Introduction
Recent automated hematology analyzers (HAs) can identify and report nucleated red blood cells (NRBC) count as a separate population out of white blood cells (WBC). The aim of this study ...was to investigate the analytical performances of NRBC enumeration on five top of the range HAs.
Methods
We evaluated the within‐run and between‐day precision, limit of blank (LoB), limit of detection (LoD), and limit of quantitation (LoQ) of XE‐2100 and XN‐module (Sysmex), ADVIA 2120i (Siemens), BC‐6800 (Mindray), and UniCel DxH 800 (Beckman Coulter). Automated NRBC counts were also compared with optical microscopy (OM).
Results
The limits of detection for NRBC of the BC‐6800, XN‐module, XE‐2100, UniCel DxH 800, and ADVIA 2120i are 0.035×109/L, 0.019×109/L, 0.067×109/L, 0.038×109/L, and 0.167×109/L, respectively. Our data indicated excellent performance in terms of precision. The agreement with OM was excellent for BC‐6800, XN‐module, and XE‐2100 (Bias 0.023, 0.019, and 0.033×109/L, respectively). ADVIA 2120i displayed a significant constant error and UniCel DxH 800 both proportional and small constant error.
Conclusion
Regards to NRBC counting, the performances shown by BC‐6800, XN‐module, and XE‐2100 are excellent also a low count, ADVIA 2120i and UniCel DxH 800 need to be improved.
Background
The aims of this study were to compare the diagnostic accuracy of blood smear review criteria, by means of three different panel rules, those proposed by: the International Consensus Group ...for Hematology 41‐ICGH rules, the Italian Survey IS rules and the Working Group on Hematology‐SIBioC (WGH) consensus rules (WGH rules).
Methods
This study is based on 2707 peripheral blood (PB) samples referred for routine hematological testing to the WGH‐associated laboratories displaced all over the Italian territory. The PB samples were processed on seven different hematology analyzers (HAs): Advia 2120i, XE‐2100, BC‐6800, ABX Pentra, XN‐1000, Cell‐DYN Sapphire, and DxH800, respectively. All the results provided by the HAs were analyzed through the application of three different blood smear review criteria: that is, the 41‐ICGH, IS, and WGH rules. Finally, data were compared with those obtained by optical microscopy (OM), as the current gold standard.
Results
The overall the agreement OM classification with ICGH, IS, and WGH panel rules is 0.83, 0.83, and 0.85, respectively. The false negatives are 2.1%, 3.0%, and 2.9%, while false positives are 15.1%, 13.7%, and 11.7%, respectively. All the seven HAs showed variable interinstrument performance, as three different criteria for OM review were adopted on each of them from time to time.
Conclusion
These results presented show that the customization of validation rules is necessary for enhancing the quality of hematological testing and optimizing workflow.
Preanalytical Phase in Haematology Banfi, Giuseppe; Germagnoli, L.
Journal of medical biochemistry,
07/2008, Letnik:
27, Številka:
3
Journal Article
Recenzirano
Odprti dostop
The preanalytical phase is particularly important in haematology, where counts of particles and cells are performed in whole anticoagulated blood. The correct use and concentration of anticoagulant ...is mandatory to avoid spurious results, which can influence clinical decision. EDTA is the anticoagulant of choice, but it has some limits, especially for preserving stability and shape of platelets. Stability of haematological parameters is high, with the exception of leukocytes and reticulocytes. However, stability (and instrumental precision) should be evaluated together with biological variability and individuality index of various haematological parameters. Hematological tests are also influenced and interfered by high amounts of lipids and chylomicrons. The mixing procedure of the tubes after blood drawing and before analysis is also crucial for obtaining correct and valid data. There are some examples of interferences on automated haematological analysers which are used for diagnosing and screening pathological conditions. Cryoglobulins and erythrocytes parasites can induce spurious results of WBC, RBC and PLT, but the repeatability of these interferences could be used for alerting the pathologist and could reveal the presence of pathological proteins or blood parasites. New parameters have been proposed by modern haematological analysers, directly defined or calculated from traditional measures, but the clinical impact of these new parameters is often dependent on preanalytical variables.
