) were used for comparisons and diagnostic value of PLT parameters between the study groups. Results Platelet count (PC) was significantly lower in the PE group compared to that in the NT group, whereas mean platelet volume (MPV), platelet large cell ratio (P‐LCR), and platelet distribution width (PDW) were significantly higher in PE. MPV had the largest area under the curve (AUC) [0.91: 95% CI; 0.85–0.96] followed by PC [0.79: 95% CI; 0.72–0.87]. MPV can differentiate PE patients from NT pregnant women at cut‐off value ≥12.10 fl (84.1% sensitivity and 87.3% specificity) while PC can indicate PE at a cut‐off value ≤176.5 × 109/L (65.1% sensitivity and 87.3% specificity). Conclusion A decreased PC and an increased MPV, P‐LCR, and PDW can be used as a simple, cost‐effective, quick, and reliable method of PE screening. Of them, MPV is the best indicator of PE.
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Affiliation(s)
- Muluken Walle
- Department of Medical laboratory science, College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Fikir Asrie
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yemataw Gelaw
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zegeye Getaneh
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Kim H, Hur M, Lee GH, Kim SW, Moon HW, Yun YM. Performance of Platelet Counting in Thrombocytopenic Samples: Comparison between Mindray BC-6800Plus and Sysmex XN-9000. Diagnostics (Basel) 2021; 12:diagnostics12010068. [PMID: 35054235 PMCID: PMC8775070 DOI: 10.3390/diagnostics12010068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/27/2021] [Accepted: 12/27/2021] [Indexed: 11/16/2022] Open
Abstract
The performance of platelet (PLT) counting in thrombocytopenic samples is crucial for transfusion decisions. We compared PLT counting and its reproducibility between Mindray BC-6800Plus (BC-6800P, Mindray, Shenzhen, China) and Sysmex XN-9000 (XN, Sysmex, Kobe, Japan), especially focused on thrombocytopenic samples. We analyzed the correlation and agreement of PLT-I channels in both analyzers and BC-6800P PLT-O mode and XN PLT-F channel in 516 samples regarding PLT counts. Ten thrombocytopenic samples (≤2.0 × 109/L by XN PLT-F) were measured 10 times to investigate the reproducibility with the desirable precision criterion, 7.6%. The correlation of BC-6800P PLT-I and XN PLT-I was arranged moderate to very high; but the correlation of BC-6800P PLT-O and XN PLT-F was arranged high to very high. Both BC-6800P PLT-I vs. XN PLT-I and BC-6800P PLT-O vs. XN PLT-F showed very good agreement (κ = 0.93 and κ = 0.94). In 41 discordant samples between BC-6800P PLT-O and XN PLT-F at transfusion thresholds, BC-6800P PLT-O showed higher PLT counts than XN-PLT-F, except the one case. BC-6800P PLT-O exceeded the precision criterion in one of 10 samples; but XN PLT-F exceeded it in six of 10 samples. BC-6800P would be a reliable option for PLT counting in thrombocytopenic samples with good reproducibility.
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Affiliation(s)
| | - Mina Hur
- Correspondence: ; Tel.: +82-2-2030-5581
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Wang S, Zhao M, Su Z, Mu R. Annual biological variation and personalized reference intervals of clinical chemistry and hematology analytes. Clin Chem Lab Med 2021; 60:606-617. [PMID: 34773728 DOI: 10.1515/cclm-2021-0479] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 10/28/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES A large number of people undergo annual health checkup but accurate laboratory criterion for evaluating their health status is limited. The present study determined annual biological variation (BV) and derived parameters of common laboratory analytes in order to accurately evaluate the test results of the annual healthcare population. METHODS A total of 43 healthy individuals who had regular healthcare once a year for six consecutive years, were enrolled using physical, electrocardiogram, ultrasonography and laboratory. The annual BV data and derived parameters, such as reference change value (RCV) and index of individuality (II) were calculated and compared with weekly data. We used annual BV and homeostatic set point to calculate personalized reference intervals (RIper) which were compared with population-based reference intervals (RIpop). RESULTS We have established the annual within-subject BV (CVI), RCV, II, RIper of 24 commonly used clinical chemistry and hematology analytes for healthy individuals. Among the 18 comparable measurands, CVI estimates of annual data for 11 measurands were significantly higher than the weekly data. Approximately 50% measurands of II were <0.6, the utility of their RIpop were limited. The distribution range of RIper for most measurands only copied small part of RIpop with reference range index for 8 measurands <0.5. CONCLUSIONS Compared with weekly BV, for annual healthcare individuals, annual BV and related parameters can provide more accurate evaluation of laboratory results. RIper based on long-term BV data is very valuable for "personalized" diagnosis on annual health assessments.
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Affiliation(s)
- Shuo Wang
- Department of Laboratory Medicine, The First Hospital of China Medical University, National Clinical Research Center for Laboratory Medicine, Shenyang, Liaoning, P.R. China
| | - Min Zhao
- Department of Laboratory Medicine, The First Hospital of China Medical University, National Clinical Research Center for Laboratory Medicine, Shenyang, Liaoning, P.R. China
| | - Zihan Su
- Department of Laboratory Medicine, The First Hospital of China Medical University, National Clinical Research Center for Laboratory Medicine, Shenyang, Liaoning, P.R. China
| | - Runqing Mu
- Department of Laboratory Medicine, The First Hospital of China Medical University, National Clinical Research Center for Laboratory Medicine, Shenyang, Liaoning, P.R. China
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Lifson MA, Wakui M, Arai T, Mitsuhashi T, Lakos G, Murata M. Alinity hq platelet results are equivalent with the international reference method in thrombocytopenic samples. Int J Lab Hematol 2021; 43:1357-1362. [PMID: 34224209 DOI: 10.1111/ijlh.13604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/15/2021] [Accepted: 05/01/2021] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Accurate and precise platelet (PLT) count is critical for the appropriate management of patients with thrombocytopenia. This study evaluated the performance of PLT counting with the Abbott Alinity hq hematology analyzer, which utilizes multi-dimensional optical technology. METHODS Imprecision, linearity, and accuracy were assessed per CLSI guidelines. Alinity hq PLT results were compared to the international flow cytometry reference method (IRM) in the concentration range of 6.3 to 103.0 × 109 /L. Additional comparisons were made with Sysmex XN-3000 PLT counts: impedance (PLT-I), optical (PLT-O), and optical fluorescent (PLT-F) methods. RESULTS The average within-run %CV was 4.7% on patient samples with PLT concentrations ranging from 13.1 to 41.7 × 109 /L, and the within-laboratory %CV was 3.6% at the level of 68.2 × 109 /L. Linearity evaluation indicated a maximum deviation of 3.1% from the linear fit in the range of 0.1 to 316.8 × 109 /L. Comparison between Alinity hq and the IRM PLT counts yielded a correlation coefficient of 0.99 and predicted bias of 0.0 and -0.5 × 109 /L at 10.0 and 20.0 × 109 /L transfusion thresholds, respectively. Alinity hq PLT counts also correlated well with Sysmex PLT counts, with strongest correlation obtained with PLT-F and PLT-O (r = .99) methods. CONCLUSION This study demonstrated excellent analytical performance of Alinity hq PLT counting in thrombocytopenic samples, equivalency with the IRM and strong agreement with Sysmex PLT-F and PLT-O methods. The Alinity hq multi-dimensional optical PLT count is available with every CBC without additional reagents and may help promote efficiency in clinical laboratories.
