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Background: Anaemia defined as reduction in the concentration in Haemoglobin is one of the key health indicators of health care system of the country. Accurate screening methods are required to estimate the levels of haemoglobin for diagnosing the cause of anaemia. Objectives of the study was to analyze and compare the results of haemoglobin concentrations estimated with automated haematology analyzer and point of care device HemoCue Hb301.Methods: It is a prospective cross-sectional study was conducted for one year after ethical approval. Non fasting capillary and venous blood samples were collected from the selected cases of children and Haemoglobin concentrations were estimated by automated analyzer and HemoCue Hb301 system and the values were noted. Quality control checks were performed for both. Statistical analysis was done using IBM SPSS Version 24.0.Results: Mean Hb% concentration was estimated in 108 children with 44 female and 64 males. The mean value of Automated hematology analyzer (11.965±1.012) was significantly higher when compared with the mean value of HemoCue Hb301 (11.697±1.312) (p=0.002). There was a significantly strong correlation between HemoCue Hb301and Automated hematology analyzer (r-value = 0.732, p <0.0001).Conclusions: The HemoCue is useful in many different settings and remains a widely used method in field settings as it has several advantages and is relatively inexpensive compared with automated haematology analysers. Further studies are needed to better understand potential sources of error in the Hb assessment by HemoCue with the aim to better train phlebotomists and implement appropriate standardised procedures.
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BACKGROUND: Here we investigated the clinical utilities of blast suspect, large unstained cell (LUC), delta neutrophil index ll (DN ll), and delta neutrophil index l (DN l), analyzed in peripheral blood samples with automated hematology analyzers to predict the relapse of acute leukemia. METHODS: We retrospectively reviewed the medical records of 112 patients, including 56 patients with acute leukemia relapse and 56 controls. Blast suspect, LUC, DN ll, and DN l were compared between the control and leukemia relapse groups. RESULTS: Significant differences in blast suspect (P<0.001), LUC (P<0.001), DN ll (P<0.001), and DN l (P=0.002) were observed between the leukemia relapse and control groups. The areas under the curve (AUC) value was 0.927 for blast suspect (95% confidence interval [CI]: 0.8750.978, P<0.001), 0.868 for LUC (95% CI: 0.794–0.941, P<0.001), and 0.900 for DN ll (95% CI: 0.841–0.960, P<0.001). Logistic regression analysis for the prediction of leukemia relapse revealed odds ratio values of 1.52 (95% CI: 1.26–1.96, P=0.0002) for blast suspect, 1.66 (95% CI: 1.27–2.42, P=0.0019) for LUC, 1.16 (95% CI: 1.08–1.29, P=0.0014) for DN ll, and 1.05 (95% CI: 1.01–1.13, P=0.0845) for DN l. CONCLUSIONS: Multiple parameters provided by automated blood cell analyzers may serve as powerful ancillary tools for the prediction and diagnosis of leukemia relapse.
Subject(s)
Humans , Blood Cells , Diagnosis , Hematology , Leukemia , Logistic Models , Medical Records , Neutrophils , Odds Ratio , Recurrence , Retrospective StudiesABSTRACT
Incidentally, hemoglobin (Hb) variants can be detected using HbA1c tests in clinical laboratories. We found 38 patients with Hb variants after reviewing a total of 29,398 HbA1c test results from January 2017 to December 2017. While reviewing the complete blood count results of the patients (N=36) using the Sysmex XN-9000 analyzer (Sysmex, Japan), 35 patients were flagged as unremarkable with respect to differential white blood cell (WBC) counts. However, 1 patient with a normal WBC count did not obtain a differential WBC count while being flagged for an abnormal WBC scattergram in the white blood cell differential (WDF) channel. The WBC histogram showed an abnormally low fluorescent signal in the WDF channel; however, the differential WBC count was normal upon microscopic examination. After testing the patient's buffy coat suspended in normal saline and removing red blood cells (RBCs), the WBC scattergram and differential WBC count returned to normal. This finding suggests that the presence of a patient's RBCs may affect WBC scattergrams and Hb variants may interfere with the fluorescent dye in the differential WBC count. Therefore, when an abnormal WBC scattergram with an abnormally low fluorescent signal is encountered on the Sysmex XN-9000 analyzer, the presence of an Hb variant can be suspected.
