Sysmex XE-2100 Hematology Analyzer Research Articles

Immature Platelet Fraction as a Predictor of Recovery of Platelets in Febrile Thrombocytopenia Patients

Abstract Introduction: Infection is the most common cause of thrombocytopenia. Thrombocytopenia is a common hematological abnormality in infections such as viral (dengue), malaria, rickettsial infections, and leptospirosis which demands platelet transfusion in many severe cases. Although platelet transfusion is lifesaving, it has its own hazards. Hence, we used new parameters such as immature platelet fraction (IPF), which is a measure of reticulated platelets that reflects the rate of thrombopoiesis. This study was performed to assess the role of IPF in predicting platelet recovery in febrile thrombocytopenia patients. Materials and Methods: Blood samples from 50 patients were collected for IPF on day 2 of admission with 5 days of platelet count (day 1 through day 5 of admission). IPF is analyzed by Sysmex XE-2100 hematology analyzer in the platelet channel with fluorescent dye and carefully designed gating system and counted with a special software IPF master 7. IPF values against platelet count were assessed separately from day 1 to day 5. Results: The reference intervals of IPF >8% and IPF <8% were assessed against platelet count. An increase in IPF favored an increase in platelet count on day 4 and day 5. It was found that IPF has a strong correlation with the recovery of platelet counts. In patients with febrile thrombocytopenia, 82.4% of patients showed recovery within 24 h after attaining the peak IPF. One hundred percent of patients showed recovery within 24–48 h of the rise of the IPF. Conclusion: A rapid and inexpensive automated measurement of IPF can be integrated as a standard parameter to evaluate the thrombopoietic state of the bone marrow. From the study, we concluded that IPF is an important predictor of increase in platelet count. Increase in IPF >8% suggests that platelet count will be increased in the next 48 h indicating that further platelet transfusion will not be required.

Reference Intervals for the Neutrophil to Lymphocyte Ratio (NLR) in the Elderly: Results from the Prospective Seniorlab Study

Introduction: The neutrophil to lymphocyte ratio (NLR) has increasingly gained interest as an independent and easy to obtain prognostic factor of morbidity and mortality in malignant, immunologic, infectious, and cardiovascular disease. Whereas reference intervals in non-geriatric patients have already been described, such decision aids are so far lacking in the elderly. Thus, reference intervals for the NLR were evaluated in seniors, where diseases with NLR-associated prognosis are frequently encountered. Methods: Within the framework of the SENIORLAB study, subjectively healthy Swiss individuals aged 60 years and older were prospectively included and followed for morbidity and mortality. Participants who had circumstances known to affect the NLR were excluded (i.e., smoking, cancer, steroids, inflammation with CRP>5mg/L, known underlying hematological disease) as were participants, who did not survive during a prespecified follow-up period. Automated blood cell differential was measured with a Sysmex XE-5000 hematology analyzer (Sysmex, Horgen, Switzerland). Double sided 95%-reference intervals (RI) together with their 90% confidence intervals (CI) were calculated according to the Clinical and Laboratory Standards Institute (CLSI) guideline EP28-A3c by means of the robust method. Outliers were eliminated according to Tukey. Results: A total of 976 individuals (441 male/535 female) aged 60 to 99 years and a mean follow-up period of 3.7+/- 0.7 years were included into the study. NLR increased significantly with age (Spearman rank rho= 0.22; p<0.001) and males had a significantly higher median NLR (1.91, interquartile range, IQR [1.5,2.47]) than females (1.73, IQR [1,34,2.25]) (p<0.001). Thus, RI were stratified according to age and gender. In males, RI were 0.98 to 3.22 (90%CI [0.92,1.06] and [3.06,3.39]) at age 60-69 years, 0.95 to 4.28 (90%CI [0.88,1.02] and [3.90,4.69]) at age 70 to 79 years, and 1.01 to 6.43 (90%CI [0.90,1.14] and [5.36,7.66] at age 80 years and older. In females the respective RI's were: 0.83 to 3.38 (90% CI [0.79,0.88] and [3.12,3.66]) at age 60-69 years, 0.84 to 3.58 (90% CI [0.77,0.91] and [3.36,3.82]) at age 70-79 years, as well as 1.09 to 4.76 (90%CI [1.01,1-18] and [4.14,5.48]) at age 80 years and older. Conclusions: In the elderly, age, and sex specific differences in the NLR can be observed. Male sex and older age is associated with higher reference limits. An age and gender specific use of reference intervals for NLR is thus suggested in the elderly.