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Affiliation(s)
| | - Masatoshi Wakui
- Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Tomoko Arai
- Clinical Laboratory, Keio University Hospital, Tokyo, Japan
| | - Takayuki Mitsuhashi
- Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan
| | | | - Mitsuru Murata
- Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan
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12
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Wirestam L, Gullstrand B, Jern A, Jönsen A, Linge P, Tydén H, Kahn R, Bengtsson AA. Low Intra-Individual Variation in Mean Platelet Volume Over Time in Systemic Lupus Erythematosus. Front Med (Lausanne) 2021; 8:638750. [PMID: 33959622 PMCID: PMC8093559 DOI: 10.3389/fmed.2021.638750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/23/2021] [Indexed: 12/13/2022] Open
Abstract
Platelets have recently emerged as important immune modulators in systemic lupus erythematosus (SLE), in addition to their role in thrombosis and cardiovascular disease. However, studies investigating mean platelet volume (MPV) in SLE are often scarce, conflicting and cross-sectional. In this study, MPV was measured in clinical routine throughout a defined time-period to quantify both individual MPV fluctuations and investigate if such variations are associated with disease activity and clinical phenotypes of SLE. Of our 212 patients, 34 patients had only one MPV value reported with the remaining 178 patients having between 2 and 19 visits with recorded MPV values. The intra-individual MPV variation was low, with a median variation of 0.7 fL. This was further supported by the finding that 84% of patients stayed within their reference interval category (i.e., small, normal or large) over time. In our cohort, no correlation between disease activity and MPV neither cross-sectionally nor longitudinally was found. Mean platelet volume values were significantly smaller in SLE patients (mean 10.5 fL) compared to controls (mean 10.8 fL), p < 0.0001. Based on the reference interval, 2.4% (n = 5) of patients had large-sized platelets, 84.4% (n = 179) had normal-sized and 13.2% (n = 28) had small-sized. A larger proportion (85.7%) of patients with small-sized platelets met the anti-dsDNA criterion (ACR10b; p = 0.003) compared to patients with normal and large (57.6%) sized platelets. In conclusion, the intra-individual MPV variation was of low magnitude and fluctuations in disease activity did not have any significant impact on MPV longitudinally. This lack of variability in MPV over time indicates that measuring MPV at any time-point is sufficient. Further studies are warranted to evaluate MPV as a possible biomarker in SLE, as well as to determine the underlying mechanisms influencing platelet size in SLE.
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Affiliation(s)
- Lina Wirestam
- Section of Rheumatology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Birgitta Gullstrand
- Section of Rheumatology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Andreas Jern
- Section of Rheumatology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Andreas Jönsen
- Section of Rheumatology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Petrus Linge
- Section of Rheumatology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Helena Tydén
- Section of Rheumatology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Robin Kahn
- Section of Pediatrics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.,Wallenberg Centre of Molecular Medicine, Lund University, Lund, Sweden
| | - Anders A Bengtsson
- Section of Rheumatology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
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13
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Napolitano G, Caracciolo A, Apassiti Esposito S, Della Malva N, Manenti B, Guerra G, Ottomano C, Lippi G, Buoro S. Complete Blood Count as point of care testing QBC STAR™: Preliminary evaluation. Int J Lab Hematol 2021; 43:973-982. [PMID: 33750012 DOI: 10.1111/ijlh.13515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Point of care testing (POCT) represents a valuable option when laboratory data shall be urgently available for timely clinical management, with a turnaround time (TAT) that is unfeasible using conventional laboratory instrumentation. This study was aimed to compare the performance of QBC STAR™ compared to Sysmex XN-module and the reference optical microscopy (OM) assessment. MATERIAL AND METHODS One hundred peripheral blood samples, collected in K3 EDTA tubes, and 50 capillary blood samples obtained by finger stick were analyzed with QBC STAR™, Sysmex XN-module, and OM. Data were compared with Passing-Bablok regression and Bland-Altman plots. RESULTS The Passing-Bablok regression analysis (QBC STAR™ capillary sample vs XN-module) yielded slopes comprised between 0.30 and 1.37, while the intercepts ranged between -17.57 and 232.6. Bland-Altman plots yielded relative bias comprised between -4.87% (for MN QBC STAR™ capillary sample vs XN-module) and 27% (PLT QBC STAR™ capillary sample vs XN-module). A significant bias was found for all parameters except MN and WBC, RBC in all and pediatric samples, and HB in adults samples. CONCLUSION The results of this analytical evaluation suggest that QBC STAR™ may not be the ideal tool for performing complete blood count analysis for diagnostic purposes, while it could be more useful in urgent/emergent conditions, such as for rapid monitoring of some hematological parameters (eg, WBC and HB).
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Affiliation(s)
- Gavino Napolitano
- Clinical Chemistry Laboratory, Hospital ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | | | - Nunzia Della Malva
- Clinical Chemistry Laboratory, Hospital ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Barbara Manenti
- Transfusion Medicine, ASST Bergamo Ovest, Hospital Treviglio- Caravaggio, Treviglio, Italy
| | - Giovanni Guerra
- Clinical Chemistry Laboratory, Hospital ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Sabrina Buoro
- Regional Reference Center for the Laboratories Quality, Hospital ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
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14
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Unalli OS, Ozarda Y. Stability of hematological analytes during 48 hours storage at three temperatures using Cell-Dyn hematology analyzer. J Med Biochem 2021; 40:252-260. [PMID: 34177369 DOI: 10.5937/jomb0-27945] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/08/2020] [Indexed: 11/02/2022] Open
Abstract
Background The complete blood count (CBC) with differential leukocyte count (DLC) is one of the most common tests requested by physicians. The results of this test are affected by storage temperature and time of incubation. This study was designed to evaluate the stability of hematologic parameters in blood specimens stored for 48 h at three temperatures. Methods K2-EDTA - blood was collected from 22 healthy adults. The CBC was performed using a hematology analyser immediately; 0 time point and at 4, 8, 12, 16, 20, 24, and 48 h after storage at 4 °C, 10 °C or 23 °C. Changes in values of CBC parameters from the 0 time point were determined and reported as % of the initial value. Results Red blood cells, platelet, hemoglobin, and mean corpuscular hemoglobin were found stable during 48 h storage at 4 °C, 10 °C or 23 °C. Hematocrite and mean corpuscular volume increased, while white blood cells decreased at 48 h when stored at 23 °C. Lymphocytes, neutrophils, eosinophils, and basophils showed significant differences after 12 h of storage at 23 °C. Conclusions Red blood cells, platelet, hemoglobin, and mean corpuscular hemoglobin are the only suitable parameters without refrigeration during 24 h storage. When CBC and DLC are performed, 4 °C can be recommended as the most suitable storage temperature for 12 h storage.
