ABSTRACT
INTRODUCTION: Hematology analyzers should optimize flagging while minimizing false-negative results and unnecessary microscopic reviews. METHODS: We compared flagging performance of Sysmex XE-5000 and XN analyzers in oncohematologic patients. Differential counts were performed by Cellavision digital system (100 cells) and a hematologist (another 100 cells). RESULTS: First, we included 292 samples (86 with blasts): 28 acute lymphoblastic leukemia, 88 acute myeloid leukemia, 91 myelodysplastic syndromes, 45 chronic myeloproliferative neoplasms, and 40 chronic myelomonocytic leukemia. Sensitivity, specificity and efficiency to detect blasts were 59.3%, 88.3%, and 79.8% for XE-5000 analyzer and 70.9%, 91.3%, and 85.2% for the XN analyzer. Then, we included 111 lymphoid malignancies. In 55 CLL XE-5000 flagged for Abn Lympho/L_Blasts?, XN flagged for Abn Lympho?. In one-third of 19 samples with splenic marginal lymphoma, none of the analyzers flagged. In 5 Sézary syndrome cases, XE-5000 triggered the Abn Lympho/L_Blasts? flag while the flagging in XN was less consistent: Abn Lympho? Blasts? and Atypical Lympho?. In 5 hairy cell leukemias, both analyzers only flagged one sample. In 13 myelomas, XE-5000 generated Atypical Lympho? flag; XN triggered more variable flags. In other lymphoid malignancies, flags were variable. XN analyzer generates less samples with false basophilia. CONCLUSION: XN analyzer has improved blast detection in oncohematologic patients. Operators cannot rely on the blast flag alone but have to consider other flags and hemogram data. In lymphoproliferative disorders, XN analyzer yields less samples with pseudobasophilia. Both analyzers must improve flagging for hairy cell leukemia.
Subject(s)
Blast Crisis/blood , Blood Cell Count/instrumentation , Hematologic Neoplasms/blood , Leukemia, Hairy Cell/blood , Blood Cell Count/methods , Female , Humans , MaleABSTRACT
Objective To explore the value of Sysmex XE 5000 blood cell analyzer in alarm of atypical lymphocytes and basophil.Methods 198 samples of Sysmex XE 5000 blood cell analyzer and suggested that atypical lymphocytes and basophils, 915 copies of the instrument tip shaped specimens.Single lymphocyte increased blood smear microscopy for examination under a microscope to detect atypical lymphocytes as the gold standard and to verify the alarm not exactly.Results The microscopic examination results as the gold standard, and suggested that atypical lymphocytes and basophilia specimens after reinspection, eosinophilic granulocyte alkaline or positive value of 1.8%,in the normal range, the positive rate of atypical lymphocytes (129/198) was 65.2%,but the instrument alone atypical lymphocytes alarm specimens the positive rate of atypical lymphocytes after review of 72.4% microscope (663/915),the former was lower than the latter with significant difference (x2=4.521,P<0.05).Conclusion Sysmex XE 5000 blood cell analyzer at the same time of atypical lymphocyte and basophil alarm, two detection levels of interference, combined with microscope examination can improve detection accuracy, reduce the misdiagnosis rate, and provide reliable data for clinical treatment.
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Objective To evaluate the value of detecting abnormal lymphocyte morphology in peripheral blood and Epstein Barr Virus(EBV)DNA quantity through real-time quantitative PCR (RT-qPCR)in the initial diagnosis for infants patients with infectious mononucleosis (IM).Methods From Jan.2013 to Dec.2014 212 infants patients with IM were analysed ret-rospectively,which were all in-patients in the hospital.The abnormal lymphocyte morphology in peripheral blood and Epstein Barr Virus (EBV)DNA quantity were both detected in the initial fever period and a week later.The latter was detected by real-time quantitative PCR (RT-qPCR),combined with all the symptoms were all analysed comprehensively.The percentage of abnormal lymphocyte more than 10% was positive,and the EBV-DNA quantity more than 1.0×103 copy per ml was posi-tive,too.Results Of all the infants patients,in the initial fever period,82 patients had more than 10% positive abnormal lymphocyte and 100 patients had positive EBV-DNA quantity.But a week later,156 patients had more than 10% positive ab-normal lymphocyte,the maximum abnormal lymphocyte was 56%.And 180 patients had positive EBV-DNA quantity.When both abnormal lymphocyte morphology in peripheral blood and Epstein Barr Virus (EBV)DNA quantity were detected,in the initial fever period,125 patients were positive,it rose significantly more than that of abnormal lymphocyte morphology in peripheral blood (χ2=17.45,P0.05).Conclusion The detecting of peripheral blood cell morphology combined with EBV-DNA quantity are very important in the initial diagnosis for infants patients with infectious mononucleosis.Including all the symp-toms,they could improve the diagnosis timely and accurately.
ABSTRACT
In Oita prefecture, where ATL is relatively endemic, the authors carried out hematology analysis using an E-4000 hematology analyzer in a health examination. This analysis screened a group of 104 males and 181 females out of randomly collected 11, 568 persons in terms of a higher (exceeded 50%) W-SCR rate (i. e. lymphocyte rate in cell size distribution). The collected peripheral blood smears from this group were further subjected to the examination of lymphocyte morphology.<BR>Abnormal lymphocytes exhibiting dyscaryosis, such as indentation or lobulation, were observed in 11 cases, and further examination of anti-ATLA antibody and earlobe blood smears revealed eight suspected cases of ATL-related condition.<BR>Clinical symptoms characteristic of ATL were not observed in the above eight cases, though the anti-ATLA antibody titer measured by the ELISA method increased by more than 25. In one case, being diagnosed as chronic-type ATL, abnormal lymphocytes amounted to 70% and the leukocyte count was 28, 000/μl. In the other seven cases, abnormal lymphocytes amounted to only 1-11%, and the leukocyte counts ranged from 5, 300 to 11, 100/μl, which was almost within the normal limits.<BR>The method in reported as an useful means for screening cases of nonsymptomatic chronic or smoldering type ATL through a health examination.
