Abstract

In current laboratory practice, obtaining a nucleated red blood cell (NRBC) count by manual microscopy (MM) is a laborious and time-consuming process. Modern hematology analyzers based on different technologies and methods have variable accuracies when determining NRBC counts. The aim of this study was to compare NRBC counts acquired by an automated Mindray BC-6800 analyzer (BC-6800), a flow cytometry (FC) reference method, and traditional MM. A hundred EDTA samples with initial NRBC flags from the BC-6800 were included. FC was used as a reference method to correlate the NRBC count with BC-6800 and MM counts. In addition, the performance of the Mindray SC-120 analyzer for preparing automated blood films for manual NRBC counting was compared to that of manually prepared blood films. The NRBC counts obtained with the BC-6800 and MM vs the reference method were highly correlated (r=.994 and .989, respectively). However, the BC-6800 showed a lower bias than MM when compared with FC (0.3×109 /L and -6.0×109 /L, respectively). NRBC counts obtained using the automated Mindray SC-120 films were comparable to manually prepared films. The Mindray CAL8000 automated hematology system, which is composed of the BC-6800 and the SC-120, yields a precise NRBC count and can replace the traditional MM method for obtaining accurate and reproducible NRBC counts in high-value samples, such as patient monitoring samples used to determine the necessity of transfusion therapy in thalassemia patients. Moreover, this method offers several advantages, including a faster turnaround time, labor savings, and cost effectiveness.

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