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Affiliation(s)
| | - Yesim Ozarda
- Uludag University, Faculty of Medicine, Department of Medical Biochemistry, Bursa, Turkey
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15
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Vidali M, Carobene A, Apassiti Esposito S, Napolitano G, Caracciolo A, Seghezzi M, Previtali G, Lippi G, Buoro S. Standardization and harmonization in hematology: Instrument alignment, quality control materials, and commutability issue. Int J Lab Hematol 2020; 43:364-371. [PMID: 33174358 DOI: 10.1111/ijlh.13379] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/13/2020] [Accepted: 10/05/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION In the hub and spoke laboratory network, the number of hematology analyzers (HAs) within each core center has increased, and the control of HAs alignment is becoming necessary requirement to ensure analytical quality. In this scenario, HA alignment can be assessed by analyzing the same control material used for internal quality control on multiple HAs, assuming its commutability. The aim of the study was to verify the applicability of a protocol for the alignment of HAs based on control material rather than on fresh whole-blood samples. METHODS The alignment of five HAs was evaluated for red (RBC, Hb, MCV, RET), white (WBC, NE, LY, MO, EO, BA, IG), and platelet (PLT) series parameters, following a protocol by SIBioC, using human sample (HS) and quality control material (QC), after the verification of commutability, according to the IFCC protocol. Maximum bias was derived from biological variation data. RESULTS A complete alignment between instruments was confirmed for the majority of the parameters investigated both for HS and QC material. Partial misalignments or inconcludent results were instead evident for MCV, MO, EO, BA, and IG. Interestingly, QC material was found to be not commutable for LY, MO, and BA. CONCLUSION The alignment of hematologic analyzers for main cell population parameters may be verified with both QC and HS, displaying consistent results and interpretation. The evaluation for some white series parameters (EO, BA, and IG) is critical, and particular attention must be paid to the values of the material used for the alignment.
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Affiliation(s)
- Matteo Vidali
- Clinical Chemistry Unit, Maggiore della Carità Hospital, Novara, Italy
| | - Anna Carobene
- Laboratory Medicine, Ospedale San Raffaele, Milan, Italy
| | | | - Gavino Napolitano
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | | | - Michela Seghezzi
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Giulia Previtali
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Sabrina Buoro
- Clinical Chemistry Laboratory, Hospital Papa Giovanni XXIII, Bergamo, Italy
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16
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Kim H, Hur M, Kim SW, Moon HW, Yun YM. Reference intervals for clinically reportable platelet parameters on the Mindray BC-6800Plus hematology analyzer. Clin Chem Lab Med 2020; 58:e213-e215. [DOI: 10.1515/cclm-2020-0020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 01/22/2020] [Indexed: 01/29/2023]
Affiliation(s)
- Hanah Kim
- Department of Laboratory Medicine , Konkuk University School of Medicine, Konkuk University Medical Center , Seoul , Korea
| | - Mina Hur
- Department of Laboratory Medicine , Konkuk University School of Medicine, Konkuk University Medical Center , Seoul , Korea
| | - Seung-Wan Kim
- Department of Laboratory Medicine , Konkuk University School of Medicine, Konkuk University Medical Center , Seoul , Korea
| | - Hee-Won Moon
- Department of Laboratory Medicine , Konkuk University School of Medicine, Konkuk University Medical Center , Seoul , Korea
| | - Yeo-Min Yun
- Department of Laboratory Medicine , Konkuk University School of Medicine, Konkuk University Medical Center , Seoul , Korea
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17
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Dima F, Salvagno GL, Danese E, Veneri D, Lippi G. An unusual case of sodium citrate-dependent artifactual platelet count. Interv Med Appl Sci 2020; 11:193-196. [PMCID: PMC9467333 DOI: 10.1556/1646.11.2019.24] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 07/24/2019] [Indexed: 11/19/2022] Open
Abstract
Background Ethylenediaminetetraacetic acid (EDTA)-dependent pseudothrombocytopenia is a rare phenomenon. Spurious pseudothrombocytopenia has also been described in other circumstances, while artifactual platelet count in whole blood samples anticoagulated with sodium citrate is an exceptional occurrence. Case report In this study, we describe the case of a 44-year-old ostensibly healthy woman who attended the local outpatient clinic for routine laboratory testing, including platelet count in EDTA and sodium citrate, for suspected artifactual pseudothrombocytopenia previously identified in another center. The results of hematological testing on both specimens were essentially normal, except for mild anemia. Nevertheless, the platelet number was 425 × 109/L in K2EDTA and 266 × 109/L (293 × 109/L after correcting for sample dilution) in sodium citrate, respectively. Microscopic revision of blood smears revealed the presence of platelet aggregates and satellitism only in the sodium citrate specimen. Conclusion Unlike previous occasional reports of concomitant EDTA- and sodium citrate-dependent pseudothrombocytopenia, we first describe a paradigmatic case of artifactual platelet count attributable to platelet clumping and satellitism, exclusively developing in blood anticoagulated with sodium citrate.
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Affiliation(s)
- Francesco Dima
- 1 Section of Clinical Biochemistry, University Hospital of Verona, Verona, Italy
| | - Gian Luca Salvagno
- 1 Section of Clinical Biochemistry, University Hospital of Verona, Verona, Italy
| | - Elisa Danese
- 1 Section of Clinical Biochemistry, University Hospital of Verona, Verona, Italy
| | - Dino Veneri
- 2 Hematology Section, Department of Medicine, University of Verona, Verona, Italy
| | - Giuseppe Lippi
- 1 Section of Clinical Biochemistry, University Hospital of Verona, Verona, Italy
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18
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Coskun A, Braga F, Carobene A, Tejedor Ganduxe X, Aarsand AK, Fernández-Calle P, Díaz-Garzón Marco J, Bartlett W, Jonker N, Aslan B, Minchinela J, Boned B, Gonzalez-Lao E, Marques-Garcia F, Perich C, Ricos C, Simón M, Sandberg S. Systematic review and meta-analysis of within-subject and between-subject biological variation estimates of 20 haematological parameters. Clin Chem Lab Med 2020; 58:25-32. [PMID: 31503541 DOI: 10.1515/cclm-2019-0658] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 08/07/2019] [Indexed: 01/06/2023]
Abstract
Background Interpretation of the complete blood count (CBC) parameters requires reliable biological variation (BV) data. The aims of this study were to appraise the quality of publications reporting BV data for CBC parameters by applying the BV Data Critical Appraisal Checklist (BIVAC) and to deliver global BV estimates based on BIVAC compliant studies. Methods Relevant publications were identified by a systematic literature search and evaluated for their compliance with the 14 BIVAC criteria, scored as A, B, C or D, indicating decreasing compliance. Global CVI and CVG estimates with 95% CI were delivered by a meta-analysis approach using data from BIVAC compliant papers (grades A-C). Results In total, 32 studies were identified; four received a BIVAC grade A, 2 B, 20 C and 6 D. Meta-analysis derived CVI and CVG estimates were generally lower or in line with those published in a historical BV database available online. Except for reticulocytes, CVI estimates of erythrocyte related parameters were below 3%, whereas platelet (except MPV and PDW) and leukocyte related parameters ranged from 5% to 15%. Conclusions A systematic review of CBC parameters has provided updated, global estimates of CVI and CVG that will be included in the newly published European Federation of Clinical Chemistry and Laboratory Medicine BV Database.
