BACKGROUND: Manual slide review (MSR) is usually triggered by the results of automated hematolgy analyzers, but each laboaratory has different ciriteria for MSR. This study was carried out to investigate the current status of MSR criteria of automated complete blood cell count (CBC) and white blood cell (WBC) differential results and to propose a basic guideline for MSR. METHODS: Total 111 laboratories were surveyed regarding MSR using questionnaires. The questionnaire asked: kinds of automated hematology analyzers used and the presence of criteria triggering MSR in seven categories: 1) CBC results, 2) 5 differential WBC counts, 3) 3 differential WBC counts, 4) automated reticulocyte counts, 5) delta check, 6) instrument flags (or messages), 7) clinical information (wards or diseases). Based on the survey results, we determined basic and extended criteria for MSR. With these criteria, we consulted nine hematology experts to get a consensus. RESULTS: All 111 laboratories had their own MSR criteria. Among 111 laboratories, 98 (88.3%) used more than three criteria for MSR including CBC results and 5-part WBC differential count results and 95 (85.6%) had criteria of flags triggering MSR. For MSR criteria with numeric values, the 10th, 50th, and 90th percentiles of upper and lower threshold values were obtained. The basic guideline for MSR was made. CONCLUSIONS: We proposed a basic guideline for MSR. This guideline would be helpful to hematology laboratories for their daily operation and providing more rapid and accurate CBC and WBC differential results.
Automation ; Blood Cell Count/instrumentation/*methods/standards ; Humans ; Laboratories, Hospital ; Leukocyte Count/instrumentation/*methods/standards ; Quality Control ; Questionnaires

In the present study, the performance of a new blood cell separator (COBE Spectra LRS Turbo Version 7.0) and that of the previous version LRS version 5.1 in the collection efficiency (CE), collection rate and residual white blood cells during platelet collection from donors were compared. 232 units of platelet concentrates (n = 232) were evaluated and 163 units were collected with the Spectra LRS version 5.1 (Group A) and 69 units with the LRS turbo version 7.0 (Group B). Donor's blood cell counts and parameters, platelet yield, collection efficiency and residual leukocytes in platelet concentrates were analysed. Results showed that the platelet yield was higher in group B than that in group A: (2.90 +/- 1.1) x 10(11) versus (2.58 +/- 1.2) x 10(11), P < 0.001; residual WBCs were less than 5 x 10(6) in 99.4% of group A platelet concentrates and in 97.1% of group B platelet concentrates. Collection efficiency was higher in group B than in group A: 51.4 +/- 8.7 versus 43.6 +/- 6.3. A correlation between platelet count before collecting blood and platelet yield was observed in both groups. In conclusion, the Spectra LRS Turbo version 7.0 showed a higher platelet yield than that with LRS version 5.1. Higher platelet counts before collection allow a higher platelet yield.
Blood Platelets ; cytology ; Cell Separation ; instrumentation ; methods ; Humans ; Leukocyte Count ; Leukocytes ; cytology ; Platelet Count

To evaluate the hematopoietic stem/progenitor cell apheresis effect of Cobe Spectra (Version 6.1) and Fenwal CS 3000 Plus cell separators, fourty-two procedures on twenty donors using Cobe Spectra cell separator and twenty-two procedures on sixteen donors using Fenwal CS 3000 Plus cell separator were retrospectively analyzed. The number of CD34(+) cells collected, the collection efficiency (CE) of CD34(+) cells and the contaminations of red blood cell and platelet in the stem/progenitor cell products of two devices were compared. The results showed that there were no significant differences in the total number of CD34(+) cells collected and the CD34(+) cell CE between the two devices. There were positive correlations between the count of peripheral blood cells including leukocyte, monocyte, hematopoietic progenitor cell and CD34(+) cell after mobilization and the total number of CD34(+) cells collected. The stepwise multiple variable analyses revealed the peripheral blood stem/progenitor cell count emerged as the only significant independent predictive factor for CE. A negative correlation was seen between the peripheral blood monocyte count and the CD34(+) cell CE for the Fenwal CS 3000 Plus. The Fenwal CS 3000 Plus product contained more red blood cells than that of the Cobe Spectra. The decrease in the peripheral platelet count after Fenwal CS 3000 Plus apheresis was also greater. It is concluded that collection efficacy of Cobe Spectra (Version 6.1) and Fenwal CS 3000 Plus was similar. Cobe Spectra shall be used preferably to assure higher CD34(+) cell CE at a high peripheral blood monocyte count. The Cobe Spectra cell separator is better for the donors with mismatched blood type and the donors with thrombocytopenia.
Antigens, CD34 ; blood ; Blood Cell Count ; Cell Separation ; instrumentation ; methods ; Hematopoietic Stem Cell Mobilization ; Hematopoietic Stem Cells ; cytology ; Humans ; Leukapheresis ; instrumentation ; Reproducibility of Results ; Retrospective Studies

BACKGROUND: The performance of Cell-Dyn Sapphire (Abbott Diagnostic, USA) was compared to the Bayer Advia 2120 (Bayer Diagnostics, USA), Sysmex XE-2100 (Sysmex Corporation, Japan), and reference microscopy. METHODS: Three hundred samples for routine CBC and WBC differentials were randomly chosen for a comparison analysis. The Cell-Dyn Sapphire system was evaluated according to the linearity, imprecision, inter-instrument correlations, and white blood cell differential. RESULTS: The CBC parameters (WBC, RBC, hemoglobin and platelet) showed a significant linearity with correlation coefficients greater than 0.99 (P<0.0001). Coefficients of variation (CV) for withinrun and differential count of WBC were less than 5% except for Total CV for monocytes, eosinophils, and basophils and within-run CV for low valued eosinophils. The correlation coefficients with manual count were lower in monocytes, eosinophils, and basophils than in neutrophils and lymphocytes. The correlation with other hematology anlayzers was significant exclusive of basophils. CONCLUSIONS: These results demonstrate that the Cell-Dyn Sapphire has a good linearity, an acceptable reproducibility, a minimal carryover, and a comparable performance with the sysmex XE-2100 and Advia 2120.
Analysis of Variance ; Autoanalysis ; Blood Cell Count/*instrumentation/methods ; Blood Specimen Collection ; Diagnostic Errors ; Humans ; Reproducibility of Results ; Sensitivity and Specificity

