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Urrechaga E. Screening of Myelodysplastic Syndromes Using Research Parameters of Complete Blood Count: Automated Detection of Dysplasia. Clin Lab Med 2024; 44:387-396. [PMID: 39089745 DOI: 10.1016/j.cll.2024.05.001] [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] [Indexed: 08/04/2024]
Abstract
Myelodysplastic syndromes (MDS) present with polymorphic and non-specific diagnostic features Research parametersfrom hematology analyzers may be useful to discriminate MDS-related cytopenia.Parameters such as Neu X (related to the cytoplasmic complexity) and Neu Y (related to nucleic acid content) show promise to detect dysplasia of MDS and aid to recognize MDS from cytopenias of other etiologies.
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Affiliation(s)
- Eloísa Urrechaga
- Hematology Laboratory, Hospital Universitario Galdakao -Usansolo, Galdakao, Vizcaya, Spain.
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Urrechaga E, Fernández M, Aguirre U. Complete Blood Counts and Research Parameters in the Detection of Myelodysplastic Syndromes. Diagnostics (Basel) 2024; 14:1322. [PMID: 39001213 PMCID: PMC11240308 DOI: 10.3390/diagnostics14131322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 06/06/2024] [Accepted: 06/20/2024] [Indexed: 07/16/2024] Open
Abstract
The diagnosis of Myelodysplastic syndromes (MDS) is frequently challenging, especially in terms of the distinction from the other non-neoplastic causes of cytopenia. Currently, it is based on the presence of peripheral blood cytopenias, peripheral blood and bone marrow dysplasia/blasts, and clonal cytogenetic abnormalities, but MDS diagnostic features are polymorphic and non-specific. We investigated the utility of complete blood count (CBC) and research parameters (RUO) from the analyzer BC 6800 Plus (Mindray Diagnostics) to discriminate MDS-related cytopenia. METHODS 100 samples from healthy individuals were used to establish the values of research parameters in normal subjects. A retrospective study was conducted including 66 patients diagnosed with MDS, 90 cytopenic patients due to other diseases (cancer patients receiving therapy, aplastic anemia, other hematological malignancies) and 50 with macrocytic anemia. The Wilcoxon test was applied to detect statistical differences among the groups of patients, considering p < 0.05 significant. The diagnostic performance of the RUO parameters for discriminating MDS among cytopenias was evaluated using receiver operating characteristic (ROC) curve analysis. Amultivariable logistic regression model was performed to identify the potential predictors for having MDS. The area under curve (AUC) and the Hosmer-Lemeshow test of the model were assessed. The performance of the model was verified in a prospective study including 224 cytopenic patients (validation group). RESULTS In the MDS group, the mean cell volume (MCV), percentage of macrocytic red cells (MAC), red cell distribution width (RDW) and immature platelets fraction (IPF) had increased values compared to the cytopenic and normal patients, while platelets, red and white cell counts, Neu X (related to the cytoplasmic complexity of neutrophils), Neu Y (related to nucleic acid content) and Neu Z (related to cell size) were lower (p < 0.001). Neu X, Neu Y, and Neu Z showed higher AUC for detecting MDS > 0.80; MAC, RDW and IPF AUC > 0.76. The multivariable model demonstrated that Neu X and Neu Y could be used in the recognition of MDS, AUC 0.88. In the validation group, 89.0% of the MDS patients were well classified. CONCLUSION MDS are common malignant disorders with a poor prognosis, and early diagnosis is warranted for optimal benefit from treatment. RUO gain insights to detect dysplasia of MDS and could be used in the differential diagnosis of MDS from cytopenias of other etiologies.
