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Åstrand A, Wingren C, Walton C, Mattsson J, Agrawal K, Lindqvist M, Odqvist L, Burmeister B, Eck S, Hughes G, Luporini Saraiva G, Schantz A, Psallidas I, McCrae C. A comparative study of blood cell count in four automated hematology analyzers: An evaluation of the impact of preanalytical factors. PLoS One 2024; 19:e0301845. [PMID: 38787860 PMCID: PMC11125483 DOI: 10.1371/journal.pone.0301845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/23/2024] [Indexed: 05/26/2024] Open
Abstract
Differential white blood cell counts are frequently used in diagnosis, patient stratification, and treatment selection to optimize therapy responses. Referral laboratories are often used but challenged with use of different hematology platforms, variable blood shipping times and storage conditions, and the different sensitivities of specific cell types. To extend the scientific literature and knowledge on the temporal commutability of blood samples between hematology analyzers, we performed a comparative ex-vivo study using four of the most utilized commercial platforms, focusing on the assessment of eosinophils given its importance in asthma management. Whole blood from healthy volunteers with and without atopy (n = 6+6) and participants with eosinophilic asthma (n = 6) were stored under different conditions (at 4, 20, 30, and 37°C, with or without agitation) and analyzed at different time points (3, 6, 24, 48 and 72h post-sampling) in parallel on the Abbott CELL-DYN Sapphire, Beckman Coulter DxH900, Siemens ADVIA 2120i and Sysmex XN-1000V. In the same blood samples, eosinophil-derived neurotoxin (EDN), eosinophil activation and death markers were analyzed. All platforms gave comparable measurements of cell differentials on fresh blood within the same day of sampling. However, by 24 hours, significant temporal and temperature-dependent differences were observed, most markedly for eosinophils. None of the platforms performed perfectly across all temperatures tested during the 72 hours, showing that handling conditions should be optimized depending on the cell type of interest and the hematology analyzer. Neither disease status (healthy vs. asthma) nor agitation of the sample affected the cell quantification result or EDN release. The eosinophil activation markers measured by flow cytometry increased with time, were influenced by temperature, and were higher in those with asthma versus healthy participants. In conclusion, hematology analyzer, time window from sampling until analysis, and temperature conditions must be considered when analyzing blood cell differentials, particularly for eosinophils, via central labs to obtain counts comparable to the values obtained in freshly sampled blood.
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Affiliation(s)
- Annika Åstrand
- Clinical Development, Late-stage Development, Respiratory and Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Cecilia Wingren
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Claire Walton
- Biometrics, Late-stage Development, Respiratory and Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, United Kingdom
| | - Johan Mattsson
- Translational Science & Experimental Medicine, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Komal Agrawal
- Translational Science & Experimental Medicine, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Madelene Lindqvist
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Lina Odqvist
- Bioscience, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Björn Burmeister
- Translational Science & Experimental Medicine, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Steven Eck
- Integrated Bioanalysis, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Gaithersburg, MD, United States of America
| | - Glen Hughes
- Precision Medicine Unit, Biopharmaceuticals R&D, AstraZeneca, Cambridge, United Kingdom
| | - Gabriela Luporini Saraiva
- Clinical Development, Late-stage Development, Respiratory and Immunology, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, United States of America
| | - Anna Schantz
- Clinical Development, Late-stage Development, Respiratory and Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Ioannis Psallidas
- Clinical Development, Late-stage Development, Respiratory and Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, United Kingdom
| | - Christopher McCrae
- Translational Science & Experimental Medicine, Research and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, United States of America
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Kim H, Hur M, Choi SG, Oh KM, Moon HW, Yun YM. Comparison of white blood cell counts by WNR, WDF, and WPC channels in Sysmex XN hematology analyzer. Int J Lab Hematol 2015; 37:869-75. [DOI: 10.1111/ijlh.12421] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 07/31/2015] [Indexed: 11/28/2022]
Affiliation(s)
- H. Kim
- Department of Laboratory Medicine; Konkuk University School of Medicine; Seoul Korea
| | - M. Hur
- Department of Laboratory Medicine; Konkuk University School of Medicine; Seoul Korea
| | - S.-G. Choi
- Department of Laboratory Medicine; Konkuk University School of Medicine; Seoul Korea
| | - K.-M. Oh
- Department of Nursing; Konkuk University Medical Center; Seoul Korea
| | - H.-W. Moon
- Department of Laboratory Medicine; Konkuk University School of Medicine; Seoul Korea
| | - Y.-M. Yun
- Department of Laboratory Medicine; Konkuk University School of Medicine; Seoul Korea
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