Combined hematologic parameters to optimize review criteria on XE-5000.

Forty-one consensus review rules are presented to a large number of hematology laboratories worldwide, as suggested by the International Consensus Group for Hematology Review. Research on the review criteria has mainly focused on adjusting the threshold of each parameter to establish optimized criteria with better efficiency based on the consensus group criteria. This study aimed to optimize the review criteria by combining hematologic parameters on a Sysmex XE-5000 hematology analyzer (XE-5000). A total of 662 nucleated red blood cell (NRBC) and 406 atypical lymphocyte cell (AL)flagged samples were used to establish hematologic parameters associated with NRBC and AL, respectively. Another set of 1423optimization samples were used to validate the optimized criteria of NRBC and AL by combining associative hematologic parameters. The efficiency of each set of criteria was compared and optimized to obtain better efficiency, an acceptable slide review rate, and a low false-negative rate. In the optimization NRBC set combining triple parameters, compared with the default setting (P<.001), the slide review rate declined from 30.26% to 14.42%, and the efficiency increased from 75.65% to 91.02%. In the optimization AL set combining triple parameters, compared with the default setting (P<.001), the slide review rate declined from 40.60% to 11.80%, and the efficiency increased from 64.02% to 93.00%. Based on the adjustment of Q-flag values combining associative hematologic parameters, the optimal criteria with a low false-negative rate not only might have a higher efficiency but also may significantly reduce the slide review rate.

Clinical utility of mean platelet volume and immature platelet fraction in acute coronary syndrome

BackgroundPlatelets play an important role in the pathogenesis of acute coronary syndrome (ACS). Patients with ACS have an increased mean platelet volume (MPV) and immature platelet fraction (IPF) resulting in elevation of thrombotic ability. In this study, we evaluated the diagnostic performance of MPV and IPF in identifying suspected ACS patients at emergency department. Moreover, we investigated the correlation between MPV or IPF with initial troponin I (TnI), one of the current ACS biomarkers. MethodsThis was a single-center study recruiting suspected ACS patients who had acute chest pain at the emergency department. Whole blood samples were obtained from all participants and MPV and IPF were measured by Sysmex XE-5000 hematology analyzer within 20 min of blood sampling. The diagnostic values of MPV and IPF in identifying ACS were analyzed retrospectively. ResultIn this study, 63 in 104 suspected ACS patients were diagnosed as ACS (65.3%). MPV and IPF were higher in ACS patients compared to non-ACS patients (MPV: 10.7 ± 0.80 fL vs 10.0 ± 0.64 fL, p < 0.001; IPF: 3.7 ± 2.64% vs 3.1 ± 2.69%, p = 0.030). MPV and IPF were similar in unstable angina and acute myocardial infarction patients. We showed that elevation of MPV could be an independent predictive factor of ACS (odds ratio: 5.038). At the optimal cut-off value of 10.55 fL (AUC 95% CI: 0.637–0.836), the diagnostic performance of MPV in predicting ACS had an area under a receiver operating characteristic curve (AUC) of 0.736 with sensitivity and specificity of 54.2% and 82.8%, respectively. Patients with both of initial TnI and MPV higher than the established cut-off value had increased incidence (3.792 fold) for ACS development compared to patients with TnI below the cut-off value. Furthermore, diagnosing ACS with both MPV and initial TnI increased the positive predictive value from 84.2% to 86.7%. No correlation was observed between MPV or IPF and the mortality rate of ACS patients (MPV: 3.8% vs 11.1%, p = 0.300; IPF: 12.0% vs 37.5%, p = 0.054). ConclusionHere we show that ACS patients have higher MPV and IPF compared to non-ACS patients. We further demonstrate that MPV can be utilized as an independent predictor for early diagnosis of low-risk ACS patients who have acute chest pain.