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Humans , Blood Cell Count , Erythrocytes , Hematology , LeukocytesABSTRACT
Objective To conduct the calibration and comparative analysis on the Mindray BC 5800 automated hematology analy-zer in our department for ensuring the traceability and consistency of experimental results .Methods The mating calibrator of the Mindray company was used to conduct the calibration in the Mindray BC5800 automated hematology analyzer ,after calibration ,the calibration verification was performed .After passing the calibration verification ,the fresh blood was conduct the fixed value ,then the Mindray BC5800 and BC5180 automated hematology analyzers were calibrated ,after calibration ,the calibration verification was conducted ,after passing the calibration verification ,with the BC5800 as the standard instrument and BC5180 as the comparison in-strument ,the comparison experiment of fresh blood was performed .Results The Mindray BC5800 ,BC5300 and BC5180 automated hematology analyzers were passed the calibration verification after calibration ,in the comparison experiment of fresh blood ,the rela-tive deviation coincidence rates of WBC ,RBC ,Hb ,MCV ,PLT ,HCT ,MCH and MCHC between BC5800 and BC5300 and between BC5800 and BC5180 all exceeded 80% ,the comparison tests were passed .Conclusion The hematology analyzer should be per-formed the calibration verification and comparison test after calibration ,and the comparison test must be passed for ensuring the traceability of results and comparability among the test results in order to meet clinical needs .
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El primer paso para obtener seguridad en los resultados emitidos por el laboratorio clínico es confirmar que los procedimientos de medida utilizados tienen un desempeño analítico aceptable. Para conseguirlo se verificó el contador hematológico Beckman Coulter LH 750 de acuerdo con las especificaciones del fabricante y con los requisitos de calidad de este laboratorio. Los parámetros de desempeño evaluados, tanto en modo manual como automático, fueron: porcentaje de arrastre, según protocolo CLSI H26-A2, precisión en condiciones de repetibilidad, precisión en condiciones de precisión intermedia y veracidad, según protocolo CLSI EP15-A2 utilizando controles BIO-RAD, intervalo de medición, según protocolo CLSI EP6-A, límite de cuantificación, según protocolo CLSI EP17-A2 e intervalos de referencia, según protocolo CLSI EP28-A3C. Los datos se analizaron mediante LinChecker y GraphPad 5. En los ensayos realizados se cumplió con las especificaciones estipuladas por el fabricante, como así también con el requisito de calidad de este laboratorio que es variabilidad biológica mínima. También se verificaron los intervalos de referencia para individuos adultos. De esta manera, se logró realizar la verificación del contador hematológico, evidenciando que los parámetros analíticos evaluados tienen un desempeño aceptable.
The first step for safety in the results issued by the clinical laboratory is to confirm that all analytical measurement procedures have shown an acceptable analytical performance. A quality performance evaluation of automated hematology analyzer Beckman Coulter LH 750 was performed according to the quality requirements of our laboratory and manufacturer's specifications. The performance parameters evaluated by both manual and automatic mode were: carryover according to CLSI H26-A2 protocol; repeatability, intermediate precision and trueness according to CLSI EP15-A2 protocol and using BIO-RAD controls; linearity according to CLSI EP6-A protocol; quantification limits according to CLSI EP17-A2 protocol; and reference intervals according to CLSI EP28-A3C protocol. Data were analyzed using LinChecker and GraphPad5 programs. The tests performed complied with the requirements stipulated by the manufacturer and the quality requirements of our laboratory like minimal biological variability. Reference intervals for adult individuals were also checked. Consequently, performance evaluation of the automated hematology analyzer showed that the assessed laboratory parameters have acceptable performance.