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Affiliation(s)
- Abdurrahman Coskun
- Acibadem Mehmet Ali Aydınlar University, School of Medicine, Department of Medical Biochemistry Atasehir, Istanbul, Turkey, Phone: +90 532 744 66 83, Fax: +90 216 576 51 20
| | - Federica Braga
- Research Centre for Metrological Traceability in Laboratory Medicine (CIRME), University of Milan, Milan, Italy
| | - Anna Carobene
- Servizio Medicina di Laboratorio, Ospedale San Raffaele, Milan, Italy
| | - Xavier Tejedor Ganduxe
- Metropolitana Nord Clinical Laboratory (LCMN), Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Aasne K Aarsand
- Department of Medical Biochemistry and Pharmacology, Norwegian Porphyria Centre (NAPOS), Haukeland University Hospital, Bergen, Norway.,Norwegian Organization for Quality Improvement of Laboratory Examinations (NOKLUS), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Pilar Fernández-Calle
- Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain.,Analytical Quality Commission, Spanish Society of Laboratory Medicine (SEQCML), Barcelona, Spain
| | - Jorge Díaz-Garzón Marco
- Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain.,Analytical Quality Commission, Spanish Society of Laboratory Medicine (SEQCML), Barcelona, Spain
| | - William Bartlett
- College of Medicine, Dentistry and Nursing, Dundee University, Dundee, Scotland, UK
| | - Niels Jonker
- Certe, Wilhelmina Ziekenhuis Assen, Assen, The Netherlands
| | - Berna Aslan
- Institute for Quality Management in Healthcare (IQMH), Centre for Proficiency Testing, Toronto, Ontario, Canada
| | - Joana Minchinela
- Analytical Quality Commission, Spanish Society of Laboratory Medicine (SEQCML), Barcelona, Spain.,Metropolitana Nord Clinical Laboratory (LCMN), Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Beatriz Boned
- Analytical Quality Commission, Spanish Society of Laboratory Medicine (SEQCML), Barcelona, Spain.,Royo Villanova Hospital, Zaragoza, Spain
| | - Elisabet Gonzalez-Lao
- Analytical Quality Commission, Spanish Society of Laboratory Medicine (SEQCML), Barcelona, Spain.,Quality Healthcare Consulting, Grupo ACMS, Madrid, Spain
| | - Fernando Marques-Garcia
- Analytical Quality Commission, Spanish Society of Laboratory Medicine (SEQCML), Barcelona, Spain.,Department of Clinical Biochemistry, University Hospital of Salamanca, Salamanca, Spain
| | - Carmen Perich
- Analytical Quality Commission, Spanish Society of Laboratory Medicine (SEQCML), Barcelona, Spain.,Clinic Laboratory Hospital Vall d'Hebron, Barcelona, Spain
| | - Carmen Ricos
- Analytical Quality Commission, Spanish Society of Laboratory Medicine (SEQCML), Barcelona, Spain
| | - Margarita Simón
- Analytical Quality Commission, Spanish Society of Laboratory Medicine (SEQCML), Barcelona, Spain.,Intercomarcal Laboratory Consortiums of Alt Penedès, Anoia and Garraf, Barcelona, Spain
| | - Sverre Sandberg
- Department of Medical Biochemistry and Pharmacology, Norwegian Porphyria Centre (NAPOS), Haukeland University Hospital, Bergen, Norway.,Norwegian Organization for Quality Improvement of Laboratory Examinations (NOKLUS), Haraldsplass Deaconess Hospital, Bergen, Norway.,Department of Global Health and Primary Care, Faculty of Medicine, University of Bergen, Norway
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19
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Li C, Peng M, Wu J, Du Z, Lu H, Zhou W. Long-term biological variation estimates of 13 hematological parameters in healthy Chinese subjects. Clin Chem Lab Med 2020; 58:1282-1290. [PMID: 32069228 DOI: 10.1515/cclm-2019-1141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 12/16/2019] [Indexed: 01/13/2023]
Abstract
Background The complete blood count (CBC) is a basic test routinely ordered by physicians as a part of initial diagnostic work-up on their patients. To ensure safe clinical application of the CBC, reliable biological variation (BV) data are needed to establish analytical performance specifications. Our aim was to define the BV of CBC parameters using a rigorous protocol that is compliant with the Biological Variation Data Critical Appraisal Checklist (BIVAC) provided by the European Federation of Clinical Chemistry and Laboratory Medicine. Methods Blood samples drawn from 41 healthy Chinese subjects (22 females and 19 males; 23-59 years of age) once monthly for 6 consecutive months were analyzed using an ABX Pentra 80 instrument. The instrument was precisely calibrated. All samples were analyzed in duplicate for 13 CBC parameters. The data were assessed for outliers, normality, and variance homogeneity prior to nested ANOVA. Gender-stratified within-subject (CVI) and between-subject (CVG) BV estimates were calculated. Results The number of remaining data for each subject was 442-484 after removing outliers. No significant differences existed between female/male CVI estimates. Except for leukocytes, neutrophils, and lymphocytes, the mean values of 10 parameters differed significantly between genders, rendering partitioning of CVG data between genders. No significant differences were detected between most BV estimates and recently published estimates representing a Europid population. Conclusions Most BV estimates in BIVAC-compliant studies are similar. The turnover time of blood cells and age distribution of participants should be considered in a CBC BV study. Our study will contribute to global BV estimates and future studies.
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Affiliation(s)
- Chenbin Li
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China.,Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Mingting Peng
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China.,Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.,Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Ji Wu
- National Center for Clinical Laboratories, Beijing, P.R. China
| | - Zhongli Du
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China.,Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Hong Lu
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China.,Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Wenbin Zhou
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing, P.R. China.,Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
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20
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Gioia M, Da Rin G, Manenti B, Birindelli S, Ciardelli ML, Gentile R, Beretta G, Lorusso G, Avino D, Di Fabio AM, Dima F, Fanelli A, Lorubbio M, Francione S, Marincheva G, Marini A, Papa A, Giannelli E, Pajola R, Panzeri A, Pipitone S, Benegiamo A, Rolla R, Vidali M, Buoro S. Multicenter evaluation of analytical performances of platelet counts and platelet parameters: Carryover, precision, and stability. Int J Lab Hematol 2020; 42:552-564. [PMID: 32304271 DOI: 10.1111/ijlh.13204] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 03/23/2020] [Accepted: 03/25/2020] [Indexed: 02/05/2023]
Abstract
INTRODUCTION The correctness of the results of automated platelet analysis is still highly debated. The aim of this multicenter study, conducted according to international guidelines, was to verify the analytical performance of nine different types of hematology analyzers (HAs) in the automated platelet analysis. METHODS Four hundred eighty-six peripheral blood samples (PB), collected in K3 EDTA tubes, were analyzed by ABX Pentra, ADVIA2120i, BC-6800, BC-6800 Plus, Cell-DYN Sapphire, DxH800, XE-2100, XE-5000, XN-20 with PLT-F App. Within-run imprecision and between-run imprecision were carried out using PB and material control, respectively. The carryover, low limit of quantification (LoQ), and the PB stability were evaluated. RESULTS The carryover was absent for all HAs. The LoQ of PLT ranged between 2.0 (Cell-Dyn Sapphire) and 25.0 × 109 /L (ADVIA 2120i), while immature platelet fraction (IPF) ranged between 1.0 (XN-20) and 12.0 × 109 /L (XE-5000). The imprecision (%CV) increases as the platelet count decreases. No HAs showed desirable CVAPS for PLT counts less than 50.0 × 109 /L, with the exception of Cell-DYN Sapphire (CV 3.0% with PLT-O mean value of 26.7 × 109 /L), XN-20 (CV 2.4% with PLT-F mean value of 21.5 × 109 /L), and BC-6800 Plus (CV 1.9% with PLT-O mean value of 26.5 × 109 /L). The sample stability ranged between under two hours for MPV by ADVIA2120i and 8 hours for other PLT parameters and HAs. CONCLUSION The findings of this study may provide useful information regarding carryover, precision, and stability of platelet counts and parameters, especially in thrombocytopenic samples. Moreover, the stability of sample for platelet analysis is conditioned by the HA and by temperature and storage time.