IMMATURE PLATELET FRACTION (IPF) DAN TROMBOPOIETIN DI SIROSIS HATI

Liver cirrhosis remains a major clinical problem worldwide when associated with significant morbidity and mortality due toits complications. The presence of liver cirrhosis state affects the production of TPO influencing the process of thrombopoiesis. Thethrombopoiesis activity can be described by the Immature Platelet Fraction (IPF) value which is young platelets. The immature Plateletfraction value increases when platelet production enhances as well, on the contrary when the production declines, the IPF value is alsodecreased. This study was performed by cross-sectional method using 31 subject samples suffering from liver cirrhosis, consisting of ChildPugh score class A 2 samples (6.4%), Child Pugh score class B 9 samples (29%) and Child Pugh score class C 20 samples (64.6%). Theexamination of TPO levels was done by ELISA method using Humans TPO QuantikineR, the IPF value was examined using Sysmex XE-2100 Hematology Analyzer. The thrombopoietin serum levels in the samples ranged from 23.5 to 96.6 pg/mL with a mean of 45.1pg/mL.The immature Platelet Fraction values varied from 1.7% to 19.1% with a mean of 6.7%. From the statistical analysis, the levels of TPO andIPF at various degrees of the disease severity were not significantly different. There was no significant correlation between the TPO leveland IPF value, r = 0.038, p = 0.837. There was no significant difference between the TPO level and the IPF value in the splenomegaly andnonsplenomegaly state. In conclusion, based on this study no significant correlation was found between the IPF value with thrombopoietinserum levels, as well as the IPF and thrombopoietin levels, and there was no association with the disease severity.

Multicenter verification of the Sysmex XN-Series.

Verification of hemocytometry equipment deviates significantly from that of clinical chemistry equipment due to the absence of appropriate control material and the need for fresh material. In practice, verification is limited to comparison with the previously used equipment and determination of reproducibilities. Particularly in multicenter settings, harmonization of results is necessary. If the same equipment is used in several laboratory departments, calibration and uniformity are important issues. In this study, seven Sysmex XN hematology modules distributed over three laboratories were evaluated with the same set of samples (n=160). Results of each Sysmex XN hematology module were compared with the results of the Sysmex XE-2100 hematology analyzer using linear regression. Although excellent correlation coefficients were obtained, in many cases the criteria for slope and/or intercept were not met. Therefore, the same data were analyzed with Bland-Altman difference plots with three times the specified CV% of the parameter as limits of agreement. At least 90% of the determinations per parameter and per module must comply with those limits of agreement. Almost all parameters on each module fulfilled these criteria, and only RBC and Ht from respectively two and four XN modules had to be recalibrated. Reproducibility of each parameter was determined 10 times in patient samples with low, normal, and high levels. Reproducibility of all parameters was within the specifications of the manufacturer and the biological variability. With this straightforward method, all seven Sysmex XN hematology modules demonstrated uniform results, which were identical to those of the previously used Sysmex XE-2100 hematology analyzer, the performance of which was well known.

Evaluation of pleural and ascitic fluid analysis on the Sysmex XE-5000 hematology analyzer

ABSTRACT Introduction: Body fluid (BF) analysis is critical to the diagnosis and monitoring of several pathological conditions. The limitations of manual cell counts have led to greater interest in the development of automated BF analysis. Objective: To evaluate the analytical performance of the Sysmex XE-5000 hematology analyzer in the analysis of pleural and ascitic fluids in the laboratory routine of a large university hospital. Methods: A total of 56 samples (35 ascitic and 21 pleural fluids) were analyzed by manual optical microscopy (OM) and XE-5000. Analytical performance includes linearity, carryover, functional sensitivity and comparison of patient samples. Results: Performance studies showed linearity up to 25,825 WBC-BF/µl (r2 = 0.999), WBC-BF showed carryover of 0.18%, and the lower limit of quantitation was set at 22 WBC-BF/µl. Good correlations between the methods were observed just for total cell (TC-BF) and white blood cell (WBC-BF) counts in pleural and ascitic fluids. The high-fluorescence cell count (HF-BF) showed poor correlation but high positive predictive value (PPV) for both fluids (94.74% for pleural and 96.97% for ascitic fluid). Conclusion: XE-5000 provides accurate and precise count for TC-BF, WBC-BF and polymorphonuclear cells (PMN-BF) in pleural and ascitic fluids in medical decision levels, but the morphological differentiation should continue to be held by OM. Histogram and scattergram displayed on XE-5000 must always be analyzed to assess if there is any interference or flag. The HF-BF parameter is a potential tool for screening.