O primeiro passo para obter segurança nos resultados emitidos pelo laboratório clínico é confirmar que os processos de medição utilizados tenham um desempenho analítico aceitável. Para obtê-los foi verificado o analisador hematológico Beckman Coulter LH 750 de acordo com as especificações do fabricante e os requisitos de qualidade deste laboratório. Os parâmetros de desempenho avaliados, tanto em modo manual quanto automático, foram: percentual de arrastamento, de acordo com o protocolo CLSI H26-A2, em condições de repetitibidade, precisão em condições de precisão intermediária e veracidade, conforme o protocolo CLSI EP15-A2 usando controles Bio-Rad, intervalo de medição segundo o protocolo CLSI EP6-A, limite de quantificação, de acordo com CLSI EP- 17-A2 e intervalos de referência, de acordo com o protocolo CLSI EP28-A3C. Os dados foram analisados através de LinChecker e GraphPad 5. Nos ensaios realizados foram obsevadas as especificações estabelecidas pelo fabricante, bem como a exigência de qualidade deste laboratório que é variabilidade biológica mínima. Os intervalos de referência para indivíduos adultos também foram verificados. Desta forma, foi possível realizar a verificação do analisador hematológico, que demonstra que os parâmetros analíticos avaliados têm um desempenho aceitável.
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Hematologic Tests , Reference Standards , Guidelines as Topic , Reference Values , Checklist , Evaluation StudyABSTRACT
Objective To evaluate the performance of the Sysmex XE-5000 analyzer for analyzing atypical lymphocytes ,baso-philic granulocytes and their abnormalities warnings .Methods A total of 197 specimens with both atypical lymphocytes and baso-philic granulocytes warnings and 914 specimens with single warning of atypical lymphocytes indicated by Sysmex-5000 blood cell analyzer were collected and inspected by microscope simultaneously .Results Using microscopic examination as a standard ,baso-philic granulocytes within the normal range ,the coincidence rate of samples with both atypical lymphocytes and basophilic granulo-cytes warnings was 64 .9% ,while the coincidence rate of samples with single warning of atypical lymphocytes was 72 .5% .The for-mer was significantly lower than the latter(P<0 .05) .Conclusion When Sysmex XE-5000 indicates atypical lymphocytes and baso-philic granulocytes simultaneously ,there is interference between each other .It should be combined with microscopic examination in order to reduce the probability of missed diagnosis and misdiagnosis .
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Objective To evaluate the performance of Sysmex XN‐9000 automated hematology analyzer .Methods According to international and domestic standards ,performance of analyzer was evaluated .Results The within‐batch and between‐batch preci‐sion ,carryover pollution rate ,linearity range and the accuracy of Sysmex XN‐9000 analyzer were all conform to related require‐ments .Leukocyte classification results compared with manual classification ,the correlation of neutrophil ,lymphocyte ,monocyte and eosinophil were fine ,but correlation of basophil was not very ideal .Conclusion The performance of Sysmex XN‐9000 analyzer could be satisfying ,could meet the needs of clinical inspection and diagnosis and treatment .
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Objective To make the detection results of the different automated hematology analyzers in laboratory to be reliable and comparable.Methods With the Beckman Coulter LH750 after calibration as the reference instrument,the fresh whole blood was extracted from the patient and divided into 3 equal parts after mixing evenly.The first part was determined the target value in the LH750 instrument;the second part was used to calibrate the HMX and ABX PENTRA 60 instruments and the third part served as a calibration validation.After calibration,the fresh whole blood of patient was performed the detection for conducting the accuracy evaluation.Results After calibration,the detection results of RBC,HGB,WBC,HCT,MCV and PLT by each instrument were largely improved and the error of the results was less than 1/3 of CLIA′88 requirements.Conclusion Adopting fresh whole blood for calibrating the hematology analyzer is feasible.
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Objective To investigate the application of hematology analyzer in cell counting of serous cavity effusion .Methods Humoral mode of Sysmex XE-5000 automated hematology analyzer and manual microscopy were employed to perform cell counting in 85 samples of serous cavity effusion .Results Compared with the manual method and instrument method ,differences of mononu-clear cells and multinucleated cells of serous cavity effusion showed no statistical significance (P>0 .05) ,while those of leukocytes , erythrocytes were found statistical significance (P<0 .05) .Conclusion Sysmex XE-5000 automated hematology analyzer has advan-tages of simple ,stability and accuracy ,however ,its application in the effusion cell counting can not completely replace the manual microscopy .
