[Laboratory evaluation of the Sysmex NE-7000 flagging system; a tool for the recognition of abnormal cells in white cell differentials].

Sysmex NE-7000 flagging system was evaluated for the recognition of abnormal cells in white cell differentials. Six flags that could mark blasts, immature granulocytes, left shift, nucleated red blood cells, atypical lymphocytes, and platelet clumps were selected for evaluation. 182 morphologic abnormal samples were screened from the Kobe University Hospital patients, by means of the 600 eye counts differentials. Blasts flag missed 8 of 28 cases, and immature granulocytes flag missed 25 of 56 cases. These missed cases contained either relatively few abnormal cells; less than 3% immature granulocytes, or absolutely few cells; less than 201 per micro liter blasts. Platelet clumps flag missed only 2 of 23 cases. But nucleated red blood cells and atypical lymphocytes flags missed all of 7 and 4 cases respectively. Left shift flag missed 36 of 64 cases, but it could help marking immature granulocytes or blasts. To use the NE-7000 as a screening tool, we compared the NE's all 35 flags versus abnormal cells or status based on the 100 eye counts. 1,153 cases were analyzed. Full agreement; 1047 (90.8%), partial agreement; 61 (5.2%), distributional false normal; 7 (1.6%), and morphological false normal; 4 (4.6%), were obtained. The more flags were used, the less abnormal cases were missed. But it accompanied the increase of the flag positive cases that must be confirmed by eye.

Lack of correlation between in vitro corticosteroid effect on hemopoietic colony formation and response to corticosteroid therapy in aplastic anemia.

We performed hemopoietic colony culture assays in 15 patients with aplastic anemia (AA) in order to test the effect of hydrocortisone (HC) on late erythroid colony (CFU-e) formation of the patients' marrow and to correlate the in vitro culture results with the clinical response to corticosteroid therapy. HC enhanced CFU-e growth in four patients. All four patients failed to respond to corticosteroid, but three improved with with androgens. The addition of HC did not increase CFU-e colony formation in 11 patients. However, two of them responded to corticosteroid therapy. Among the nine patients showing no HC effect in vitro, two subsequently improved with androgens and one each with anti-thymocyte globulin and anti-lymphocyte globulin. The results suggest that the in vitro corticosteroid effect may not necessarily correlate with responsiveness to corticosteroid therapy.