Minimal Hematology Analyzer Plus Blood Smear Digital Imaging/ Analysis Provides Better Clinical Hematology Results Than a Complex Hematology Analyzer Alone

Introduction: Devices such as the CellaVision® DM96 (CellaVision AB, Lund, Sweden) locate and image nucleated cells on blood smears. Using image recognition software, the DM96 also pre-classifies those cells into differential categories similar to the most complex hematology analyzers. We compared the cell counts, differential counts and flagging information gained from a complex hematology analyzer, the XE5000 (Sysmex, Kobe, Japan), with information from a minimal hematology analyzer (Sysmex PocHi) plus the DM96. We found that the cell counts, differential and flagging capabilities are similar, but the PocHi plus DM96 advantages include allowing remote review of the blood smear.Methods: 210 blood samples, selected for various abnormalities, had complete blood counts with automated differentials produced by a Sysmex XE5000 hematology analyzer. These results were compared with cell counts from the Sysmex PocHi hematology analyzer, their 100-cell DM96 post reclassification differentials, and with DM96 pre-classification differentials using standard regression analyses and Rumke 95% confidence intervals (CI) as calculated using the Clopper-Pearson method. Flagging by the XE5000 for immature granulocytes (IG’s) and for blasts/abnormal cells was compared to the DM96 pre-classification using truth tables with the DM96 post reclassification as the gold standard. The following translations were used to compare flagging: IG’s > 2 for either post reclassification DM96 differential, XE5000 or the DM96 pre-classification differential; Any blast cells on the manual differential were compared to XE5000 flags WBC Abn Scg; NRBC Abn Scg; Blasts?; Atyp LY?; Abn Ly/ L_Bl? and to DM96 pre-classification % Blasts > 0%; unidentified cells >3%. .Results: Non-differential blood count parameters including white blood count, red blood count, hemoglobin, mean corpuscular volume (MCV), and platelet count showed excellent correlation between the PocHi and the XE5000 with R2>0.95. Differential-dependent blood count parameters including neutrophils, lymphocytes, monocytes, eosinophils, basophils and immature granulocytes showed excellent correlation between the XE5000 and pre-classification DM96 with R2>0.95. Nucleated red cells also showed excellent correlation between the XE5000 and the DM96 with R2>0.85.For blasts/abnormal cells, the DM96 showed 100% sensitivity and 40% specificity with 0% false negatives. The XE5000 showed 93% sensitivity and 19% specificity with 3% false negative. Two of the false negatives were shared by both instruments and were 1% blasts. Of the three false negatives with the XE5000 that were true positives with the DM96, two had 1% blasts while one had 2% blasts. For immature granulocytes (IG’s), the XE5000 showed 94% sensitivity and 79% specificity with 2% false negatives. The DM96 showed 85% sensitivity and 95% specificity with 4% false negatives. All of the false negatives were for IG’s < 5%Conclusions: Pairing the DM96 or a similar imaging instrument with a relatively inexpensive hematology analyzer, such as those commonly used in physician office laboratories, would provide all of the information available from expensive, complex hematology analyzers in high throughput laboratories AND allow remote review of the blood smear findings by experts. DisclosuresBroome:CellaVision: Consultancy, Research Funding. Bengtsson:CellaVision AB: Employment, Equity Ownership. Palm:CellaVision: Employment, Equity Ownership.

Reference intervals for mean platelet volume and immature platelet fraction determined on a sysmex XE5000 hematology analyzer

Background New parameters describing the platelet population of the blood are mean platelet volume (MPV), which is a crude estimate of thrombocyte reactivity, and immature platelet fraction (IPF), which reflects megakaryopoietic activity. This study aimed to define reference intervals for MPV and IPF and to investigate whether separate reference intervals according to smoking status, age or sex are necessary.Methods Blood samples were obtained from subjects participating in The Danish General Suburban Population Study. MPV and IPF measurements were performed by the use of the Sysmex XE-5000 hematology analyzer. Reference intervals were established by a non-parametric method.Results In total, 1674 apparently healthy individuals (910 females and 764 males) were included. No significant age, sex or smoking status difference was observed. The reference interval was 9.6–13.1 fL for MPV and 1.3–9.0% for IPF, respectively.Conclusion We have generated reference intervals for MPV and IPF in a large, adult Danish population and found those parameters remarkably stable across age, sex and smoking status.

Automated Nucleated RBC Measurement Using the Sysmex XE-5000 Hematology Analyzer: Frequency and Clinical Significance of the Nucleated RBCs.