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Affiliation(s)
- Maria Gioia
- Clinical Chemistry Laboratory, Abele Ajello Hospital, Mazara del Vallo, Italy
| | - Giorgio Da Rin
- Medicine Laboratory, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Barbara Manenti
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Sarah Birindelli
- Clinical Pathology Unit, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Maria Laura Ciardelli
- Clinical Chemistry Laboratory, Policlinico San Matteo-IRCCS, University of Pavia, Pavia, Italy
| | - Roberto Gentile
- Clinical Chemistry Laboratory, Policlinico San Matteo-IRCCS, University of Pavia, Pavia, Italy
| | - Gianluca Beretta
- Clinical Chemistry Laboratory, Policlinico San Pietro - Istituti Ospedalieri Bergamaschi, San Pietro, Italy
| | - Giuseppe Lorusso
- Clinical Chemistry Laboratory, Policlinico San Pietro - Istituti Ospedalieri Bergamaschi, San Pietro, Italy
| | - Daniela Avino
- Hematological diagnostic Laboratory, P. O. "A. Tortora", Pagani, Italy
| | | | - Francesco Dima
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | | | - Maria Lorubbio
- Laboratory Department, Azienda Ospedaliera Careggi, Florence, Italy
| | - Sara Francione
- Department of Clinical Chemistry and Microbiology, ASL Novara, Borgomanero, Italy
| | - Galina Marincheva
- Department of Clinical Chemistry and Microbiology, ASL Novara, Borgomanero, Italy
| | - Alessandra Marini
- Department of Clinical Chemistry, Versilia Hospital, Lido di Camaiore, Italy
| | - Angela Papa
- Laboratory Medicine, Fondazione G. Monasterio CNR Regione Toscana, Pisa, Italy
| | - Elena Giannelli
- Laboratory Medicine, Fondazione G. Monasterio CNR Regione Toscana, Pisa, Italy
| | - Rachele Pajola
- Clinical Chemistry Laboratory, Ospedali Riuniti Padova Sud Schiavonia, Italy
| | - Andrea Panzeri
- Clinical Pathology Unit, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Silvia Pipitone
- Clinical Chemistry and Hematology Laboratory, University Hospital of Parma, Parma, Italy
| | - Anna Benegiamo
- Clinical Chemistry and Hematology Laboratory, University Hospital of Parma, Parma, Italy
| | - Roberta Rolla
- Clinical Chemistry Laboratory, Department of Health Sciences, Maggiore Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Matteo Vidali
- Clinical Chemistry Laboratory, Department of Health Sciences, Maggiore Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Sabrina Buoro
- Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Bergamo, Italy
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21
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Buttarello M, Mezzapelle G, Freguglia F, Plebani M. Reticulated platelets and immature platelet fraction: Clinical applications and method limitations. Int J Lab Hematol 2020; 42:363-370. [PMID: 32157813 DOI: 10.1111/ijlh.13177] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 01/21/2020] [Accepted: 02/12/2020] [Indexed: 12/23/2022]
Abstract
So-called "reticulated" or "immature platelets," which are newly released into the circulation, are more reactive than mature platelets, contain more RNA, and can be counted using flow cytometry after staining with thiazole orange or using some fully automated hematology analyzers, albeit with numerical disagreement. This review provides an overview of the state of the art of available technology for measuring immature or reticulated platelets (RP) with preanalytical (time stability, biological variation), analytical (methods, imprecision), and postanalytical (reference range) limitations. We also analyzed the clinical conditions in which immature/RP can be considered a diagnostic or prognostic tool (ie, differential diagnosis of thrombocytopenia, recovery after bone marrow or stem cell transplantation, risk assessment in cardiovascular diseases, response to antiplatelet drugs). They might also be of clinical utility in other settings but with lower evidence. The lack of a specific reference method and universal control material, as well as dependency of results on the measurement technique used, calls for different reference intervals and compromises comparison between clinical studies carried out using different analytical methods. To obviate lack of agreement between methods, more specific RNA dyes are necessary and the impact of the platelet size on the fluorescence signal defined. In the harmonization age, also in nomenclature field, a new definition instead of "reticulated" or "immature" platelets would be useful, and "young platelets" might be a more appropriate definition taking into account both the age and the functionality of this platelet fraction.
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Affiliation(s)
- Mauro Buttarello
- Department of Laboratory Medicine, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | | | | | - Mario Plebani
- Department of Laboratory Medicine, Azienda Ospedaliera-Università di Padova, Padova, Italy
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22
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Imperiali CE, Lopez-Delgado JC, Dastis-Arias M, Sanchez-Navarro L. Evaluation of the delta of immature platelet fraction as a predictive biomarker of inflammatory response after cardiac surgery. J Clin Pathol 2019; 73:335-340. [PMID: 31732619 DOI: 10.1136/jclinpath-2019-206068] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 10/28/2019] [Accepted: 10/30/2019] [Indexed: 12/23/2022]
Abstract
AIMS Cardiac surgery (CS) can induce an inflammatory response (IR) that is associated with poorer outcomes. Immature platelets are among the factors that may be associated with IR development. We aimed to evaluate whether immature platelet fraction (IPF) could be a predictive biomarker for IR and whether IPF could improve the prognosis assessment of IR for Acute Physiologic and Chronic Health Evaluation (APACHE II) and Sequential Organ Failure Assessment (SOFA) following CS. METHODS Three-hundred and twenty-seven (327) patients who underwent CS were enrolled during the study period. IR was defined according to the need for vasopressor support (>48 hours). Perioperative variables and outcomes were registered in our database. IPF was measured immediately following CS and at 24 hours by Sysmex XN analyzer and the difference between both measurements (ΔIPF) was calculated. To assess the relationship between ΔIPF and IR, univariate and multivariate logistic regression were performed. To analyse the additive value of ΔIPF in APACHE II and SOFA scores in predicting IR, an area under the receiver operating characteristic (AUROC) curve was calculated. RESULTS Among 327 patients included, 60 patients (18.3%) developed IR. Multivariate analysis showed ΔIPF was significantly associated with IR (OR: 1.26; 95% CI: 1.01 to 1.56; p=0.038). The combination of ΔIPF with scores improved the AUROC for IR prediction: 0.629 vs 0.728 (p=0.010) for APACHE II and 0.676 vs 0.715 (p=0.106) for SOFA. CONCLUSION These findings suggested that ΔIPF may be a useful and low-cost biomarker for the early identification of patients at risk of IR development.
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Affiliation(s)
- Claudia Elizabeth Imperiali
- Clinical Laboratory, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain .,Biochemistry and Molecular Biology Department, Universitat Autonoma de Barcelona, Barcelona, Spain
| | | | - Macarena Dastis-Arias
- Clinical Laboratory, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Lourdes Sanchez-Navarro
- Clinical Laboratory, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
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23
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Li J, Li Y, Ouyang J, Zhang F, Liang C, Ye Z, Chen S, Cheng J. Immature platelet fraction related parameters in the differential diagnosis of thrombocytopenia. Platelets 2019; 31:771-776. [PMID: 31621450 DOI: 10.1080/09537104.2019.1678118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The pathogenesis of thrombocytopenia can be divided into increased destruction (ID) of platelets in the peripheral blood and decreased production (DP) of platelets in the bone marrow. This study aimed to analyze the efficacy of immature platelet fraction (IPF) related parameters, including the IPF count (IPF#), IPF percentage (IPF%) and highly fluorescence IPF percentage (H-IPF%), measured by XN-9000, in the differential diagnosis of thrombocytopenia. One hundred and twenty healthy volunteers were enrolled in the healthy control (HC) group, and 180 thrombocytopenia patients were grouped into either the increased destruction (ID) group or the decreased production (DP) group according to their final diagnosis. IPF# was significantly lower in the DP group than in the ID and HC groups (P < .01). Among the three groups, the ID group had the highest IPF% and H-IPF%, and the HC group had the lowest IPF% and H-IPF%. The differences between the three groups were all statistically significant (P < .01). In differentiating the ID patients from the DP patients, the areas under the operating characteristics curve of IPF#, IPF% and H-IPF% were 0.859, 0.944 and 0.930, respectively. False positive rates were below 0.04 when IPF#, IPF% and H-IPF% were above 2.65, 7.55 and 2.35, respectively. IPF related parameters showed high efficacy in the differential diagnosis of thrombocytopenia. However, due to the small numerical values of the IPF related parameters in some thrombocytopenia patients, the fluctuations of IPF% and H-IPF% should also be taken into consideration. Though H-IPF% is a new parameter, its effectiveness in the differential diagnosis of thrombocytopenia is not better than IPF%'s.