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Affiliation(s)
| | - Mónica Fernández
- Hematology, Hospital Universitario Araba, 01009 Vitoria-Gasteiz, Spain;
| | - Urko Aguirre
- Research Unit, Osakidetza Basque Health Service, Barrualde-Galdakao Integrated Health Organisation, Galdakao-Usansolo Hospital, 48960 Galdakao, Spain;
- Kronikgune Institute for Health Services Research, 48902 Barakaldo, Spain
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Choi YJ, Park JH, Cho S, Park H, Kim S, Kwon E, Cho HI, Nah EH. Reference intervals of cell population data parameters in Sysmex XN-Series and its patterns of changes from early adulthood to geriatric ages in South Korea. Int J Lab Hematol 2024; 46:466-473. [PMID: 38263481 DOI: 10.1111/ijlh.14231] [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: 08/29/2023] [Accepted: 01/05/2024] [Indexed: 01/25/2024]
Abstract
INTRODUCTION Cell population data (CPD) parameters may be putative biomarkers for the screening of various diseases including some infections and myelodysplastic syndrome. This study aimed to establish the age- and sex-specific reference intervals (RIs) for the CPD parameters in the Korean population. METHODS The reference population for the RIs of CPD parameters comprised 124 856 subjects aged 20-99 years. CPD parameters were obtained from Sysmex XN-2000 (Kobe, Japan) datasets from 17 health promotion centers in 13 South Korean cities. We determined significant partitions for age and sex, and calculated RIs according to Clinical and Laboratory Standards Institute C28-A3 guidelines. RESULTS The side scattered light intensity in the neutrophil area and the lymphocyte area did not require sex-related partitioning except in those over the age of 50, among whom the lower limit (LL) and upper limit (UL) were lower in females. However, the side scattered light distribution width in the lymphocyte area required age- and sex-related partitioning, in which LL and UL were higher in females. The LL and UL of the fluorescent light distribution width were higher in males in the neutrophil area and higher in females in the lymphocyte area, but age-related partitioning was not required. The forward scattered light intensity in the neutrophil area, lymphocyte area, and monocyte area did not require age-related partitioning in males. CONCLUSION This study has determined comprehensive age- and sex-specific RIs for CPD parameters, which could help to prove the clinical significance of these parameters in the Sysmex XN-2000.
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Affiliation(s)
- Yong Jun Choi
- Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - Ju-Heon Park
- Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - Seon Cho
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, South Korea
| | - Hyeran Park
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, South Korea
| | - Suyoung Kim
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, South Korea
| | - Eunjoo Kwon
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, South Korea
| | - Han-Ik Cho
- MEDIcheck LAB, Korea Association of Health Promotion, Seoul, South Korea
| | - Eun-Hee Nah
- Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Hwasun, South Korea
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Kim H, Hur M, Yi JH, Lee GH, Lee S, Moon HW, Yun YM. Detection of blasts using flags and cell population data rules on Beckman Coulter DxH 900 hematology analyzer in patients with hematologic diseases. Clin Chem Lab Med 2024; 62:958-966. [PMID: 38000045 DOI: 10.1515/cclm-2023-0932] [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: 08/24/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023]
Abstract
OBJECTIVES White blood cell (WBC)-related flags are essential for detecting abnormal cells including blasts in automated hematology analyzers (AHAs). Cell population data (CPD) may characterize each WBC population, and customized CPD rules can be also useful for detecting blasts. We evaluated the performance of WBC-related flags, customized CPD rules, and their combination for detecting blasts on the Beckman Coulter DxH 900 AHA (DxH 900, Beckman Coulter, Miami, Florida, USA). METHODS In a total of 239 samples from patients with hematologic diseases, complete blood count on DxH 900 and manual slide review (MSR) were conducted. The sensitivity, specificity, and efficiency of the five WBC-related flags, nine customized CPD rules, and their combination were evaluated for detecting blasts, in comparison with MSR. RESULTS Blasts were detected by MSR in 40 out of 239 (16.7 %) samples. The combination of flags and CPD rules showed the highest sensitivity compared with each of flags and CPD rules for detecting blasts (97.5 vs. 72.5 % vs. 92.5 %). Compared with any flag, the combination of flags and CPD rules significantly reduced false-negative samples from 11 to one for detecting blasts (27.5 vs. 2.5 %, p=0.002). CONCLUSIONS This is the first study that evaluated the performance of both flags and CPD rules on DxH 900. The customized CPD rules as well as the combination of flags and CPD rules outperformed WBC-related flags for detecting blasts on DxH 900. The customized CPD rules can play a complementary role for improving the capability of blast detection on DxH 900.
