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Lu Q, Li Y, Li T, Hou T, Zhao Y, Feng S, Yang X, Zhu M, Shen Y. Evaluation of immature granulocyte parameters in myeloid neoplasms assayed by Sysmex XN hematology analyzer. J Hematop 2022; 15:1-6. [PMID: 38358601 PMCID: PMC10869398 DOI: 10.1007/s12308-022-00484-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/25/2022] [Indexed: 10/19/2022] Open
Abstract
Immature granulocytes (IGs) have significance for the diagnosis of myeloid neoplasms (MNs). The current study aims to use a hematology analyzer to evaluate the accuracy of IG parameters in MNs. Blood specimens from 388 patients with MN, 524 with non-hematological neoplasms (non-HNs), including 109 patients with inflammation and 68 undergoing G-CSF administration, and 500 healthy control subjects were analyzed. IG parameters was assayed by Sysmex XN-9000 (XN) and compared with manual assessments. A high level of agreement between IG% derived from XN and manual measurements for MN patients (r = 0.828, p < 0.0001) was revealed but only a moderate correlation for acute myeloid leukemia patients (AML; r = 0.597; p < 0.0001). Bland-Altman bias analysis was conducted, and the results showed that differences in IG% from XN and manual analysis for MN patients were considered clinically insignificant. ROC analysis demonstrated a good performance of IG# (AUC = 0.842) and IG% (AUC = 0.885) assessed by XN for MN patients with cut-off values of 0.200 × 109/L and 1.95%, respectively. IG parameters from Sysmex XN analyzer are helpful for screening of MNs even though granulocyte morphological abnormalities may interfere with IG parameter accuracy.
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Affiliation(s)
- Qifeng Lu
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong Province, China
| | - Ying Li
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong Province, China
| | - Tian Li
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong Province, China
| | - Tingting Hou
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong Province, China
| | - Yajuan Zhao
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong Province, China
| | - Shu Feng
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong Province, China
| | - Xixian Yang
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong Province, China
| | - Mengyu Zhu
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong Province, China
| | - Yajuan Shen
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong Province, China.
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Koch SPR, Thomasen IN, Nielsen JØ, Philipsen JP, Smith J. Interchangeability of multiple Sysmex XN10 and XN20 modules for six types of leukocytes. Int J Lab Hematol 2021; 44:273-280. [PMID: 34726344 DOI: 10.1111/ijlh.13748] [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: 07/28/2021] [Revised: 09/20/2021] [Accepted: 10/08/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Differential counts of leukocytes are frequent, and often several automated blood cell counters are needed in contemporary laboratories. However, these modules are often individually quality assured. Our aim was therefore to validate the interchangeability of five hematology modules in a large modern laboratory and to compare them with our gold standard (GS) manual white blood cell differential count. METHODS At Copenhagen University Hospital, we compared five Sysmex XN-modules for neutrophils, lymphocytes, monocytes, eosinophils, basophils, and immature granulocytes (IG). We analyzed control samples in three levels to evaluate intra- and intermodular precision. Bias between modules was evaluated by analyzing 93 random patient samples within reference intervals. XN-modules' mean counts were compared with GS. RESULTS We found acceptable intramodular CV% (0.92%-8.76%), only neutrophils and eosinophils exceeded state-of-the-art imprecision or desirable specifications for medium control levels. Intermodular CV% showed significance difference for only monocytes (ANOVA, P < .0001). For patient samples, there were significant differences between XN-modules regarding four WBC types (ANOVA); however, proportional bias ranged from 1.7% to 3.8%, being within desirable specifications except basophils and IG (bias = 13.3% and 24.9%, respectively). Comparisons with GS, XN-modules exceeded desirable bias for basophils (lower than GS); monocytes and IG (higher than GS). CONCLUSION This multimodule comparison shows acceptable intermodular imprecision and bias for clinical purposes, which is important for patient safety. Similar multimodule study should be performed with samples out of reference range in large-scale laboratories to confirm the interchangeability.
