Possible automatic cell classification of bone marrow aspirate using the CELL‐DYN 4000^® automatic blood cell analyzer

Abstract

In clinical hematology, the demand for bone marrow aspiration testing is increasing. However, conventional automatic blood cell analyzers cannot completely analyze erythroblasts, and evaluation has mainly been performed by visual examination (the microscopic method). Using the CELL-DYN 4000 automatic blood cell analyzer (CD4000) (Abbott Laboratories, North Chicago, IL), specific recognition and classification of erythroblasts by DNA staining is possible. In the present study, using bone marrow blood collected from normal subjects and patients with hematological malignancy, we classified cells by the microscopic method and with the CD4000, and compared the results. Good correlations were found for total nucleated cell count (TNCC), neutrophils, lymphocytes, erythroblasts, and the myeloid series to erythroid series (M/E) ratio. It is possible to detect blasts that emerge in patients with hematological malignancy using the blast flag system installed on the CD4000. Since all of the items can be analyzed in about 80 sec with the CD4000, cells in bone marrow aspirates can be classified faster with this apparatus than by the microscopic method. Therefore, analysis of bone marrow aspirates with this apparatus appears to be very useful not only for laboratory testing but also for clinical screening.

Automatic analysis of normal bone marrow blood cells using the XE‐2100 automated hematology analyzer

“…Previous studies of automated bone marrow analysis by a hematology analyzer, the Cell-Dyn 4000 (which provides a mechanism for removal of fat globules) showed that the total cell count does not falsely increase when original liquid specimens are used (17). However, the XE-2100 is superior to the Cell-Dyn 4000 from the standpoint of correlation (22).…”

Accurate quantification of fourteen normal bone marrow cell subsets in infants to the elderly by flow cytometry

“…BM cell subset frequencies reported in the literature mainly come from cytomorphological examinations and only 3 studies, including 2 from the early 1990s, have used flow cytometry . A strength of our study is the large number of cell subsets quantified, 7 in the lymphoid lineage and 7 in the myeloid lineage, compared to previous studies .…”

“…Unfortunately, they are a restricted rather young population that does not include children, or older people. Consequently, we used BM samples from patients with various clinical conditions (Table ), but according to strict normal quantitative and qualitative criteria upon morphological examination and flow cytometric evaluation, as previously described . No difference in the BM subset frequencies were found between stem cell donors and age‐matched patients.…”

“…It is well documented that In peripheral blood the relative proportions of various leukocyte cell subsets vary with the age of the individual ; however, to our knowledge, this has been little studied in BM. Normal values are available from cytological examination, but microscopy does not reveal exactly the same cell subsets as seen by flow cytometry, and values have only been reported for adults . Two of the three flow cytometry studies date from the early 1990s and only quantify a few subsets , sometimes not the most relevant for hematological investigations, and with no lymphoid cell analysis .…”

“…In practice, the only available BM samples from truly healthy individuals are those from donors for stem cell transplantation, but they do not cover all age groups. So, as usually performed, our control samples come from patients with various diseases and have been selected as meeting strict normal qualitative and quantitative cytomorphological criteria .…”