We validated the automatic nucleated RBC (nRBC) count on a Sysmex XE-5000 hematology analyzer (Sysmex Corporation, Kobe, Japan) and then evaluated the frequency of nRBCs in our patient population. We correlated automated nRBC enumeration by the Sysmex XE-5000 hematology analyzer on 463 peripheral blood (PB) samples with the manual nRBC count. Results from 360,504 consecutive blood samples were reviewed to determine the frequency of nRBCs in various patient populations in our hospital. There was a strong correlation between the automated and manual nRBC count (Pearson's r = 0.97). Frequency of nRBCs varied in different patient populations and was significantly higher in the presence of other morphology flags or abnormal CBC parameters. Low-level nRBCs (0.2%-1.3%) were detected in 0.5% of samples with otherwise normal parameters. The automated method offers many advantages for high-throughput laboratories, including faster turnaround time, labor savings, and high reliability. Automated nRBC measurement allowed us to recognize a group of individuals who have low-level circulating nRBCs with otherwise normal CBC parameters. Nucleated RBC levels below 1.5% as detected by the automated count may be present in patients without increased erythropoiesis or a pathologic bone marrow process.

How Significant is the "Reticulocyte Channel" Request on the Sysmex XE-5000 Hematology Analyzer?

How Significant is the "Reticulocyte Channel" Request on the Sysmex XE-5000 Hematology Analyzer?

Evaluation of Mindray BC-5000 hematology analyzer: a new miniature 5-part WBC differential instrument.

The Mindray BC-5000 automated hematology analyzer is a miniature, automated hematology analyzer, and 5-part leukocyte differential counter for in vitro diagnostic use in clinical laboratories. Precision, linearity, carryover, and method comparison were carried out. The analyzer was evaluated and compared with the Sysmex XE-2100 hematology analyzer and manual microscopic in the hematology laboratory of a tertiary hospital in Chinese. There were minimal carryover (<0.25%), and excellent linearity for white blood cell, and platelet counts (r > 0.99). Within-run precision was good at all levels for the routine cell blood count parameters (CV < 3.5%). Between-run precision was acceptable at all levels for the analysis parameters (CV < 5%) except for eosinophil and basophil (CV% >10%). BC-5000 displayed very good correlation (r > 0.94) with the XE-2100 for cell blood count and cell differential parameters except for basophil (r = 0.72). The comparison of 258 leukocyte differential count results analyzed in parallel with manual microscopy, BC-5000 analyzer showed perfect specificity (93%) and negative predictive value (90%) on abnormal blood samples. It is concluded that the overall performance of the BC-5000 is acceptable. The miniature analyzer is suitable for use in small- to medium-size laboratories.

The Potential of Dewa Leaves (Gynura Pseudochina (L) D.C) and Temu Ireng Rhizomes (Curcuma aeruginosa Roxb.) as Medicinal Herbs for Dengue Fever Treatment

There are a lot of natural resources that potentially used as herbal medicines in Indonesia. Some of the herbs, like Dewa leaves (Gynura pseudochina (L) D.C) and temu ireng rhizome (Curcuma aeruginosa Roxb.), were ussually used to increase number of thrombocytes in dengue patient. This current study was to determine the potential of dewa leaves (Gynura pseudochina (L) D.C) and temu ireng rhizome (Curcuma aeruginosa Roxb.) against the number of trombocytes, erythrocytes, and hematocrits level on male white rats (Rattus novergicus) by using Heparin Induction. Dosages of the extracts were 250mg/kg BW and 500mg/kg BW used for both dewa leaves and temu ireng rhizome. Extracts were given orally to the tested animals for seven continuous days. The number of trombocytes, erythrocytes, and hematocrites level were examine at day 7 using sysmex XE-5000 hematology analyzer. The result showed that the rat groups which were treated with dewa leaves extract at 500mg/kgBW; temu ireng Rhizomes extract at 250mg/kgBW and 500mg/kgBW dosages had significant differences (α = 0.05) on number of thrombocytes. The percentages of thrombocytes number enhancement for temu ireng rhizomes extract 500mg/kgBW, temu ireng rhizomes extract 250mg/kgBW, dewa leaves extract 500mg/kgBW were 26.98%, 24.48%, 19.44% respectively. The rats group which were treated with temu ireng Rhizomes extract at 500mg/kgBW, dewa leaves extract at 250mg/kgBW and 500mg/kgBW had significant differences (α = 0.05) on erythrocytes number and hematocrits level enhancement. The percentages of erythrocytes number enhancement for dewa leaves extract at dose of 500mg/kgBW and 250mg/kgBW, temu ireng rhizomes extract 500mg/kgBW were 9.59%, 9.11%, 9.02% respectively. The highest percentages of hematocrits level enhancement was given by dewa leaves extract at dose of 500mg/kgBW (10,97%), suggesting that the extracts treatment would not trigger plasma leakage. Thus, dewa leaves extract at 500mg/kgBW; temu ireng rhizomes extract at 250mg/kgBW and 500mg/kgBW dosages are potential as candidates to be medicinal herbs to increase numbers of thrombocytes on dengue fever treatment