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Affiliation(s)
- Hanah Kim
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Mina Hur
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Jong-Ho Yi
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Gun-Hyuk Lee
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Seungho Lee
- Department of Preventive Medicine, College of Medicine, Dong-A University, Busan, Korea
| | - Hee-Won Moon
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Yeo-Min Yun
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
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Kaneda M, Nagaoka K, Yoshida R, Iwasaki Y, Niimi H, Yamamoto Y. Time-dependent changes in cell population data obtained using Sysmex XN-series hematology analyzer in bacterial infections. J Infect Chemother 2024:S1341-321X(24)00083-7. [PMID: 38522794 DOI: 10.1016/j.jiac.2024.03.008] [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: 01/24/2024] [Revised: 02/28/2024] [Accepted: 03/06/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Time-dependent changes in cell populations during acute bacterial infections remain unclear. We assessed time-dependent changes in fluorescent light intensity of the neutrophil area (NE-SFL) and fluorescent light distribution width index of the neutrophil area (NE-WY) and their association with sepsis and bacteremia. METHODS Patients with acute bacterial infections were enrolled in this prospective, observational cohort study. Blood samples were collected from all patients at the onset of bacterial infections (day 0) and on days 1 and 3. Microbiological evaluation included the examination of blood bacterial load using PCR. Cell population data were assessed using an automated hematology analyzer (Sysmex series XN-2000). RESULTS Forty-three participants with acute bacterial infections were enrolled in the study. Twenty-five participants developed definite sepsis. All the participants improved after the onset of infection. NE-WY levels showed significant time-dependent changes in participants with sepsis, peaking on day 0 and significantly decreasing until day 3, whereas these changes were not statistically significant for NE-SFL. A significant correlation with the Sequential Organ Failure Assessment score was observed with NE-WY and NE-SFL in the entire cohort on days 0 and 1. However, only NE-WY showed a significant correlation with blood bacterial load on days 0 and 1. CONCLUSION This study demonstrated that NE-WY elevation in sepsis peaked earlier than NE-SFL, which may partly reflect the early bacterial invasion into circulation. These findings advocate caution in interpreting cell population data values as sepsis biomarkers and propose the potential of NE-WY as a therapeutic indicator.
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Affiliation(s)
- Makito Kaneda
- Department of Clinical Infectious Diseases, Toyama University Hospital, Toyama, Japan
| | - Kentaro Nagaoka
- Department of Clinical Infectious Diseases, Toyama University Hospital, Toyama, Japan.
| | - Rinako Yoshida
- Scientific Affairs, Medical & Scientific Affairs, Sysmex Corporation, Hyogo, Japan
| | - Yosuke Iwasaki
- Scientific Affairs, Medical & Scientific Affairs, Sysmex Corporation, Hyogo, Japan
| | - Hideki Niimi
- Department of Clinical Laboratory and Molecular Pathology, Toyama University Hospital, Toyama, Japan
| | - Yoshihiro Yamamoto
- Department of Clinical Infectious Diseases, Toyama University Hospital, Toyama, Japan
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Kwiecień I, Rutkowska E, Gawroński K, Kulik K, Dudzik A, Zakrzewska A, Raniszewska A, Sawicki W, Rzepecki P. Usefulness of New Neutrophil-Related Hematologic Parameters in Patients with Myelodysplastic Syndrome. Cancers (Basel) 2023; 15:cancers15092488. [PMID: 37173954 PMCID: PMC10177198 DOI: 10.3390/cancers15092488] [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: 04/12/2023] [Revised: 04/20/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