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BACKGROUND: Test results in a laboratory are simply relayed to the laboratory information system through the interface. Middleware facilitates and manages the interaction between applications across heterogeneous computing platforms. We applied middleware to automated hematology analyzers in a clinical laboratory. METHODS: We used HemLink (Beckman Coulter Korea, Korea) as middleware between the laboratory information system and hematology analyzers. It provides quality control programs including the Westgard multirule chart and moving averages. RESULTS: Unlike the previous system, middleware does not require manual input of the quality control results. Amendment of quality control, if necessary, could be done without the help of hospital information teams. Identification of abnormal results with patient information could be achieved with moving averages. Morphology flags and system flags are checked at remote computers. CONCLUSIONS: Management of quality control results of hematology analyzers was easy via middleware. Thus, middleware could be useful to connect proficiency testing programs with HemLink and to compare results from laboratories using the same middleware.
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Humans , Clinical Laboratory Information Systems , Hematology , Korea , Quality ControlABSTRACT
Background: Diagnosis of malaria is usually made by microscopy [Giemsa, Acridine Orange (AO), and Quantitative Buffy Coat (QBC) assay], which requires expertise. Currently, automated haematology analyzers are being used for complete blood count (CBC), in all acute febrile and non-febrile illnesses which simultaneously detects malaria. The normal scattergram by the analyzer (Sysmex 2100) comprises of five parameters i.e. lymphocytes (pink), monocytes (green), neutrophils (blue), eosinophils (red) with a space between the neutrophil and eosinophil populations. Aims : We carried out a prospective study to compare the efficacy of Sysmex XE-2100 (Sysmex Corporation, Kobe) for detection of malaria in comparison to other conventional techniques. Materials and Methods : 430 cases were analyzed for malaria by microscopy (QBC, AO, Giemsa), ICT (Immunochromatography) and flowcytometric analyzer (Sysmex XE-2100). The abnormal scattergrams were observed as double neutrophil, double eosinophil, grey zone, extended neutrophil zone with a decrease space between eosinophil and neutrophil, and a combination of above patterns. Results : Out of 70 positive cases [49/70 (70%) P. vivax, 18/70 (25.7%) P. falciparum, and 3/70 (4.2%) both P. vivax and P. falciparum], 52 showed abnormal scattergrams by the analyzer. The sensitivity and specificity of hematology analyzer found to be 74.2% and 88%, respectively. Conclusion : Flowcytometric analyzer is a rapid, high throughput device which needs less expertization for the diagnosis of malaria. Hence, it can be used in the diagnostic laboratories as an early modality for diagnosis of malaria in suspected as well as clinically in apparent cases.
Subject(s)
Autoanalysis/instrumentation , Blood Cell Count/instrumentation , Flow Cytometry/instrumentation , Hematologic Tests/instrumentation , Humans , Malaria/diagnosis , Malaria, Falciparum/diagnosis , Malaria, Vivax/diagnosis , Plasmodium falciparum/analysis , Plasmodium vivax/analysis , Sensitivity and SpecificityABSTRACT
0.05.Conclusion Using XT-2000i Automated Hematology Analyzer to test the reticulocyte the reproducibility is better,and the linearity can content well with clinic,the rate of carry contamination is low,the stability is better too.Compared XT-2000i with the manual methods,the relativity is better. It can replace the manual methods.
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Myeloperoxidase (MPO) deficiency is rare and its symptoms are not specific; and therefore, it is not easy to identify persons either totally or partially who are myeloperoxidase deficient with every routine analysis. MPO deficiency can be detected by the pattern of the cytogram and the mean peroxidase index (MPXI) using the automated hematology analyzer Technicon H*2. A case of MPO deficiency is reported with some review of the available literatures.