Establishing biological reference intervals for novel platelet parameters (immature platelet fraction, high immature platelet fraction, platelet distribution width, platelet large cell ratio, platelet-X, plateletcrit, and platelet distribution width) and their correlations among each other.

This study aims to establish biological reference interval for novel platelet parameters. A total of 945 healthy individuals, age ranges from 18 to 64 years (881 males and 64 females) coming for voluntary blood donation from June to August 2012 (3 months) were enrolled after exclusion of rejection criteria. The samples were assayed by running in complete blood count + reticulocyte mode on the Sysmex XE-2100 hematology analyzer and the reference interval for the population was calculated using Clinical and Laboratory Standards Institute guidelines. Tests were performed using SPSS (Statistical Product and Service Solutions, developed by IBM corporation), version 13. Student t test and pearsons correlation analysis were also used. The normal range for various parameters was platelet count: 150-520 × 10(3)/cu mm, immature platelet fraction (IPF): 0.3-8.7%, platelet distribution width (PDW): 8.3-25.0 fL, mean platelet volume (MPV): 8.6-15.5 fL, plateletcrit (PCT): 0.15-0.62%, high immature platelet fraction (H-IPF): 0.1-2.7%, platelet large cell ratio (P-LCR): 11.9-66.9% and platelet-X (PLT-X) (ch): 11.0-22.0. Negative correlation was observed between platelet count (r = -0.468 to r = -0.531; P < 0.001) and PCT (r = -0.080 to r = -0.235; P < 0.05 to P < 0.001) with IPF, PDW, MPV, H-IPF, P-LCR, and platelet-X. IPF/H-IPF showed a positive correlation among them and also with PDW, MPV, P-LCR, platelet-X (r = +0.662 to r = +0.925; P < 0.001). These novel platelet parameters offer newer avenues in research and clinical use. Establishing biological reference interval for different platelet parameters would help determine true high and low values and help guide treatment decisions.

Utility of neut-X, neut-Y and neut-Z parameters for rapidly assessing sepsis in tumor patients

BackgroundThe Sysmex XE-5000 hematology analyzer evaluates toxic granulation and the nuclear maturity of toxic granulation neutrophils via the parameters neut-X and neut-Y. This study investigated whether neut-X and neut-Y could facilitate the auxiliary diagnosis of sepsis. MethodsBlood samples were collected from 113 patients with tumors and 130 healthy individuals to detect neut-X, neut-Y, and C-reactive protein (CRP) values. Then, we created a new parameter, neut-Z, the vector sum of neut-X and neut-Y. Furthermore, we assessed procalcitonin (PCT) concentrations in patients with sepsis and compared the values with those for neut-X, neut-Y, and neut-Z. ResultsNeut-X, neut-Y, neut-Z, and CRP values were significantly higher in the sepsis group than in the non-sepsis and healthy groups. The ROC-AUCs for neut-X, neut-Y, neut-Z, and CRP for a diagnosis of sepsis were 0.87 (sensitivity 82%, specificity 79%), 0.87 (78 and 94%, respectively), 0.91 (82 and 88%, respectively), and 0.95 (96 and 89%, respectively), respectively. Additionally, neut-X, neut-Y, and neut-Z were correlated with CRP and PCT levels. ConclusionsNeut-X and neut-Y can be used as rapid and simple auxiliary indicators in the diagnosis of sepsis in patients with tumors, and neut-Z appears to display better performance than its 2 components.