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Affiliation(s)
- Junxun Li
- Department of Medical Laboratory, The First Affiliated Hospital of Sun Yat-sen University , Guangzhou, Guangdong Province, China
| | - Ying Li
- State Key Laboratory of Applied Microbiology Southern China , Guangzhou, China.,Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Guangdong Institute of Microbiology , Guangzhou, China
| | - Juan Ouyang
- Department of Medical Laboratory, The First Affiliated Hospital of Sun Yat-sen University , Guangzhou, Guangdong Province, China
| | - Fan Zhang
- Department of Medical Laboratory, The First Affiliated Hospital of Sun Yat-sen University , Guangzhou, Guangdong Province, China
| | - Chujia Liang
- Department of Medical Laboratory, The First Affiliated Hospital of Sun Yat-sen University , Guangzhou, Guangdong Province, China
| | - Zhuangjian Ye
- Department of Medical Laboratory, The First Affiliated Hospital of Sun Yat-sen University , Guangzhou, Guangdong Province, China
| | - Shaoqian Chen
- Department of Medical Laboratory, The First Affiliated Hospital of Sun Yat-sen University , Guangzhou, Guangdong Province, China
| | - Jing Cheng
- Department of Medical Laboratory, The First Affiliated Hospital of Sun Yat-sen University , Guangzhou, Guangdong Province, China
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24
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Harrison TE, Bowler J, Levins TN, Cheng AL, Reeves KD. Platelet yield and yield consistency for six single-spin methods of platelet rich plasma preparation. Platelets 2019; 31:661-666. [DOI: 10.1080/09537104.2019.1663808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
| | | | | | - An-Lin Cheng
- Biostatistician, Department of Biomedical and Health Informatics, University of Missouri-Kansas City, School of Medicine, Kansas City, Missouri, USA
| | - K. Dean Reeves
- Private Practice Physical Medicine and Rehabilitation, Roeland Park, Kansas, USA
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25
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Coşkun A, Carobene A, Kilercik M, Serteser M, Sandberg S, Aarsand AK, Fernandez-Calle P, Jonker N, Bartlett WA, Díaz-Garzón J, Huet S, Kızıltaş C, Dalgakıran I, Ugur E, Unsal I. Within-subject and between-subject biological variation estimates of 21 hematological parameters in 30 healthy subjects. Clin Chem Lab Med 2019; 56:1309-1318. [PMID: 29605821 DOI: 10.1515/cclm-2017-1155] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 02/22/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND The complete blood count (CBC) is used to evaluate health status in the contexts of various clinical situations such as anemia, infection, inflammation, trauma, malignancies, etc. To ensure safe clinical application of the CBC, reliable biological variation (BV) data are required. The study aim was to define the BVs of CBC parameters employing a strict protocol. METHODS Blood samples, drawn from 30 healthy subjects (17 females, 13 males) once weekly for 10 weeks, were analyzed using a Sysmex XN 3000 instrument. The data were assessed for normality, trends, outliers and variance homogeneity prior to coefficient of variation (CV)-analysis of variance (ANOVA). Sex-stratified within-subject (CVI) and between-subjects (CVG) BV estimates were determined for 21 CBC parameters. RESULTS For leukocyte parameters, with the exception of lymphocytes and basophils, significant differences were found between female/male CVI estimates. The mean values of all erythrocyte-, reticulocyte- and platelet parameters differed significantly between the sexes, except for mean corpuscular hemoglobin concentration, mean corpuscular volume and platelet numbers. Most CVI and CVG estimates appear to be lower than those previously published. CONCLUSIONS Our study, based on a rigorous protocol, provides updated and more stringent BV estimates for CBC parameters. Sex stratification of data is necessary when exploring the significance of changes in consecutive results and when setting analytical performance specifications.
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Affiliation(s)
- Abdurrahman Coşkun
- Department of Medical Biochemistry, Acibadem Mehmet Ali Aydınlar University, School of Medicine, Atasehir, Istanbul, Turkey
| | - Anna Carobene
- Servizio Medicina di Laboratorio, Ospedale San Raffaele, Milan, Italy
| | - Meltem Kilercik
- Department of Medical Biochemistry, Acibadem Mehmet Ali Aydınlar University, School of Medicine, Atasehir, Istanbul, Turkey
| | - Mustafa Serteser
- Department of Medical Biochemistry, Acibadem Mehmet Ali Aydınlar University, School of Medicine, Atasehir, Istanbul, Turkey
| | - Sverre Sandberg
- Norwegian Quality Improvement of Primary Health Care Laboratories (Noklus), Haraldsplass Hospital, Bergen, Norway.,Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
| | - Aasne K Aarsand
- Norwegian Quality Improvement of Primary Health Care Laboratories (Noklus), Haraldsplass Hospital, Bergen, Norway.,Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
| | - Pilar Fernandez-Calle
- Department of Laboratory Medicine, Hospital Universitario La Paz, Madrid, Spain.,Quality Analytical Commission of Spanish Society of Clinical Chemistry (SEQC-ML), Madrid, Spain
| | - Niels Jonker
- Certe, Wilhelmina Ziekenhuis Assen, RK Assen, theNetherlands
| | | | - Jorge Díaz-Garzón
- Department of Laboratory Medicine, Hospital Universitario La Paz, Madrid, Spain.,Quality Analytical Commission of Spanish Society of Clinical Chemistry (SEQC-ML), Madrid, Spain
| | - Sibel Huet
- Acibadem Mehmet Ali Aydınlar University, School of Medicine, Atasehir, Istanbul, Turkey
| | - Cansu Kızıltaş
- Acibadem Mehmet Ali Aydınlar University, School of Medicine, Atasehir, Istanbul, Turkey
| | - Ilayda Dalgakıran
- Acibadem Mehmet Ali Aydınlar University, School of Medicine, Atasehir, Istanbul, Turkey
| | - Esra Ugur
- Acibadem Mehmet Ali Aydınlar University, School of Health Science, Atasehir, Istanbul, Turkey
| | - Ibrahim Unsal
- Department of Medical Biochemistry, Acibadem Mehmet Ali Aydınlar University, School of Medicine, Atasehir, Istanbul, Turkey
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26
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Lopez M, Nowak G. Platelet number in different anticoagulants as a diagnostic biomarker for increased intestinal permeability. Platelets 2019; 31:242-247. [PMID: 31043103 DOI: 10.1080/09537104.2019.1609662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The main pathological process associated to increased intestinal permeability is the translocation of toxic products, predominantly endotoxins/lipopolysaccharide (LPS), from the intestinal tract into the microcirculation. In blood, LPS binds to surface receptors on immune cells initiating an inflammatory response. LPS can also bind to platelets leading to preactivated platelets that have a lower threshold to be aggregated in presence heparin. The aim of this study was to validate a simple, fast and reliable test for screening LPS-loaded platelets. This test named PANDA (acronym for Platelet Number in Different Anticoagulants) consists in the measurement of the mean platelet number in blood samples collected into EDTA and heparin. We analyzed blood samples from 92 patients with gastrointestinal diseases and 23 healthy volunteers and found a markedly low number of platelets in heparinized blood compared to EDTA-anticoagulated blood in patients but not in healthy volunteers. Furthermore, ex vivo addition of endotoxin to blood samples induced a remarkable decrease in platelet count in heparinized blood of the volunteers but not in the patient's group, where platelets could be previously saturated by endotoxin circulating in blood. Platelet should be counted during the first hour after blood collection, in order to avoid false results due to a progressive platelet aggregation in heparinized blood in function of the time. Our results demonstrated that PANDA test can be used for screening LPS-loaded platelets as an indirect diagnostic biomarker for increased intestinal permeability and also for monitoring the gut barrier function during the treatment of gastrointestinal diseases.
