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Journal: International journal of laboratory hematology


Nucleated red blood cells (NRBCs) and reticulocytes are early and important measures of red blood cells' (RBCs) turnover, but little is known on how spurious hemolysis may affect the reliability of these parameters.

Concepts: Hemoglobin, Cell nucleus, Blood, Red blood cell, Anemia, Hematology, Blood cells, Reticulocyte


Heparin-induced thrombocytopenia (HIT) is an immune-mediated complication of heparin therapy. Our objective was (i) to compare various laboratory assays for HIT against clinical probability (4-T score) and C-serotonin release assay (SRA), which was the composite gold standard and (ii) to determine the incidence of HIT in the ICU.

Concepts: Assay, Heparin, Titration, Heparin-induced thrombocytopenia


The determination of factor VIII (FVIII) potency in FVIII concentrates can be performed using both manual and automated methods. This work aimed to validate the use of the chromogenic kit Coamatic(®) FVIII (Chromogenix) on the automated ACL(®) Elite PRO analyzer for evaluating the potency of FVIII in commercial preparations in pharmaceutical analytical laboratories. After setting the activation and reading times to 2 min and 3 min, respectively, the validation parameters, according to the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use guideline Q2 (R1), were as follows: linearity, expressed by the adjusted model: log (Absorbance) = 1.848 + 0.777∙log (Concentration), with r(2)  = 0.998; accuracy was verified (P-value = 0.6959); and the coefficient of variation for repeatability and intermediate precision was ≤6.5%. The Coamatic(®) FVIII kit method has been adapted to the ACL Elite PRO analyzer with improved performance compared with a manual microplate method.

Concepts: Pharmacology, Validation, Psychometrics, Performance, Pharmaceutical drug, Factor VIII, Verification, Verification and validation


INTRODUCTION: Schistocytes are major signs of micro- and macroangiopathic haemolytic anaemia. The aim was to evaluate automated fragmented red cell (FRC) count compared to visual microscopy, and to assess FRCs in the presence of microcytosis and hypochromia using Sysmex automated counters. METHODS: Schistocytes were determined with visual microscopy after the observation of 1000 erythrocytes, and the automated counting with Sysmex XE-5000. Indices of microcytosis (%MicroR) and hypochromia (%Hypo-He) were also analysed in the XE-5000 analyser. RESULTS: Linear regression analysis showed a good correlation between automated and manual FRC% count (r = 0.824, P < 0.0001), but Bland-Altman's plot revealed an overestimation of FRC of 0.82%. There is a global correlation between %MicroR and FRCs. In subgroup analysis of %MicroR (reference value: 0.3-3%, mild microcytosis: 3.1-7.2% and severe microcytosis: 7.3-56.7%), no correlations with automated %FRC were noticed (P > 0.05). Based on %Hypo-He subgroups (mild hypochromia: 1.2-5.2%, and severe hypochromia: 5.3-35.4%), a significant correlation of automated %FRC with mild hypochromia was found (r = 0.621, P < 0.01). CONCLUSION: Despite the agreement between FRC count and the manual method, the overvaluation of FRC was high, leading to false-positive results. Microcytosis appeared to have no impact on FRC count, whereas mild hypochromia seemed to be related with FRC count. Particular attention is required to assess automated FRCs in samples with mild hypochromia.

Concepts: Hemoglobin, Regression analysis, Linear regression, Red blood cell, Anemia, Hemolytic anemia, Hemolysis, Hematology


Despite the advancements in instrumentation within hematology laboratories, there is still a need for review of a peripheral blood film (PBF). For a thorough PBF evaluation, it is critical that a well spread and stained film is available.

Concepts: Blood, Evaluation, Hematology, Venous blood, Educational evaluation, Critical path method, Blood film


INTRODUCTION: The CELL-DYN Emerald is a compact bench-top hematology analyzer that can be used for a three-part white cell differential analysis. To determine its utility for analysis of human and mouse samples, we evaluated this machine against the larger CELL-DYN Sapphire and Sysmex XT2000iV hematology analyzers. METHODS: 120 human (normal and abnormal) and 30 mouse (normal and abnormal) samples were analyzed on both the CELL-DYN Emerald and CELL-DYN Sapphire or Sysmex XT2000iV analyzers. For mouse samples, the CELL-DYN Emerald analyzer required manual recalibration based on the histogram populations. RESULTS: Analysis of the CELL-DYN Emerald showed excellent precision, within accepted ranges (white cell count CV% = 2.09%; hemoglobin CV% = 1.68%; platelets CV% = 4.13%). Linearity was excellent (R(2)  ≥ 0.99), carryover was minimal (<1%), and overall interinstrument agreement was acceptable for both human and mouse samples. Comparison between the CELL-DYN Emerald and Sapphire analyzers for human samples or Sysmex XT2000iV analyzer for mouse samples showed excellent correlation for all parameters. CONCLUSION: The CELL-DYN Emerald was generally comparable to the larger reference analyzer for both human and mouse samples. It would be suitable for use in satellite research laboratories or as a backup system in larger laboratories.

Concepts: Hemoglobin, Red blood cell, Anemia, Hematocrit, Thrombocytopenia, Complete blood count, Algebraic geometry, Abbott Laboratories


The CS5100 analyzer (Sysmex) was validated for the determination of routine coagulation parameters. This fully automated coagulation analyzer uses multiple wavelength technology to perform coagulation (e.g., activated partial thromboplastin time - APTT, prothrombin time - PT, fibrinogen - FBG), chromogenic (e.g., antithrombin - AT) and immunological (e.g., D-dimers - DDi) assays.

Concepts: Coagulation, Warfarin, Blood tests, Factor XII, Thrombin, Prothrombin time, Disseminated intravascular coagulation, Partial thromboplastin time


The study evaluated the performance of a dynamic imaging telepathology system (Panoptiq(™) ) as a diagnostic aid to the identification of peripheral blood film (PBF) abnormalities.

Concepts: Blood, Evaluation, Assessment, Hematology, Educational evaluation, Blood film


Peripheral blood and bone marrow smear examination is an important basic tool for the diagnosis of different haematological conditions including haematological malignancies. We created a newer modification of the conventional Leishman and Giemsa stains as Leishman and Giemsa (L&G) stain and compared the efficacy and reliability of this stain with conventional stains. The study was performed to evaluate the staining efficacy, feasibility, time and cost of L&G stain over the conventional Leishman and Giemsa stains.

Concepts: Blood, Bone marrow, Leukemia, Staining, Stain, Gram staining, Giemsa stain, Wright's stain


Point-of-care International Normalised Ratio (INR) testing is used frequently. We evaluated the microINR(®) POC system for accuracy, precision and measurement repeatability, and investigated instrument and test chip variability and error rates.

Concepts: Evaluation, Measurement, Metrology, Psychometrics, Test method, Accuracy and precision, Prothrombin time, Educational evaluation