Differential Leukocyte Analysis

Béné, Marie‐Christine; Lacombe, Francis

doi:10.1002/9781444398595.ch4

Cited by 5 publications

(8 citation statements)

References 27 publications

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“…The observed negative bias for Alinity %NEU compared to the manual differential, and the positive bias for %MONO and %LYM is attributed to the uneven distribution of cells on the smear, that is, larger cells being accumulated toward the feather edge of the smear . No bias was seen when these results were compared to those obtained with CELL‐DYN Sapphire.…”

Section: Discussionmentioning

confidence: 99%

Performance evaluation of the prototype Abbott Alinity hq hematology analyzer

Beken

Dalem

Moer

et al. 2019

Int J Lab Hematology

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Introduction The analytical and clinical performance as well as the workflow efficiency of the novel, prototype Alinity hq hematology analyzer was evaluated in the clinical laboratory of Universitair Ziekenhuis Brussel, Department of Hematology, Brussels, Belgium. Methods Within‐run and within‐laboratory imprecision, linearity, and carryover were assessed using clinical blood samples and commercial blood products. Four hundred and seventeen samples were selected for method comparison with Abbott CELL‐DYN Sapphire, and for flagging performance analysis in comparison with smear review and manual microscopic white blood cell (WBC) differential. Results Within‐run and within‐laboratory imprecision verification demonstrated low %CV for complete blood count and WBC differential results within the normal ranges (0.1%‐10.4%), except for basophil granulocytes. The linearity of the analytical measuring ranges was verified for WBCs, red blood cells, hemoglobin, and platelets. Alinity hq results showed strong agreement with those of CELL‐DYN Sapphire. Good correlation was demonstrated with manual WBC differential results, with negative bias for neutrophil (NEU) granulocytes, and positive bias for lymphocytes and monocytes. Blasts were detected with 75% sensitivity and 96% specificity at 1% blast threshold, and 100% sensitivity at 5% blast threshold. Immature granulocyte detection was more sensitive (81% vs 76%, P = 0.086) and specific (88% vs 78%, P = 0.0002) than with CELL‐DYN Sapphire. Nucleated red blood cell detection was more sensitive (89% vs 63%, P < 0.001) and just slightly less specific (96% vs 99%, P = 0.0067) than with CELL‐DYN Sapphire. Re‐run and reflex testing rates were lower with Alinity hq. Conclusion The Alinity hq hematology analyzer is suitable for clinical use.

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Section: Discussionmentioning

confidence: 99%

Performance evaluation of the prototype Abbott Alinity hq hematology analyzer

Beken

Dalem

Moer

et al. 2019

Int J Lab Hematology

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“…As stated in many reports, flags are generated for 10 to 30% of the samples processed by CBC automated instruments generating flags and require manual review of blood smears . The selection of cases to be microscopically reviewed is performed based on the medical history of the patients, current clinical observations and on a set of CBC‐dependent flags.…”

Section: Discussionmentioning

confidence: 99%

“…A decrease of FP cases could also result from improved software and a better CytoDiff™ reagent. Briefly, we recommend three improvements: additional statistical data for CD16 expression, efficient use of CD2 intensity, improvement of CRTH2 staining. Visual examination of bivariate histograms showed in many cases the difficulty to build an efficient flag in case of decreased CD16 expression on neutrophils and/or IG which is relatively frequent in sepsis .…”

Section: Discussionmentioning

confidence: 99%

“…This nomenclature is summarized in Tables and . Each flag selectively refers to one of the eight subsets consecutively numbered as follows: neutrophils, eosinophils, basophils, lymphocytes, monocytes, X cells, IG, cell fragments. The following information was collected for each flag: number of the official histogram in the HRG system, flag region name, gating and thresholds (in absolute number (#) or percentage (%)) determined for flag activation.…”

Section: Methodsmentioning

confidence: 99%

“…The counts of red blood cells, WBC, and platelets are performed with high accuracy, specificity, and sensitivity by modern routine hematology instruments, which also identify and properly count the major normal leukocyte subsets. When flags are generated, current practice is that the results cannot be validated and manual counts are performed to distinguish both normal and abnormal cells . A reference differential has been published in 2007 by the Clinical and Laboratory Standards Institute (CLSI) using standardized procedures for slide‐making and microscopic examination .…”

Section: Introductionmentioning

confidence: 99%

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The routine leukocyte differential flow cytometryHematoFlow™ method: A new flagging system for automatic validation

Allou

Vial

Béné

et al. 2015

Cytometry Part B Clinical

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The complete blood cell count and white blood cell differential are the first step in the biological diagnosis of hematological diseases. Both are currently performed by automated instruments which control data and produce alerts. If such flags are activated, the automated differential cannot be validated and the operator must activate a visual blood smear review. Microscopic examination is still today the reference method despite its lack of sensitivity and reproducibility. The HematoFlow TM (Beckman Coulter) system is the first flow cytometry commercialized method designed for the routine differential. Using six markers in five colors and an automated gating strategy, it provides differentials proven to be reliable for 17 leukocyte subpopulations detection.Relying first on a retrospective analysis of 6,462 blood samples processed by HematoFlow TM , thresholds were determined to detect the presence of immature granulocytes and/or blast cells. All possible gating strategy misclassifications of leukocyte subpopulations were then summarized in a systematic nomenclature leading to the development of an original flag system based on the detection of aberrant localization of cell events in specific new bivariate histograms. Ultimately, more than 50% of the results could be automatically validated using the HematoFlow TM system, without any false negative, thereby dramatically contributing to an important decrease of technicians' workload. Moreover a noticeable help was given for smear review interpretation and new immunological flags led to the confirmation of blood disease after classical immunophenotyping.These results were confirmed in a second prospective study including 15,335 cases, where more than 50% of the results were automatically validated by this new flag system. MFC stands as being more and more essential for analyzing differentials in routine and this new flag system could greatly improve its implementation. V C 2015 International Clinical Cytometry Society

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Verification and quality control of routine hematology analyzers

Vis

Huisman

2016

Int J Lab Hematology

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S U M M A RYVerification of hematology analyzers (automated blood cell counters) is mandatory before new hematology analyzers may be used in routine clinical care. The verification process consists of several items which comprise among others: precision, accuracy, comparability, carryover, background and linearity throughout the expected range of results. Yet, which standard should be met or which verification limit be used is at the discretion of the laboratory specialist. This paper offers practical guidance on verification and quality control of automated hematology analyzers and provides an expert opinion on the performance standard that should be met by the contemporary generation of hematology analyzers. Therefore (i) the state-of-the-art performance of hematology analyzers for complete blood count parameters is summarized, (ii) considerations, challenges, and pitfalls concerning the development of a verification plan are discussed, (iii) guidance is given regarding the establishment of reference intervals, and (iv) different methods on quality control of hematology analyzers are reviewed.

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Differential Leukocyte Analysis

Cited by 5 publications

References 27 publications

Performance evaluation of the prototype Abbott Alinity hq hematology analyzer

Performance evaluation of the prototype Abbott Alinity hq hematology analyzer

The routine leukocyte differential flow cytometryHematoFlow™ method: A new flagging system for automatic validation

Verification and quality control of routine hematology analyzers

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