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Affiliation(s)
- Mercedes Lopez
- Löwen Apotheke, Giessen, Germany.,Centro de Biofisica y Bioquimica, Instituto Venezolano de Investigaciones Cientificas, Caracas, Venezuela
| | - Goetz Nowak
- Friedrich Schiller University Jena, University Hospital Jena, Jena, Germany
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27
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Imperiali CE, Arbiol-Roca A, Sanchez-Navarro L, Dastis-Arias M, Lopez-Delgado JC, Cortes-Bosch A, Sancho-Cerro A, Dot-Bach D. Reference interval for immature platelet fraction on Sysmex XN haematology analyser in adult population. Biochem Med (Zagreb) 2019; 28:010708. [PMID: 29472803 PMCID: PMC5812701 DOI: 10.11613/bm.2018.010708] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 01/07/2018] [Indexed: 02/05/2023] Open
Abstract
Introduction The Sysmex XN-series haematology analyser has newly adopted a fluorescent channel to measure immature platelet fraction (IPF). To promote the clinical utility of this promising parameter, establishing a reliable reference interval is mandatory. According to previous studies, IPF values may be affected by the employed analyser and the ethnic background of the individual, but no differences seem to be found between individuals’ genders. Therefore, this study aimed to define the reference interval for IPF in a Spanish population following Clinical and Laboratory Standard Institute (CLSI) guidelines. Materials and methods A total of 153 healthy Caucasian adults from Spain met the inclusion criteria. IPF measurement was performed by means of a Sysmex XN-2000 haematology analyser. A non-parametric percentile method was used to calculate the reference intervals in accordance with CLSI guidelines. Results The obtained reference interval for IPF on the Sysmex XN-2000 was 1.6–9.6% (90% confidence intervals (CIs) were 1.5–1.8 and 9.3–11.5, respectively). No significant gender difference in IPF reference intervals was observed (P = 0.101). Conclusions This study provides, for the first time, a reference interval for IPF using a Sysmex XN-2000 in a Spanish population, ranging from 1.6 to 9.6%. These data are needed to evaluate platelet production in several conditions such as thrombocytopenia, inflammatory states and cardiovascular diseases, as well as for future research.
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Affiliation(s)
- Claudia E Imperiali
- Clinical Laboratory, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ariadna Arbiol-Roca
- Clinical Laboratory, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Lourdes Sanchez-Navarro
- Clinical Laboratory, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Macarena Dastis-Arias
- Clinical Laboratory, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Juan C Lopez-Delgado
- Critical Care Unit, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Anna Cortes-Bosch
- Clinical Laboratory, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ana Sancho-Cerro
- Clinical Laboratory, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Dolors Dot-Bach
- Clinical Laboratory, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
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28
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Buttarello M, Mezzapelle G, Plebani M. Effect of preanalytical and analytical variables on the clinical utility of mean platelet volume. Clin Chem Lab Med 2019; 56:830-837. [PMID: 29194040 DOI: 10.1515/cclm-2017-0730] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 10/20/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND The study endpoint was to analyze the effect of preanalytical (time, temperature, anticoagulant) and analytical (imprecision, correlation between volume and platelet concentration) variables on mean platelet volume (MPV). A further aim was to calculate in an adult population the reference intervals using the Sysmex XE-5000 analyzer. A critical evaluation was also made of the clinical utility of these parameters. METHODS Analyses of the above values were performed in duplicate in 170 healthy adults of both sexes: (1) within 30 min from collection, and (2) after 4 h. To evaluate stability over time, the value of the platelet parameters of 20 subjects were determined, a re-analysis being performed for a period of up to 24 h on samples maintained at room temperature and 4°C using either K2-EDTA or Na-citrate as anticoagulants. RESULTS The stability over time of MPV closely depends on the anticoagulant used, storage temperature and time interval between venipuncture and analysis. An inverse, non-linear correlation between MPV and platelet count was also found. CONCLUSIONS In view of their effect on MPV and other related indices, the preanalytical and analytical variables make them, little more than experimental.
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Affiliation(s)
- Mauro Buttarello
- Department of Laboratory Medicine, University-Hospital, Padova, Italy
| | | | - Mario Plebani
- Department of Laboratory Medicine, University-Hospital, Padova, Italy
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29
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Targher G, Lippi G. Editorial: importance of an elevated mean platelet volume for prediction of major adverse cardiovascular events in non-alcoholic fatty liver disease. Aliment Pharmacol Ther 2019; 49:1092-1093. [PMID: 30920047 DOI: 10.1111/apt.15208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Giovanni Targher
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
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30
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A practical guide to validation and verification of analytical methods in the clinical laboratory. Adv Clin Chem 2019; 90:215-281. [PMID: 31122610 DOI: 10.1016/bs.acc.2019.01.006] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Although the measures to improve quality in the clinical laboratory have been enormous in the past years, not least of all due to the introduction of the ISO standards 15189 and 17025, the handling of validation and verification of method performance often still differs widely from laboratory to laboratory. Much of what is published on the topic contains complex statistics and is difficult to implement in routine laboratories. The result is, that this point is often neglected or implemented incorrectly, which in turn can lead to false conclusions about method performances, potentially compromising patient safety or contributing to incorrect diagnoses. As it has long become a standard requirement for accredited laboratories to evaluate and document the analytical performance of all methods not only prior to their first implementation, but also during ongoing operation, there is a need for clear, standardized and practical guidelines on the subject. This review summarizes the current literature on the topic, focusing on the requirements for method validations, or as the case may be, verifications and describes when to validate, when to verify and which statistical tests are appropriate for each. Proper interpretation of statistical test results and acceptance criteria for each procedure are alluded to. Specific topics, which are addressed, are precision and bias verification of quantitative, qualitative and semi-quantitative procedures, method comparisons with Bland-Altman Plots, Passing-Bablok regression analysis, 2×2 contingency tables and bubble charts, linearity studies, analytical sensitivity and specificity, performing carry-over studies and establishing and confirming reference ranges.