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Affiliation(s)
- Sheila Perez Rovsing Koch
- Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Isa Neimann Thomasen
- Department of Technology, Faculty of Health, University College Copenhagen, Copenhagen, Denmark
| | - Jesper Østrup Nielsen
- Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | | | - Julie Smith
- Department of Technology, Faculty of Health, University College Copenhagen, Copenhagen, Denmark
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GonzÁlez-Hernandez J, Varela C, Michel I, Laime IV, Uyaguari J, March JR. Neutrophil-lymphocyte ratio as a link between complex pedal ulcers and poor clinical results after infrainguinal surgical revascularization. INT ANGIOL 2021; 40:112-124. [PMID: 33496158 DOI: 10.23736/s0392-9590.21.04582-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Our aim was to evaluate the influence of preoperative neutrophil-lymphocyte ratio (NLR) on patency and clinical results after infrainguinal surgical revascularization for chronic limb ischemia. METHODS Retrospective analysis of 150 infrainguinal autologous bypasses performed to infragenicular popliteal artery or tibial vessels in 140 (93%) patients with chronic limb-threatening ischemia (CLTI) and in 10 (7%) with disabling claudication. NLR was calculated using blood samples obtained 24 hours preoperatively. The cohort was stratified into 2 groups according to interquartile ranges of NLR: "ELEVATED-NLR" (Quartile 4 N.=37) and "LOW-NLR" (Quartile 1-2-3 N.=113). Reperfused ulcers were described using the WIfI classification. Patency, freedom from MALE and amputation-free survival at 24 months were calculated using the Kaplan-Meier method. Univariate comparisons between NLR groups were performed using the Log-Rank test. Statistical differences on univariate analysis were adjusted in a multivariate model (Cox regression). RESULTS NLR values were similar between CLTI and claudication. Ischemic ulcers were more frequent, (83.4% vs. 59.3% P<0.01), more severe (W2-3: 37.8% vs. 22.1% P=0.01) and pedal infection was deeper (fI 2-3: 40.5% vs. 18.6% P=0.003) in "ELEVATED-NLR" group. Severe ischemia (I3) was similar between groups. High NLR values were independent predictors of patency loss (HR: 1.77 CI95% [1.01-3.10] P=0.04), MALE (HR: 2.04 CI95% [1.03-4.04] P=0.04) and worse amputation-free survival (HR:2.10 CI95% [1.06-4.14] P=0.03) rates at 24 months. CONCLUSIONS High preoperative NLR values are associated with severe and deep infected ulcers and predicts primary patency loss, higher major adverse limb events and worse amputation-free survival rates on long-term follow-up after infrainguinal surgical revascularization.
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Affiliation(s)
- Julio GonzÁlez-Hernandez
- Department of Angiology and Vascular-Endovascular Surgery, University Hospital of Getafe, Getafe, Spain
| | - César Varela
- Department of Angiology and Vascular-Endovascular Surgery, University Hospital of Getafe, Getafe, Spain -
| | - Ignacio Michel
- Department of Angiology and Vascular-Endovascular Surgery, University Hospital of Getafe, Getafe, Spain
| | - Ilsem V Laime
- Department of Angiology and Vascular-Endovascular Surgery, University Hospital of Getafe, Getafe, Spain
| | - Jhenifer Uyaguari
- Department of Angiology and Vascular-Endovascular Surgery, University Hospital of Getafe, Getafe, Spain
| | - José R March
- Department of Angiology and Vascular-Endovascular Surgery, University Hospital of Getafe, Getafe, Spain
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Hoffmann JJML. Basophil counting in hematology analyzers: time to discontinue? Clin Chem Lab Med 2020; 59:cclm-2020-1528. [PMID: 33554563 DOI: 10.1515/cclm-2020-1528] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 12/02/2020] [Indexed: 02/24/2024]
Abstract
Basophils (basophilic granulocytes) are the least abundant cells in blood. Nowadays, basophils are included in the complete blood count performed by hematology analyzers and therefore reported in practically all patients in whom hematologic investigations are requested. However, hematology analyzers are not reliable enough to report clinically useful results. This is due to a combination of very high analytical imprecision and poor specificity, because the chemical and physical methods used for basophil counting in hematology analyzers are ill-defined and thus basophils are not well recognized by the analyzers. As a result, false basophil counts are quite common. In view of increasing analytical performance demands, hematology laboratories should stop reporting basophil counts produced by hematology analyzers. Suggestions for alternative pathways are presented for those situations where basophils are of clinical relevance.