This study was aimed to compare the difference of quality between buffy-coat-collected platelet concentrates (BC-PC) and single-donor plateletpheresis (SDP). 15 packs of BC-PC and 15 units SDP were stored at 20 degrees C - 24 degrees C with agitation. Platelet concentration, platelet volume, residual leukocyte and residual erythrocyte in two groups were examined after preparation for 1 hour. Mean platelet volume, pH value, hypotonic shock response (HSR), CD62p expression and CD62p re-expression of platelet were detected on 0, 1, 2, 3, 4, 5 days of platelet preservation. The results showed that the platelet yields, residual leukocyte and residual erythrocyte in two groups accorded with the national quality standard respectively, but residual leukocyte and residual erythrocyte in BC-PC group were higher than those in SDP group when platelet yields in two groups were equal (p < 0.01). Lactate concentration, CD62p expression of platelet increased with prolongation of preseved time, while pH value decreased gradually. Compared with SDP group, there were significant differences in CD62p expression, CD62p re-expression of platelet preserved for 0 - 5 days (p < 0.01), and in pH value of platelet preserved 2 - 5 days (p < 0.01). There was no changes in HSR of SDP group for 0 - 5 days, while HSR in BC-PC group decreased gradually. There were significant differences in HSR of platelet preserved for 1 - 5 days (p < 0.01). It is concluded that the platelet concentrates prepared by BC-PC are not equal to SDP in quality, the preparation technology of BC-PC should be optimized further in order to reduce residual leukocyte, residual erythrocyte and activated platelet yields, as well as improve the quality of BC-PC.
Blood Platelets ; metabolism ; physiology ; Blood Preservation ; Cell Separation ; methods ; Erythrocytes ; cytology ; Humans ; Lactic Acid ; blood ; Leukocytes ; cytology ; P-Selectin ; blood ; Platelet Count ; Plateletpheresis ; instrumentation ; methods ; Quality Control

BACKGROUND: Automated blood cell analyzers often read leukemic blasts as normal cells. In this study, we evaluated the 5-part differential patterns of blasts using automated analyzers to determine if they can differentiate among blast types. METHODS: Blood samples containing 10% or more blasts were collected from patients with acute leukemia (N=175). The 5-part differential count was conducted using DxH 800 (Beckman Coulter, USA) and XE-2100 analyzers (Sysmex Co., Japan), and the results were compared with manual differential counts, which was used as a reference method. RESULTS: The DxH 800 reported the 5-part white blood cell differential count in 98.9% of the cases. The XE-2100 provided an invalid automated differential count in 72% of the cases. Both analyzers counted most lymphoblasts as lymphocytes and most myeloblasts as monocytes. In 11 cases, the DxH 800 reported a 5-part differential count without a blast flag. CONCLUSIONS: Some automated analyzers are able to recognize and count blasts according to their characteristic cell types. Therefore, complete blood counts obtained automatically can provide valuable data for making provisional decisions regarding the lineage of leukemia cells before further investigation.
Acute Disease ; Automation ; Blood Cell Count/*instrumentation/methods ; Humans ; Leukemia/blood/*diagnosis ; Leukemia, Monocytic, Acute/blood/diagnosis ; Leukemia, Myeloid, Acute/blood/diagnosis ; Leukemia, Promyelocytic, Acute/blood/diagnosis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/blood/diagnosis

No abstract available.
Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; Automation ; Blood Cell Count/instrumentation/*methods ; Female ; Humans ; Leukemia, Myeloid, Acute/*diagnosis ; Leukemia, Promyelocytic, Acute/*diagnosis ; Male ; Middle Aged ; Prospective Studies ; ROC Curve ; Young Adult

OBJECTIVETo study the relationship between low benzene exposure doses with workers' peripheral blood parameters of different similar exposure groups (SEG).

METHODSThe workers were from a shoe factory and divided into different SEG, according to the observation method and sampling method. Exposure levels, blood samples and job histories were collected. The relationship between benzene level and blood routine were analyzed using multiple regression method.

RESULTSFive SEGs were defined. No significant differences were found among different SEG in length of service, smoking, drinking, blood routine and symptoms except for ages. Significant negative correlation (r = -0.36, P < 0.05) between benzene exposure levels and white blood cell counts were found by multiple regression analysis. Similar negative correlation was also found between length of benzene exposure and red blood cell counts (r = -0.29, P < 0.05). No significantly statistical relationships were found between benzene exposure and red blood cell counts or platelet count.

CONCLUSIONSEGs method is sensitive for determining the relationship between benzene exposure levels and white blood cell counts. Further study is needed by increasing the number of workers to study the relationship between low benzene exposure and peripheral blood parameters.

Benzene ; adverse effects ; analysis ; Blood Cell Count ; Carcinogens ; adverse effects ; analysis ; China ; Dose-Response Relationship, Drug ; Environmental Monitoring ; instrumentation ; methods ; Humans ; Industry ; No-Observed-Adverse-Effect Level ; Occupational Exposure ; adverse effects ; analysis