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31
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Sex-divided reference intervals for mean platelet volume, platelet large cell ratio and plateletcrit using the Sysmex XN-10 automated haematology analyzer in a UK population. Hematol Transfus Cell Ther 2018; 41:153-157. [PMID: 31079661 PMCID: PMC6517618 DOI: 10.1016/j.htct.2018.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 08/07/2018] [Accepted: 09/03/2018] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND This study aimed to define the sex-divided reference intervals for platelet indices (mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR) and plateletcrit (PCT)) on the Sysmex XN-10. METHODS A total of 2376 samples were assayed for full blood count on the Sysmex XN-10 haematology analyzer. After removing the outliers, reference intervals were calculated using the mean±2SD. The P value 0.05 was adopted to denote statistical significance. RESULTS There was a statistical significance (α=0.05) between sex-divided reference intervals for MPV (p=0.007), P-LCR (p=0.015) and PCT (p<0.001), thus separate reference intervals were calculated for these indices, with orientation to the sex-divisions as follows: MPV, 9.1-13.0fL [males] and 9.2-12.8fL [females]; P-LCR, 17.6-47.0% [males] and 17.8-47.8% [females]; and PCT, 0.16-0.35% [males] and 0.18-0.37% [females]. No significance was found between sex-divided reference intervals for the PDW (p=0.838), therefore a reference interval for total individuals was calculated for this platelet measurement as 9.3-17.3fL. CONCLUSION This study showed comparable reference intervals, using the Sysmex XN-10, with the previous literature. It determined the need to define sex-specific reference intervals for the MPV, P-LCR and PCT, but not for the PDW. These reference intervals will allow for low and high values to be facilitated in order to do further research and guide platelet disorder management.
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Buoro S, Carobene A, Seghezzi M, Manenti B, Dominoni P, Pacioni A, Ceriotti F, Ottomano C, Lippi G. Short- and medium-term biological variation estimates of red blood cell and reticulocyte parameters in healthy subjects. ACTA ACUST UNITED AC 2018; 56:954-963. [DOI: 10.1515/cclm-2017-0902] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 11/22/2017] [Indexed: 11/15/2022]
Abstract
Abstract
Background:
The integrated evaluation of traditional and innovative red blood cell (RBC) and reticulocyte parameters is a rapid, inexpensive and non-invasive diagnostic tools for differential diagnosis and follow-up of anemia and other pathological conditions needing bone marrow erythropoiesis assessment. Therefore, estimating the biological variation (BV) of these parameters is essential for evaluating the analytical performance of hematological analyzers, and for enabling accurate data interpretation and appropriate clinical management. This study aims to define short- and medium-term BV estimates and reference change value (RCV) of RBC and reticulocyte parameters.
Methods:
Twenty-one healthy volunteers participated in the assessment of medium-term BV (blood sampling once/week, five consecutive weeks) and 22 volunteers in the assessment of short-term BV (blood sampling once/day, five consecutive days) using Sysmex XN. Outlier analysis was performed before CV-ANOVA, to determine BV estimates with confidence intervals (CI).
Results:
Medium- and short-term within-subject BV were between 0.3% and 16.4% and 0.2%–10.4% (MCH and IRF), respectively, whereas medium and short-term between-subjects BV ranged between 0.9% and 66.6% (MCHC and Micro-R) and 1.4%–43.6% (MCHC and IRF), respectively. The RCVs were similar for all parameters in both arms of the study, except for hemoglobin, RDW-CV and MCV.
Conclusions:
This study allowed for estimating the BV of many RBC and reticulocyte parameters, some of which have not been currently explored. For RBC, hemoglobin, RDW-CV and MCV it seems advisable to use RCV calculated according to monitoring time and/or differentiated by sex. As regards analytical goals, we suggest using the most stringent targets found in the short-term arm of this study.
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Affiliation(s)
- Sabrina Buoro
- Clinical Chemistry Laboratory , Papa Giovanni XXIII Hospital , Piazza OMS , 1 – 24127 Bergamo , Italy , Phone: (+039) 0352674550, Fax: (+039) 0352674939
| | - Anna Carobene
- Medical Laboratory Service, San Raffaele Hospital , Milan , Italy
| | - Michela Seghezzi
- Clinical Chemistry Laboratory , Papa Giovanni XXIII Hospital , Bergamo , Italy
| | - Barbara Manenti
- Clinical Chemistry Laboratory , Papa Giovanni XXIII Hospital , Bergamo , Italy
| | - Paola Dominoni
- Clinical Chemistry Laboratory , Papa Giovanni XXIII Hospital , Bergamo , Italy
| | | | - Ferruccio Ceriotti
- Central Laboratory , Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico , Milan , Italy
| | | | - Giuseppe Lippi
- Section of Clinical Biochemistry , University of Verona , Verona , Italy
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Ali U, Knight G, Gibbs R, Tsitsikas DA. Reference intervals for absolute and percentage immature platelet fraction using the Sysmex XN-10 automated haematology analyser in a UK population. Scandinavian Journal of Clinical and Laboratory Investigation 2017; 77:658-664. [PMID: 29117724 DOI: 10.1080/00365513.2017.1394488] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Immature platelet fraction (IPF) estimation is a non-invasive and sensitive test that is available on recently introduced Sysmex XN-series of automated haematology analysers. It is a direct cellular indicator of thrombopoiesis. The aim of this study was to establish reference intervals for IPF, for both absolute (A-IPF) and percentage (%-IPF) measurements. MATERIAL AND METHODS A total of 2366 samples that met the inclusion criteria were assayed for full blood count on the Sysmex XN-10 and a non-parametric percentile method was used for calculating the reference intervals. RESULTS After the outliers were excluded, the reference interval for %-IPF and A-IPF on Sysmex XN-10 were 1.6-10.1% and 4.37-23.21 × 109/L in total individuals, respectively. There was a statistical significance noted between the sexes (p = .004) for %-IPF, therefore a sex-specific reference interval was established, which was 1.8-10.0% for the males and 1.5-10.1% for females. No significant difference in sex status for A-IPF and age status for both %-IPF and A-IPF was observed. A very poor correlation was estimated between age versus %-IPF, ρ = 0.0156, and age versus A-IPF, ρ = -0.0023, indicating that there is no overall biological relationship between age and these parameters. As expected, a strong correlation between %-IPF and A-IPF was noted which could be attributed to their inter-relatedness. CONCLUSIONS This large-scale study showed comparable reference intervals with the previous studies for %-IPF and A-IPF in a UK population. It found the need to establish sex-specific reference intervals for %-IPF, but not for A-IPF, whereas reference intervals were found to be stable across the age range.
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Affiliation(s)
- Usman Ali
- a Department of Haematology , Homerton University Hospital NHS Foundation Trust , London , UK
| | - Gavin Knight
- b School of Pharmacy and Biomedical Sciences , University of Portsmouth , Portsmouth , UK
| | - Roz Gibbs
- b School of Pharmacy and Biomedical Sciences , University of Portsmouth , Portsmouth , UK
| | - Dimitris A Tsitsikas
- a Department of Haematology , Homerton University Hospital NHS Foundation Trust , London , UK
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Buoro S, Carobene A, Seghezzi M, Manenti B, Pacioni A, Ceriotti F, Ottomano C, Lippi G. Short- and medium-term biological variation estimates of leukocytes extended to differential count and morphology-structural parameters (cell population data) in blood samples obtained from healthy people. Clin Chim Acta 2017; 473:147-156. [DOI: 10.1016/j.cca.2017.07.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 07/08/2017] [Indexed: 10/19/2022]
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