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Kristian Kur D, Thøgersen D, Kjeldsen L, Friis-Hansen L. The HemoScreen hematology point-of-care device is suitable for rapid evaluation of acute leukemia patients. Int J Lab Hematol 2020; 43:52-60. [PMID: 32894640 DOI: 10.1111/ijlh.13330] [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: 05/07/2020] [Revised: 07/21/2020] [Accepted: 08/05/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hematological patients, receiving intensive chemotherapy (predominantly acute leukemia patients), have repeated postchemotherapy periods with severe bone marrow suppression. As a result, these patients require regular monitoring of the complete blood counts (CBC) for optimal patient care. To reduce the strain on the patient, there is a need for a point-of-care (POC) hematology device that provides rapid and reliable results both in general and in cytopenic samples and is suitable for outpatient clinics. We evaluated the HemoScreen device for the most used CBC parameter both overall and at the lower range. METHODS The HemoScreen was compared with the Sysmex XN-9000 in 206 routine venous samples and 79 capillary bedside samples focusing on white blood cells (WBC), absolute neutrophil count (ANC), red blood cells (RBC), PLT and HGB. RESULTS The HemoScreen was less precise compared to the acceptance criteria set for larger and more advanced hematology instrument with a CV% 3.0-3.7 for WBCs, 3.6-8.4 for ANCs, 1.1-1.5 for RBCs, 2.5-4.4 for PLTs, and 1.7-2.3 for HGB. Correlation coefficient for all five parameters for the entire range was r >.95 and r >.90 at lower range for venous and capillary samples. Bias limits were within the CTCAE acceptance limits. CONCLUSIONS The HemoScreen provides rapid and accurate test results, for evaluation of WBC, PLT, and HGB, as well as at low concentrations for guiding transfusions and postchemotherapy treatment. The device is easy to operate and can measure both venous and capillary samples. Therefore, the HemoScreen is well suited for smaller outpatient clinics and potentially home use.
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Affiliation(s)
- Dår Kristian Kur
- Department of Clinical Biochemistry, North Zealand Hospital, University of Copenhagen, Hilleroed, Denmark
| | - Danny Thøgersen
- Department of Clinical Biochemistry, North Zealand Hospital, University of Copenhagen, Hilleroed, Denmark
| | - Lars Kjeldsen
- Department of Hematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lennart Friis-Hansen
- Department of Clinical Biochemistry, North Zealand Hospital, University of Copenhagen, Hilleroed, Denmark.,Department of Clinical Biochemistry, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.,Institute of Clinical Medicine, University of Southern Denmark, Odense, Denmark
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Florin L, Oyaert M, Vandevenne M, Van den Bossche J, Vanden Driessche M, Claeys R, Marcelis L, Robbrecht J, Jacobs N, Nijs A, Janssen K, Van Ruymbeke A, de Mûelenaere G, Stove V. Establishment of common reference intervals for hematology parameters in adults, measured in a multicenter study on the Sysmex XN-series analyzer. Int J Lab Hematol 2020; 42:e110-e115. [PMID: 31917886 DOI: 10.1111/ijlh.13151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 12/02/2019] [Accepted: 12/13/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Lisa Florin
