Evaluation of Four Automated Hematology Analyzers: A Comparative Study of Differential Counts (Imprecision and Inaccuracy) (original) (raw)
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The Abbott (R) Cell-Dyn 3500 (Abbott CD 3500, Abbott Diagnostics Division, Mountain View, CA) is a fully automated hematology analyzer capable of providing a complete blood count (CBC) profile, including a five-part differential leukocyte count (DLC) and flagging system in this study. The CBC profile and DLC flagging system of the Abbott CD 3500 were evaluated according to the HA-20 protocol of the National Committee for Clinical and Laboratory Standards (NCCLS) and compared to the Technicon H*2 blood analyzer currently used in the authors' laboratory. Linearity, carryover, precision, and stability were all within the limits established by the manufacturer. No significant break-downs were found during the evaluation period. Evaluation of DLC indicated an excellent correlation with the manual reference method for neutrophils, lymphocytes, and eosinophils (r = 0.916, 0.936, 0.967, respectively), a good correlation for monocytes (r = 0.811) and a poor correlation for basophils (r =...
Evaluation of the Abbott CELL-DYN 4000 Hematology Analyzer
American Journal of Clinical Pathology, 2000
A new generation hematology analyzer, Abbott CELL-DYN 4000 (CD 4000), capable of providing 26 parameters, including fully automated reticulocyte, nucleated RBC, blast, band, and immature granulocyte, and variant lymphocyte counts, was evaluated by using the National Committee for Clinical Laboratory Standards H20-A protocol and compared with the Bayer-Technicon H-2 analyzer, which is used routinely in our laboratory. A lipid interference experiment and a sample aging study also were performed. Linearity, carryover, and precision were within the limits established by the manufacturer, and satisfactory agreement was found with the H-2 analyzer. The evaluation of leukocyte differential counts indicated an excellent correlation with the manual reference method for neutrophils and lymphocytes, a good correlation for monocytes and eosinophils, and a poor correlation for basophils in samples with low counts; for basophil counts of 2% or higher, we found an improvement of the correlation coefficient. In the lipid interference experiment, only hemoglobin determination was influenced significantly on the CD 4000, but by using a new Abbott hemoglobin reagent, the interference was eliminated. The CBC and differential counts were stable and reportable up to at least 24 hours. Intrasample viability information on leukocytes provided a quality check on each individual specimen.
Blood research, 2014
We evaluated the efficacy of white blood cell (WBC) differential counts in severely leukopenic samples by the Hematoflow method and by automated hematology analyzers and compared the results with manual counts. EDTA-anticoagulated blood samples (175 samples) with WBC counts of 40-990/µL were selected. Hematoflow differential counts were performed in duplicates employing flow cytometry using the CytoDiff reagent and analysis software. Differential counts were also performed using the DxH 800 (Beckman Coulter) and XE-2100 (Sysmex) automated hematology analyzers. The sum of the manual counts by a hematology technician and a resident were used as the manual counts. The total analysis time and hands-on time required by the Hematoflow method were shorter than those required by manual counting. Hematoflow counts were reproducible, showed a good correlation with automated analyzers, and also showed strong correlation with manual counts (r > 0.8) in neutrophils, lymphocytes, and monocytes...
American journal of clinical pathology, 1993
An evaluation of SYSMEX NE-8000 (Toa Medical Electronics Co., Ltd., Kobe, Japan) hematology analyzer, including its automated five-part white blood cell (WBC) differential count, was performed in a high-volume outpatient laboratory. Precision, mixing studies, stability, carry-over, and linearity were all within the limits stated by the manufacturer. Evaluation of the five-part WBC differential revealed excellent correlation with manual differential neutrophil and lymphocyte counts. Monocyte, eosinophil, and basophil data were acceptable given the known poor precision of 200 cell manual WBC differential counts when low percentages of individual cell types are present. Overall, flagging for morphologic abnormalities displayed a sensitivity of 87% and a specificity of 97%. The combination of the flagging system with the visual record provided by the NE-8000 WBC histogram represents an effective tool for separating normal from abnormal specimens, and allows considerable selectivity in t...
