The diagnostic use of ADVIA 2120i Siemens and an “APL criteria” can help to reduce the rate of early death in the APL

Abstract

Introduction Acute promyelocytic leukemia (APL) is a type of acute myeloid leukemia (AML) with a life‐threatening coagulopathy. Once it is suspected, ATRA should be started. Appreciation of APL details is critical, but an experienced hematopathologist may not be available. We developed an algorithm, based on the parameters generated by automated blood cell counter ADVIA 2120i Siemens that can aid the diagnosis of APL. Methods All parameters in the algorithm were selected on the bases of the pathophysiology of the APL and the analyzer's technology. We used c1 cutoff: PLT < 150 × 103; % Mono<10; % LUC<4; % hyperchromic cells > 2; %saturated cells ≥ 1; % blasts > 4. Satisfying at least five of six cutoffs, we obtained an “APL criteria”. It was tested on 247.209 raw‐data from routine and emergency samples and on 124 raw‐data from APL. We performed a multiparametric analyses and obtained definitive cutoffs (c2). It was validated on a new group of 51.002 raw‐data from routine and emergency. Finally, it was tested on AML and ALL, MDS, MPN, oncologic samples, and hemolytic and megaloblastic anemia. Results The algorithm provided a high sensitivity (86.30%) and high specificity (99.83%) in APL with high or normal number of WBC and satisfactory results in APL with cytopenia (80%). The specificity was very high also in groups of hematological and nonhematological diseases. It can be used as an “APL criteria” to alert pathologists of the possible presence of APL. It together with instrumental and classical morphology may allow to reduce the time of diagnosis with further reduction in early death.

Perbedaan Jumlah Blast pada Hitung Manual dengan Alat Hematologi Siemens Advia 2120i

“…This is in accordance with research conducted by Rocco et al in 2018, which stated that the Siemens ADVIA 2120i hematology tool had sensitivity (86.3%) and specificity (99.83%) in diagnosing acute myelocytic leukemia. 15 Differences in the number of blasts were also found in samples with leukopenia but had good sensitivity and specificity in samples with leukocytosis. where the morphology of leukocytes had not undergone many changes so they could better differentiate between blast and non-blast cells.…”

Establishment of sex-specific reference intervals for automated haematology analyser-delivered research parameters in healthy Korean adults: a retrospective database review

“…11 Furthermore, Rocco et al detected acute promyelocytic leukaemia by combining six haematologic parameters including large unstained cells (LUCs), hyperchromic cells, per cent saturated cells, platelets, monocyte percentage and blast percentage. 12 Such research parameters as well as others would be more applicable to real-world practice if reliable reference intervals are provided for each.…”