Use of RBC-O and S-MCV Parameters of Sysmex XE-2100 in a Patient with RBC Cold Agglutination

Sometimes EDTA blood of erythrocyte agglutination cannot be well resolved by incubation at 37 degrees C. In this case report, however, such a specimen was detected from a lymphoma patient at room temperature by using RBC-O and S-MCV parameters of the SYSMEX XE-2100 hematology analyzer. The specimen was diluted with 0.9% NaCL solution at 1:1 before measurement. HCT, MCV, and MCHC, corrected by RBC-O, HGB and S-MCV, were all in their normal ranges. This case indicates that RBC-O and S-MCV parameters of XE-2100 can be used in the routine blood examination of erythrocyte agglutination specimen at room temperature.

Is the Platelet Clumping (PC) Flag on the Sysmex XE-5000 Hematology Analyzer Reliable?

Is the Platelet Clumping (PC) Flag on the Sysmex XE-5000 Hematology Analyzer Reliable?

Efficacy of Advanced Discriminating Algorithms for Screening on Iron-Deficiency Anemia and β-Thalassemia Trait

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.

Characteristics of patients suffering from cow milk allergy

The most frequent symptoms among the manifestations of cow milk allergy (CMA) are gastrointestinal. CMA pathogenesis involves immunological mechanisms with participation of immunocompetent cells, production of immunoglobulin E (IgE) and immunoglobulin G (IgG). We aim to determine whether cow milk-specific IgE antibodies coexist with cow milk-specific IgG antibodies in CMA patients with diarrhea symptom, and if there is any relationship between both antibody types. 65 CMA patients (average age of 17years, ranging from 2 to 74years), all of who had diarrhea symptom of CMA, were enrolled in this study. The total cow IgE and IgG subclass in serum were measured by electrochemiluminescence immunoassay and rate immune scatter turbidimetry, respectively. And also the cow milk-specific IgE was determined by enzyme-linked immunosorbent assay. The number of eosinophils in serum was calculated by Sysmex XE-2100 Hematology Analyzer. Our data showed that both cow milk-specific IgG and IgE levels were significantly elevated in CMA patients compared to those of age-matched control subjects. Out of the 65 CMA patients, 40 showed elevated cow milk-specific IgE antibody level, among which, 28 cases presented highly sensitive reaction to cow milk-specific IgG, along with each six of moderate and mild sensitive reaction to cow milk-specific IgG; while 20 showed elevated total IgG levels. The IgG3 positive rate was 16.9%, which was the highest. A moderate correlation between cow milk-specific IgE and cow milk-specific IgG was found in the CMA patients (r=0.415, P=0.001). The results indicated that cow milk-specific IgE antibodies could coexist with cow milk-specific IgG antibodies in patients suffering from CMA. The aberrant changes in the concentration of cow milk-specific IgE antibodies were associated with cow milk-specific IgG antibodies.

Performance Evaluation of the Sysmex XE-5000 Hematology Analyzer for White Blood Cell Analysis in Cerebrospinal Fluid

The newest generation hematology analyzer, Sysmex XE-5000 (Sysmex Corporation, Kobe, Japan) is equipped with an improved body fluid analysis mode. To evaluate the applicability of the XE-5000 analyzer to white blood cell (WBC) analysis in cerebrospinal fluid (CSF). A total of 425 routinely collected, consecutive CSF samples were included in the study. For a comparison of total WBC counts, the results of routine chamber counts were grouped into categories of 0 to 5 (n = 330), >5 to 10 (n = 36), >10 to 50 (n = 39), >50 to 200 (n = 15), and >200 (n = 5) WBC/µL. Microscopic differential counts were performed using cytospins from 276 samples. Results were grouped according to the percent content of polymorphonuclear (PMN) cells, 0% to 25% (n = 263), >25% to 50% (n = 7), >50% to 75% (n = 3), and >75% to 100% (n = 3) of WBC. Corresponding results of XE-5000 analysis were matched to these particular count categories. For total WBC counts, the proportions of samples correctly classified by the XE-5000 from the percentage groups described above were 88%, 47%, 72%, 93%, and 100%, respectively. After the two lowest count categories were combined into one range of 0 to 10 WBC/µL, matches increased to 95%. For PMN counts in the 0% to 25% group, 37% of samples were misclassified by the XE-5000. Conversely, for samples with microscopic PMN counts of more than 25%, there was a trend toward underestimation by the XE-5000. Mismatches were most pronounced in samples with fewer than 10 WBC/µL. The Sysmex XE-5000 hematology analyzer yields valid total CSF cell counts and may be considered an acceptable alternative to the traditional chamber method, even for samples with low WBC counts. However, it cannot be recommended as a suitable alternative for manual differential cytologic workup.