Abstract
The performance of platelet (PLT) counting in thrombocytopenic samples is crucial for transfusion decisions. We compared PLT counting and its reproducibility between Mindray BC-6800Plus (BC-6800P, Mindray, Shenzhen, China) and Sysmex XN-9000 (XN, Sysmex, Kobe, Japan), especially focused on thrombocytopenic samples. We analyzed the correlation and agreement of PLT-I channels in both analyzers and BC-6800P PLT-O mode and XN PLT-F channel in 516 samples regarding PLT counts. Ten thrombocytopenic samples (≤2.0 × 109/L by XN PLT-F) were measured 10 times to investigate the reproducibility with the desirable precision criterion, 7.6%. The correlation of BC-6800P PLT-I and XN PLT-I was arranged moderate to very high; but the correlation of BC-6800P PLT-O and XN PLT-F was arranged high to very high. Both BC-6800P PLT-I vs. XN PLT-I and BC-6800P PLT-O vs. XN PLT-F showed very good agreement (κ = 0.93 and κ = 0.94). In 41 discordant samples between BC-6800P PLT-O and XN PLT-F at transfusion thresholds, BC-6800P PLT-O showed higher PLT counts than XN-PLT-F, except the one case. BC-6800P PLT-O exceeded the precision criterion in one of 10 samples; but XN PLT-F exceeded it in six of 10 samples. BC-6800P would be a reliable option for PLT counting in thrombocytopenic samples with good reproducibility.
Highlights
Clinical practice guidelines and researches have suggested that the threshold for prophylactic platelet (PLT) transfusion can be safely set at 20 × 109/L, 10 × 109/L, or even lower according to the patients’ condition and the reversibility of their bone marrow failure [1,2,3,4,5,6,7]
The international reference method is based on flow cytometry using monoclonal antibodies (i.e., CD61 and CD41) for PLT counting proposed by the International Council for Standardization in Haematology (ICSH) [9,10]
We evaluated the performance of PLT counting of BC-6800P compared with Sysmex XN-9000 (XN), which is currently used as a routine hematology analyzer in our laboratory, according to their PLT counting methods
Summary
Clinical practice guidelines and researches have suggested that the threshold for prophylactic platelet (PLT) transfusion can be safely set at 20 × 109/L, 10 × 109/L, or even lower according to the patients’ condition and the reversibility of their bone marrow failure [1,2,3,4,5,6,7]. The performance of PLT counting in thrombocytopenic samples is crucial for clinical practice, especially in PLT transfusion management [8]. The international reference method is based on flow cytometry using monoclonal antibodies (i.e., CD61 and CD41) for PLT counting proposed by the International Council for Standardization in Haematology (ICSH) [9,10]. Flow cytometric analysis has some obstacles, such as lack of widespread availability of dedicated instrumentation, standardization issues, labor intensiveness, and the higher cost of its analysis compared with modern automated hematology analyzers using impedance and/or optic detection with fluorescent labeling and flow cytometry [8,9,10,11]. Mindray BC-6800Plus (BC-6800P, Mindray Bio-Medical Electronics Co., Ltd., Shenzhen, China) uses an impedance channel (PLT-I) and an optic detection with fluorescent labeling mode (PLT-O). Sysmex XN-9000 (XN, Sysmex, Kobe, Japan) uses an impedance channel (PLT-I), optical channels (PLT-O), and fluorescent channel (PLT-F), separately
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