Peripheral blood morphology review and diagnostic proficiency evaluation by a new Spanish EQAS during the period 2011‐2019

Abstract

Introduction The Spanish Haematology and Haemotherapy Society organizes peripheral blood smear review scheme, focused on the evaluation of diagnostic proficiency of participants by blood cell morphology analysis. The objective was to evaluate the efficacy of this scheme as an educational tool to improve the diagnostic proficiency of the participants. Methods During 2011‐2019, 54 peripheral blood smears, alongside with patient details such as age, sex, blood cell counts and relevant clinical information, were sent to an average of 125 ± 13 laboratories per year. A number of 44 shipments were selected to analyse whether successive surveys of the same disease may lead to an improvement in the diagnostic success rate proposed by the laboratories. Participants were asked to select the most relevant morphological abnormalities, alongside the diagnostic orientation. Agreement of participant responses with RR was evaluated. Results Spanish laboratories showed a diagnostic proficiency greater than 80% in acute myeloid leukaemia, including acute promyelocytic leukaemia, mature B‐cell neoplasms (hairy cell leukaemia and splenic marginal zone lymphoma), chronic myeloid leukaemia, sickle cell disease, Bernard‐Soulier syndrome and infectious mononucleosis. It was important to note the significant improvement over the time in the successive shipments of the same disease, with a 31% and 13% increase in their diagnostic orientation success rate for acute myeloid leukaemia and acute promyelocytic leukaemia cases, respectively, 15% for mantle cell lymphoma and 6% for sickle cell disease. Conclusions The present study provides evidence that peripheral blood smear review scheme can be a valid educational tool to improve the clinical pathologist skills in blood morphology and haematological diagnosis.

Performance of the new MC‐80 automated digital cell morphology analyser in detection of normal and abnormal blood cells: Comparison with the CellaVision DM9600

“…With respect to ALC, external quality control programs have revealed the difficulties for their recognition by morphology, being the cells more difficult to identify by the participants 27 . In this work, we found that the MC‐80 is the first analyser capable of detecting ALC, since they were automatically identified in almost 50% of smears from patients with B‐LN (NOS), FL, MCL, and SMZL.…”

“…With respect to ALC, external quality control programs have revealed the difficulties for their recognition by morphology, being the cells more difficult to identify by the participants. 27 In this work, we found that the MC-80 is the first analyser capable of detecting ALC, since they were automatically identified in almost 50% of smears from patients with B-LN (NOS), FL, MCL, and SMZL. Although an improvement over previous technologies has been achieved with the MC-80, sensitivity for ALC automatic detection is very low and further advances in their automatic recognition is still needed.…”

“…Abnormal cells are difficult to identify, especially blast cells and ALC, as reported in some external quality control surveys. 27,28 According to the World Health Organization (WHO), the diagnosis of AL requires the integration of clinical history, morphological studies, molecular genetic analysis and immunophenotyping. 29 However, in some cases, results of molecular genetic analysis and immunophenotyping are not immediately available, so blast cell morphology plays a relevant role in indicating a diagnostic suspicion.…”

“…A second aspect to discuss is the MC‐80 performance for the DLC obtained on abnormal samples. Abnormal cells are difficult to identify, especially blast cells and ALC, as reported in some external quality control surveys 27,28 . According to the World Health Organization (WHO), the diagnosis of AL requires the integration of clinical history, morphological studies, molecular genetic analysis and immunophenotyping 29 .…”

AI-Enhanced Blood Cell Recognition and Analysis: Advancing Traditional Microscopy with the Web-Based Platform IKOSA

“…Microscopy of stained peripheral blood smears still holds significant relevance in hematological studies [1][2][3]. This simple protocol requires the expertise of physicians, who provide the robustness and versatility of the human power of pattern recognition but, simultaneously, the protocol has the limitation of being time-consuming.…”