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Matthijs Oyaert
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Marleen Vandevenne
- Department of Laboratory Medicine, Algemeen Ziekenhuis Sint-Maarten, Mechelen, Belgium
| | - Jan Van den Bossche
- Department of Laboratory Medicine, Antwerp University Hospital, Antwerp, Belgium
| | | | - Rowan Claeys
- Department of Laboratory Medicine, Heilig Hart Ziekenhuis Leuven, Leuven, Belgium
| | - Ludo Marcelis
- Department of Laboratory Medicine, Algemeen Ziekenhuis Delta, Roeselare, Belgium
| | - Johan Robbrecht
- Department of Laboratory Medicine, Algemeen Ziekenhuis Sint-Lucas, Brugge, Belgium
| | - Nadia Jacobs
- Department of Laboratory Medicine, Algemeen Ziekenhuis Klina, Brasschaat, Belgium
| | - An Nijs
- Department of Laboratory Medicine, Algemeen Ziekenhuis Groeninge, Kortrijk, Belgium
| | - Karen Janssen
- Department of Laboratory Medicine, Algemeen Ziekenhuis Zeno, Knokke-Heist, Belgium
| | | | - Guy de Mûelenaere
- Department of Laboratory Medicine, Algemeen Ziekenhuis Sint-Dimpna, Geel, Belgium
| | - Veronique Stove
- Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium.,Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
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Lippi G, Salvagno GL, Lampus S, Danese E, Gelati M, Bovo C, Montagnana M, Simundic AM. Impact of blood cell counts and volumes on glucose concentration in uncentrifuged serum and lithium-heparin blood tubes. Clin Chem Lab Med 2019; 56:2125-2131. [PMID: 29935113 DOI: 10.1515/cclm-2018-0523] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 05/30/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Although it is known that glucose concentration exhibits a time-dependent decay in uncentrifuged serum and lithium-heparin blood tubes, no evidence exists on how this variation may depend on blood cell counts (CBC) and volumes. METHODS Venous blood was drawn from 30 non fasting healthy volunteers into three serum and three lithium-heparin tubes. One serum and lithium-heparin tubes were centrifuged within 15 min after collection and glucose was measured with a hexokinase assay. The second and third serum and lithium-heparin tubes were maintained at room temperature for 1 and 2 h after the first tubes were centrifuged. These other tubes were then centrifuged and glucose was measured. CBC was performed in the first lithium-heparin tube, before centrifugation. RESULTS The mean decrease of glucose was higher in lithium-heparin plasma than in serum (0.33 vs. 0.24 mmol/L/h; p<0.001). Glucose concentration decreased by 7% and 5% per hour in lithium-heparin plasma and serum, respectively. In univariate analysis, the absolute decrease of glucose concentration was associated with sex (higher in men than in women), red blood cell (RBC) count, hematocrit, white blood cell (WBC) count, neutrophils and monocytes in both lithium-heparin plasma and serum. In multivariate analysis, the decrease of glucose concentration remained independently associated with RBC, WBC, neutrophils and monocytes in both sample matrices. No significant association was found with platelet number and erythrocyte or platelet volume. CONCLUSIONS Glucose concentration decrease in uncentrifuged lithium-heparin and serum tubes depends on the baseline number of RBC, WBC, neutrophils and monocytes within the tubes.
