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Norderstedt, Germany

Lesesve J.-F.,University of Lorraine | Speyer E.,University of Lorraine | Perol J.-P.,Sysmex Europe GmbH
International Journal of Laboratory Hematology | Year: 2015

Introduction: Fragmented red cells (FRCs) are a new parameter determined automatically by the latest generation of blood cell counters. FRC counts may be of interest as they may reflect schistocyte counts measured on a stained peripheral blood smear observed under the microscope. However, FRC counts depend on the technical procedure used to detect them so that reference ranges are device dependent. The XN-9000® is one of the latest models from the Sysmex series of analysers. Material, methods and results: We aimed to establish a reference range for FRCs based on 1366 normal patient samples. The mean ± SD was 0.14 ± 0.35% and the median was 0% (95% confidence interval of the mean: 0.12-0.16%). We observed that the percentage of red blood cells with <17 pg of haemoglobin content (Hypo-He) was correlated to an FRC increase and that flagged results relating to red blood cells, reticulocytes or platelets might have presented with artefactually increased FRCs. Conclusion: The FRCs reference range (healthy subjects) should be useful for laboratory staff for selecting which blood smears to check optically. © 2015 John Wiley & Sons Ltd.

Schoorl M.,Medical Center Alkmaar | Linssen J.,Sysmex Europe GmbH | Villanueva M.M.,Hospital Universitario Virgen Of La Arrixaca | Velasco NoGuera J.A.,Hospital Universitario Virgen Of La Arrixaca | And 2 more authors.
American Journal of Clinical Pathology | Year: 2012

For many years, application of RBC indices has been recommended for discriminating between subjects with iron deficiency from those with thalassemia. However, application of the algorithms resulted in only 30% to 40% of subjects being appropriately classified. The aim of the study was to establish the efficacy of algorithms for anemia screening including new hematologic parameters such as percentage of hypochromic and microcytic RBCs and hemoglobin content of reticulocytes. Subjects with iron deficiency anemia (IDA) (n = 142) and subjects with β-thalassemia (n = 34) were enrolled in a European multicenter study. Apparently healthy subjects were used as a reference group (n = 309). Hemocytometric investigations were performed on a Sysmex XE5000 hematology analyzer. The algorithms for IDA discrimination yielded results for area under the curve, sensitivity, specificity, and positive and negative predictive values of 0.88, 79%, 97%, 74%, and 98%, respectively. The algorithms for β-thalassemia discrimination revealed similar results (0.86, 74%, 98%, 75%, and 99%, respectively). We conclude that the advanced algorithms, derived from extended RBC parameters provided by the Sysmex XE5000 analyzer, are useful as laboratory anemia screening devices. Copyright© by the American Society for Clinical Pathology.

Zimmermann M.,Charite - Medical University of Berlin | Zimmermann M.,Charite Vivantes Services GmbH | Steenhuis P.,Sysmex Europe GmbH | Linssen J.,Sysmex Europe GmbH | Weimann A.,Charite Vivantes Services GmbH
Clinical Laboratory | Year: 2015

Background: Since the recent introduction of Sysmex hematology analyzers of the XN-series it can be expected that the values of individual hematological parameters might differ between the new XN and the well-established XE platform. One such parameter is called Neutrophil-Granularity-Intensity or NEUT-GI on the XN-series and NEUT-X on the XE-series. Both parameters are used by clinicians to calculate the Granularity-Index (GI-Index), an important tool to detect hypo- or hypergranulated neutrophils occurring during myelodysplasia or inflammation. The aims of this study were to determine if previously reported reference intervals for NEUT-X can be used for NEUT-GI as well and if the GI-Indices on both analyzer platforms correlate with each other. Methods: NEUT-GI and NEUT-X were assessed in a set of 789 blood samples (n = 543 samples from adult intensive care units and n = 246 samples from adult "blood-healthy" control patients) and the corresponding Granularity-Indices were calculated for all samples using data obtained from XE-5000 and XN-1000 hematology analyzers. Results: NEUT-GI and NEUT-X correlated significantly with each other (r2: 0.6512; p < 0.0001) with statistically significant higher values for NEUT-GI compared to NEUT-X in the control group (p < 0.0001) as well as in the ICU patients (p < 0.0001). This indicated that previously established reference intervals for NEUT-X cannot be used for NEUT-GI. In contrast, the Gl-Indices showed no statistically significant difference between the analyzers in both groups. The Gl-Indices were higher in the ICU patients compared to the control group on both analyzer platforms (p < 0.0001), as would be expected. Conclusions: Our study revealed the emphatic need for a new reference interval for NEUT-GI on the XN platform. The resulting 95% reference intervals were 140.91-160.46 channels for NEUT-GI and 129.20-142.33 channels for NEUT-X. The Gl-Indices showed no significant statistical difference between the XN- and XE-series in both cohorts.

Ulset R.A.,Molde Sjukehus | Petrasch E.,Medizinisches Versorgungszentrum Dr Stein Kollegen GbR | Saker J.,Sysmex Europe GmbH | Linssen J.,Sysmex Europe GmbH | And 4 more authors.
Clinical Laboratory | Year: 2014

Background: Storing K,EDTA-conjugated blood samples at room temperature or under insufficient cooling conditions results in various morphological changes such as swelling of the blood cells. These changes are reproducible and have already been described well. However, they can lead to incorrect flagging when using automated hematology analyzers for complete blood counts and white blood cell differentials. The aim of this study was to determine if those changes can be detected automatically and used to prevent false positive flagging. Methods: 150 blood samples were aged under controlled conditions and the impact on the "Aged sample" software was checked retrospectively. The results were verified in a second retrospective study including 6288 routine samples. Results: When tested in a routine laboratory, the "Aged sample" software was able to reduce overall flagging by 23% without increasing false negative flagging. Conclusions: The "Aged sample" software of XN-Series analyzers does not only detect and flag samples that are aging or were stored under suboptimal conditions but also prevents false positive flagging. © Copyright.

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