Myelodysplastic syndromes (MDS) are common malignant disorders with a poor prognosis. It is necessary to search for new rapid diagnostic methods to detect MDS patients with cytogenetic changes. The aim of the study was to assess new hematological neutrophil- and monocyte- related parameters I then bone marrow of MDS patient with and without cytogenetic changes. A total of 45 patients with MDS, including 17 patients with cytogenetic changes, were examined. The study was conducted using the Sysmex XN-Series hematological analyzer. New neutrophil and monocyte parameters, such as immature granulocytes (IG), neutrophil reactivity intensity (NEUT-RI), neutrophil granularity intensity (NEUT-GI), neutrophil size (NE-FSC) and neutrophil/monocyte data relating to granularity, activity and volume (NE-WX/MO-WX, NE-WY/MO-WY, NE-WZ/MO-WZ, MO-X, MO-Y, MO-Z) were evaluated. We observed higher median proportions of NE-WX, NE-WY, NE-WZ, and IG counts in MDS patients with cytogenetic changes than in patients without cytogenetic changes. The NE-FSC parameter was lower in MDS patients with cytogenetic changes than in patients without cytogenetic changes. The combination of new neutrophil parameters was found to be a new successful approach in distinguishing MDS patients with cytogenetic changes from patients without cytogenetic changes. It appears that there may be unique neutrophil parameter signatures associated with an underlying mutation.
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Affiliation(s)
- Iwona Kwiecień
- Laboratory of Hematology and Flow Cytometry, Department of Internal Medicine and Hematology, Military Institute of Medicine-National Research Institute, Szaserów 128 Street, 04-141 Warsaw, Poland
| | - Elżbieta Rutkowska
- Laboratory of Hematology and Flow Cytometry, Department of Internal Medicine and Hematology, Military Institute of Medicine-National Research Institute, Szaserów 128 Street, 04-141 Warsaw, Poland
| | - Krzysztof Gawroński
- Department of Internal Medicine and Hematology, Military Institute of Medicine-National Research Institute, Szaserów 128 Street, 04-141 Warsaw, Poland
| | - Katarzyna Kulik
- Laboratory of Hematology and Flow Cytometry, Department of Internal Medicine and Hematology, Military Institute of Medicine-National Research Institute, Szaserów 128 Street, 04-141 Warsaw, Poland
| | - Alicja Dudzik
- Laboratory of Hematology and Flow Cytometry, Department of Internal Medicine and Hematology, Military Institute of Medicine-National Research Institute, Szaserów 128 Street, 04-141 Warsaw, Poland
| | - Agata Zakrzewska
- Laboratory of Hematology and Flow Cytometry, Department of Internal Medicine and Hematology, Military Institute of Medicine-National Research Institute, Szaserów 128 Street, 04-141 Warsaw, Poland
| | - Agata Raniszewska
- Laboratory of Hematology and Flow Cytometry, Department of Internal Medicine and Hematology, Military Institute of Medicine-National Research Institute, Szaserów 128 Street, 04-141 Warsaw, Poland
| | - Waldemar Sawicki
- Department of Internal Medicine and Hematology, Military Institute of Medicine-National Research Institute, Szaserów 128 Street, 04-141 Warsaw, Poland
| | - Piotr Rzepecki
- Department of Internal Medicine and Hematology, Military Institute of Medicine-National Research Institute, Szaserów 128 Street, 04-141 Warsaw, Poland
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Murphy PT, Bergin S, O'Brien M, Healy G, Murphy PW, Glavey S, Quinn J. Cell population data from Sysmex XN analyzer and myelodysplastic syndrome. Int J Lab Hematol 2021; 44:e138-e139. [PMID: 34877805 DOI: 10.1111/ijlh.13779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 10/28/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Philip T Murphy
- Department of Haematology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Stephen Bergin
- Department of Haematology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Michelle O'Brien
- Department of Haematology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Geraldine Healy
- Department of Haematology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Philip W Murphy
- Department of Haematology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Siobhan Glavey
- Department of Haematology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland
| | - John Quinn
- Department of Haematology, Beaumont Hospital and Royal College of Surgeons in Ireland, Dublin, Ireland
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