Evaluation of the Abbott Cell-DYN 3500 Hematology Analyzer in a University Hospital
American Journal of Clinical Pathology, 1996
The Abbott" Cell-Dyn 3500 (Abbott CD 3500, Abbott Diagnostics Division, Mountain View, CA) is a fully automated hematology analyzer capable of providing a complete blood count (CBC) profile, including a five-part differential leukocyte count (DLC) and flagging system in this study. The CBC profile and DLC flagging system of the Abbott CD 3500 were evaluated according to the HA-20 protocol of the National Committee for Clinical and Laboratory Standards (NCCLS) and compared to the Technicon H*2 blood analyzer currently used in the authors' laboratory. Linearity, carryover, precision, and stability were all within the limits established by the manufacturer. No significant breakdowns were found during the evaluation period. Advances in hematology automation have resulted in reliable devices that perform multicell differentials, allowing significant gains in speed and precision compared with the traditional 100-cell manual differential. The CELL-DYN 3500 (Abbott Diagnostics Division, Mountain View, CA) is a fully automated hematology analyzer that provides a comprehensive profile including complete blood count (CBC) and differential leukocyte count (DLC). To separate the five leukocyte subpopulations, the instrument uses the multiple angle polarized light scatter separation (MAPSS) process. 1 ' 2 Moreover, when abnormal leukocytes are present, the system generates different "suspect" flags and can estimate the percentage of blasts, variant lymphocytes, immature granulocytes, and bands. Over a period of 3 months, we evaluated CBC and DLC performance of the Abbott CD 3500 in a Uni
Evaluation of the leukocyte differential flags on an hematologic analyzer. The Cobas Argos 5 Diff
American journal of clinical pathology, 1995
To evaluate the leukocyte differential flags of the Cobas Argos 5 Diff., the authors performed a comparative study between their current analyzer, the Technicon H2, and the manual leukocyte differential. Samples (n = 1,600) were collected from the Blood Disease Department of their hospital and were tested on both Cobas Argos 5 Diff. (ABX/Roche Hematology Division, Montpellier, France) and Technicon H2. Abnormalities of the manual leukocyte differential (immature granulocytes, blast cells, atypical lymphocytes, hyperbasophil cells, erythroblasts, and hairy cells) were found in 597 samples. The authors determined the best cut-off of the quantitative flags--atypical lymphocytes (ALYs) and large immature cells (LICs)--using the likelihood ratio method, and the capability of the 5 Diff. qualitative flags to determine abnormal subpopulations by the predictive value of a positive result. The presence of particular combinations of flags was associated with band cells and blast cells of acut...
2014
Introduction: The Sysmex ® XE-2100D is a multiparameter hematology analyzer designed for hematology testing in samples with ethylenediamine tetraacetic acid (EDTA). Objectives: Considering the importance of this hematology analyzer for clinical and laboratory practice, the objective of this study was to evaluate its analytical performance, comparing the obtained results with quality specifications described in literature. Material and method: In the evaluation of analytical performance, according to recommendations of the document H26-A2 of the Clinical and Laboratory Standards Institute (CLSI), intra-run imprecision, inter-run imprecision, linearity, carryover, autosampler evaluation, clinical sensitivity of the atypical lymphocytes flag (n = 400 samples) were included, as well as the comparison between automated and manual leukocyte differential count (n = 400 samples), based on an adaptation of the document H20-A2 of CLSI. Results: Repeatability, reproducibility, linearity and carryover were satisfactory according to the manufacturer's specifications. The clinical sensitivity of the atypical lymphocytes flag showed efficiency, sensitivity and specificity of 92.5%, 65.2% and 94.1% respectively. The correlation coefficients between the automated and manual differential counts of neutrophils, lymphocytes, monocytes, eosinophils and basophils were 0.991, 0.99, 0.872, 0.974 and 0.557, respectively. Conclusions: The results were in accordance with quality specifications described in literature, indicating reliability in Sysmex ® XE-2100D. This fact ensures certainty to both laboratory professionals and medical staff. We conclude that the Sysmex ® XE-2100D showed excellent analytical performance, and is useful to provide reliable hematology data.