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Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry, University Hospital of Verona, Verona, Italy
| | - Gian Luca Salvagno
- Section of Clinical Biochemistry, University Hospital of Verona, Verona, Italy
| | - Simona Lampus
- Section of Clinical Biochemistry, University Hospital of Verona, Verona, Italy
| | - Elisa Danese
- Section of Clinical Biochemistry, University Hospital of Verona, Verona, Italy
| | - Matteo Gelati
- Section of Clinical Biochemistry, University Hospital of Verona, Verona, Italy
| | - Chiara Bovo
- Medical Direction, University Hospital of Verona, Verona, Italy
| | - Martina Montagnana
- Section of Clinical Biochemistry, University Hospital of Verona, Verona, Italy
| | - Ana-Maria Simundic
- Department of Medical Laboratory Diagnostics, University Hospital Sveti Duh, Zagreb, Croatia
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La Gioia A, Fumi M, Fiorini F, Pezzati P, Balboni F, Bombara M, Marini A, Pancione Y, Solarino L, Marchese E, Sale S, Rocco V, Fiorini M. Short preheating at 41°C leads to a red blood cells count comparable to that in RET channel of Sysmex analysers in samples showing cold agglutination. J Clin Pathol 2018. [PMID: 29535214 DOI: 10.1136/jclinpath-2017-204954] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS The presence of cold agglutinin in blood samples can cause a spontaneous agglutination of red blood cells (RBCs) when low temperature occurs. This phenomenon causes a spurious lowering of RBC count on the automated haematological analysers that are detected by incongruous values (≥370 g/L) of the mean cellular haemoglobi concentration (MCHC). A preheating at 37°C can remove the RBC agglutination generally resulting in a reliable count. It has been reported that the same result can be reached by using the optical reticulocyte (RET) channel of Sysmex analysers where the RBC count is not influenced by the presence of cold agglutinin. This study aims to evaluate these data in a larger population, with regard to environmental conditions on Sysmex analysers. We have also evaluated the influence of different thermal pretreatments on the RBC count. METHODS This study was performed on 96 remnants of peripheral blood samples (48 with MCHC in normal range and 48 with MCHC>370 g/L) which have been analysed in different preanalytical conditions on the Sysmex analysers. RESULTS A preheating of samples at 41°C for 1 min leads to a reversibility of the cold agglutination comparable to the one observed in the RET channel and yields better results compared with 37°C for 2 hours. CONCLUSIONS None of described procedures assure the complete cold agglutination reversibility in every case. Consequently, since the haematological analysers not yet provide reliable parameters to confirm the complete resolution of agglutination, further verification of RBC count accuracy needs to be performed.
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Affiliation(s)
- Antonio La Gioia
- Docemus Onlus "Theoretical and Practical Training School for Improving Specialty Medicine", Torrevecchia Teatina, Italy
| | - Maurizio Fumi
- U.O. Patologia Clinica A.O.R.N. "G.Rummo", Benevento, Italy
| | - Fabiana Fiorini
- UOC Medicina di Laboratorio Azienda USL Toscana Nord Ovest, Pontedera, Italy
| | - Paola Pezzati
- Centro Regionale Controllo di Qualità AOU Careggi, Firenze, Italy
| | - Fiamma Balboni
- Laboratorio Analisi IFCA (Istituto Fiorentino di Cura ed Assistenza), Firenze, Italy
| | - Maria Bombara
- UOC Medicina di Laboratorio Azienda USL Toscana Nord Ovest, Livorno, Italy
| | - Alessandra Marini
- UOC Medicina di Laboratorio Azienda USL Toscana Nord Ovest, Versilia, Italy
| | | | - Leonardo Solarino
- UOC Laboratorio Analisi I - Policlinico Vittorio Emanuele, Azienda Universitaria Ospedaliera, Catania, Italy
| | - Elisa Marchese
- UOC Laboratorio Analisi I - Policlinico Vittorio Emanuele, Azienda Universitaria Ospedaliera, Catania, Italy
| | - Silvia Sale
- U.O. Patologia Clinica A.O.R.N. "G.Rummo", Benevento, Italy
| | - Vincenzo Rocco
- U.O. Patologia Clinica A.O.R.N. "G.Rummo", Benevento, Italy
| | - Marcello Fiorini
- UOC Medicina di Laboratorio Azienda USL Toscana Nord Ovest, Livorno, Italy
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Schapkaitz E, Raburabu S. Performance evaluation of the new measurement channels on the automated Sysmex XN-9000 hematology analyzer. Clin Biochem 2018; 53:132-138. [DOI: 10.1016/j.clinbiochem.2018.01.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 01/18/2018] [Accepted: 01/20/2018] [Indexed: 10/17/2022]
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