E Schapkaitz1, S Raburabu2. 1. Department of Molecular Medicine and Haematology, University of Witwatersrand Medical School, Johannesburg, South Africa. Electronic address: elise.schapkaitz@nhls.ac.za. 2. Department of Molecular Medicine and Haematology, National Health Laboratory Service, Johannesburg, South Africa.
Abstract
BACKGROUND: The automated Sysmex XN-9000 hematology system has been designed to meet the throughput and efficiency requirements of high volume laboratories with predominantly abnormal samples. New measurement channels have been introduced namely the white cell nucleated (WNR), white cell differential (WDF), white cell precursor (WPC) and fluorescent platelet (PLT-F) channels. METHODS: The performance of the new measurement channels was evaluated with regards to precision, accuracy, linearity, carryover, throughput and stability. 275 slides were assessed for morphology flagging. Adult and pediatric samples with normal and abnormal hematology profiles were included. RESULTS: The XN-9000 demonstrated acceptable imprecision, good linearity for high and low ranges and no carryover. The full blood count and reticulocyte on the XN-9000 correlated well with the reference ADVIA(2)120. The PLT-F (127±84×109/l) compared with the optical platelet count (131±76×109/l) (r=0.97) and the imprecision was <4% on thrombocytopenic samples. The low white blood cell (WBC) mode reported accurate differentials for samples with a WBC count<0.5×109/l (r=0.93). The nucleated red blood cell count from the WNR (1.22±3.96%) showed an excellent correlation with the manual method (1.12±4.79%) (r=0.99). The WPC channel showed 100% sensitivity for the detection of blasts and abnormal lymphocytes. Further, the WPC correctly suppressed the initial blast/abnormal lymphocyte flag in 34% of the reflexed samples. CONCLUSION: The XN-9000 showed enhanced analytical performance and workflow efficiency for a wide range of patient samples which can be attributed to the incorporation of new measurement channels.
BACKGROUND: The automated Sysmex XN-9000 hematology system has been designed to meet the throughput and efficiency requirements of high volume laboratories with predominantly abnormal samples. New measurement channels have been introduced namely the white cell nucleated (WNR), white cell differential (WDF), white cell precursor (WPC) and fluorescent platelet (PLT-F) channels. METHODS: The performance of the new measurement channels was evaluated with regards to precision, accuracy, linearity, carryover, throughput and stability. 275 slides were assessed for morphology flagging. Adult and pediatric samples with normal and abnormal hematology profiles were included. RESULTS: The XN-9000 demonstrated acceptable imprecision, good linearity for high and low ranges and no carryover. The full blood count and reticulocyte on the XN-9000 correlated well with the reference ADVIA(2)120. The PLT-F (127±84×109/l) compared with the optical platelet count (131±76×109/l) (r=0.97) and the imprecision was <4% on thrombocytopenic samples. The low white blood cell (WBC) mode reported accurate differentials for samples with a WBC count<0.5×109/l (r=0.93). The nucleated red blood cell count from the WNR (1.22±3.96%) showed an excellent correlation with the manual method (1.12±4.79%) (r=0.99). The WPC channel showed 100% sensitivity for the detection of blasts and abnormal lymphocytes. Further, the WPC correctly suppressed the initial blast/abnormal lymphocyte flag in 34% of the reflexed samples. CONCLUSION: The XN-9000 showed enhanced analytical performance and workflow efficiency for a wide range of patient samples which can be attributed to the incorporation of new measurement channels.
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