Clinical Chemistry and Laboratory Medicine, 2000
We processed 317 samples from healthy adult volunteers for a complete blood count, including leukocyte differentials and reticulocyte parameters, through five new-generation haematology analysers: Abx Pentra 120 Retic, Coulter Gen-S, Sysmex SE 9500, Abbott Cell Dyn 4000 and Bayer Advia 120. From these data nonparametric 2.5-97.5 percentile reference intervals were calculated for all parameters on all analysers. Some differences were found compared with previously reported reference intervals. Reference intervals for platelet parameters and reticulocytes agreed with these usually accepted. For red blood cell parameters, including haemoglobin and haematocrit, and white blood cell count, including absolute white blood cell differentials, our calculated reference intervals were in agreement with less frequently cited earlier reports, but were lower compared to the usually accepted reference intervals. Clin Chem Lab Med 2002; 40(1): 69-73
An Evaluation of the Sysmex NE-8000® Hematology Analyzer
American Journal of Clinical Pathology
The Sysmex NE-8000® is a new, fully automated hematology analyzer capable of providing a five-part white blood cell differential count and identifying abnormal specimens. This instrument was evaluated on 5,000 consecutive blood specimens and compared to the Coulter S Plus-IV® analyzer and manual differential cell counts to determine the efficacy of its five-cell differential and screening capabilities. There was a high correlation between the commercial counters for the standard parameters, white blood cell count, red blood cell count, hemoglobin level, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, and platelet count (r > 0.95), except for the mean corpuscular hemoglobin concentration (r = 0.51), for which the NE-8000 was considered the more accurate measurement. Precision and linearity studies were excellent. The white blood cell count, red blood cell count, hemoglobin level, and platelet count were reproducible on specimens stored at 4°C or room temperature for 72 hours and the differential counts were reproducible for 12 hours. The correlations between automated and manual counts for neutrophils, eosinophils, basophils, and lymphocytes were excellent: r = 0.912, 0.945, 0.332, and 0.964, The Sysmex NE-8000® (Toa Medical Electronics, Kobe Japan) is a recently developed, high throughput automated hematology analyzer with the capacity to test 23 parameters at a maximal rate of 120 samples per hour in automatic mode. The instrument tests white blood cell count (WBC); red blood cell (RBC) count; hemoglobin concentration (HGB); hematocrit (HCT); mean corpuscular volume (MCV); mean corpuscular hemoglobin (MCH); mean corpuscular hemoglobin concentration (MCHC);
Clinical and Laboratory Haematology, 2004
The Coulter LH 750 is a new haematology analyser with several new features: a count of nucleated red blood cells (NRBCs), automated WBC correction in presence of a flag indicating a cellular interference and a lower incidence of platelet or WBC interference flags when compared with the GEN.S, our current instrument. We had three main goals in our study: evaluating the LH 750 WBC counts when a GEN.S flag suggests a risk of WBC interference, ascertaining whether the platelet counts not flagged by the LH 750 were accurately assessed in samples flagged by the GEN.S and evaluating the NRBC assay provided by the LH 750. Flow cytometry, using CD45 and CD41, respectively for WBC and platelet labelling, was used as a reference method to assess the accuracy of the LH 750 counts. NRBC were identified by double labelling with propidium iodide (PI) and CD45, NRBCs being CD45-/PI+. A significant relationship was found between LH 750 and flow cytometric WBC counts, whether a WBC correction was made by the LH 750 (r = 0.9809, n = 54) or not (r = 0.9901, n = 23). A highly significant relationship was observed for platelets not only in the range from 0 to 450 x 10(9)/l (r = 0.981, n = 108) but also in cases of thrombocytopenia (range: 0-80 x 10(9)/l; r = 0.956, n = 51). In samples with NRBCs, the NRBC percentages given by the LH 750 and by flow cytometry were highly correlated (r = 0.977, n = 60) and WBC counts were accurate. In conclusion, the reduction in flagging by the LH 750, the accuracy of the results, and the availability of a NRBC count, constitute major advantages.