Preanalitička faza je naročito važna u hematologiji, gde se merenja čestica i ćelija vrše u celoj antikoagulisanoj krvi. Ispravna upotreba kao i koncentracija antikoagulansa je obavezna kako bi se izbegli nejasni rezultati, koji mogu uticati na kliničko odlučivanje. EDTA je preporučljivi antikoagulans, mada ima izvesna ograničenja, posebno u vezi sa očuvanjem stabilnosti i oblika pločica. Stabilnost hematoloških parametara je visoka, sa izuzetkom leukocita i retikulocita. Međutim, stabilnost (i instrumentalnu preciznost) treba ocenjivati zajedno sa biološkom varijabilnošću i indeksom individualnosti različitih hematoloških parametara. Na hematološke testove takođe utiču visoke koncentracije lipida i kilomikrona. Postupak mešanja epruveta posle uzimanja krvi a pre analize takođe je ključan za dobijanje tačnih i validnih podataka. Postoje primeri interferencije na automatizovanim hematološkim analizatorima koji se koriste za dijagnostikovanje i praćenje patoloških stanja. Krioglobulini i paraziti eritrocita mogu izazvati nejasne rezultate WBC, RBC i PLT, ali ponavljanje takvih interferencija može se iskoristiti za alarmiranje lekara i može ukazati na prisustvo patoloških proteina ili parazita u krvi. Moderni hematološki analizatori donose nove parametre, direktno definisane ili izračunate na osnovu tradicionalnih mera, ali klinički uticaj tih novih parametara često zavisi od preanalitičkih varijabli.
BACKGROUND:Serum creatine kinase and myoglobin elevation has been described involving muscle manipulation after surgery and also after bariatric, urologic and gynaecologic procedures. It encompasses ...a wide range of severity, reflecting in the worst cases true rhabdomyolysis. We occasionally noted creatine kinase elevations after intracranial neurosurgery, an occurrence that has not yet been described. To assess whether the issue of postoperative muscle enzyme elevation is relevant to neurosurgery, we prospectively measured serum creatine kinase and myoglobin in a series of neurosurgical patients submitted to craniotomy.
MATERIALS AND METHODS:We studied 30 patients aged 22–69 yr submitted to craniotomy. Blood samples were taken prior to the procedure, at the end of anaesthesia and on the first, second and third postoperative days. Blood was checked for creatine kinase, myoglobin, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen, creatinine and serum electrolytes. We recorded the patientʼs age, sex, height, weight and body mass index. Throughout surgery, we recorded the highest and the lowest body temperature and sampled the mean arterial pressure at 5 min intervals. We performed backwards stepwise logistic regression analysis to identify the elements that best correlate with the development of cell muscle damage.
RESULTS:On the first postoperative day creatine kinase peaked from baseline (305 (107–1306) UI L vs. 59 (42–94) UI L; P < 0.001) while myoglobin rose significantly from baseline to the end of surgery (70 (42–147) ng mL vs. 36 (30–44) ng mL; P = 0.002). Logistic regression showed that length of surgery was the only factor clearly influencing peak creatine kinase (P < 0.001; R 0.7) and myoglobin (P = 0.011; R 0.41) concentration.
CONCLUSIONS:Creatine kinase and myoglobin elevation may occur after intracranial neurosurgery. In our series, length of surgery was a risk factor.
Carbohydrate‐deficient transferrin (CDT) is the most specific marker for diagnosis of chronic excessive alcohol consumption and includes the serum transferrin (Tf) isoforms with two or less sialic ...acid residues (di‐, mono‐, and asialo‐Tf). To monitor serum CDT, we developed a capillary zone electrophoresis (CZE) method based on the dynamic capillary coating with diethylenetriamine (DETA). The separation was performed in a bare fused‐silica capillary (50 μm ID, 57 cm in length), applying a voltage of 25 kV and a temperature of 40°C. Using a 100 mmol/L borate buffer, pH 8.4 with 3 mmol/L DETA, the Tf isoforms (asialo‐ to pentasialo‐Tf) were resolved within 16 min. Enzymatic cleavage of sialic acid residues with neuraminidase and immunosubtraction were used to identify CDT isoforms. The relative amount of CDT expressed as area % of disialo‐Tf isoform related to the area of tetrasialo‐Tf in 50 healthy donors (24 males and 26 females; aged 25–50 years) was 3.15 ± 0.76% (mean ± SD). The comparison between CDT values obtained by this CZE procedure and the “Axis‐Shield %CDT” kit gave r = 0.644, p < 0.001 (n = 290). This easy to use and inexpensive CZE procedure could be an ideal tool to investigate CDT proteins for clinical or forensic purposes.
Fifty bone marrow biopsies (BMB) and aspirates (BMA) of AIDS patients were examined to identify possible morphologic signs of HIV infection. The following parameters were evaluated: 1) cellularity; ...2) myelo-erythroid ratio (M:E); 3) morphology of haemopoietic lineages; 4)plasmacell amount; 5) lymphocytes amount; 6)reticulin content. Hypercellularity, increase in number and morphological alterations of megakaryocytes, raised reticulin content, mild plasmacytosis and frequent presence of reactive lymphoid aggregates are features suggestive, thought not diagnostic, for HIV infection on BMB. It results that bone marrow morphologic examination in HIV-positive patients plays a distinctive role in ruling out the presence of opportunistic infections or associated neoplasias (haematologic or not) and in contributing to clarify the significance of a peripheral pancytopenia.
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