Four trials of external quality assessment in diagnostic hematology were performed in 2002 with about 400 participating laboratories in Korea. We performed quality assessment for white blood cell count, hemoglobin, red blood cell count, platelet count, reticulocyte count, white cell differential count, and red blood cell morphology test. The response rate was more than 90%. The performance of quality assessment appeared to be gradually improved year by year.
Equidae* ; Erythrocyte Count ; Erythrocytes ; Hematology* ; Korea* ; Leukocyte Count ; Platelet Count ; Reticulocyte Count

The author has studied on the differences in blood pictures, especially the differences of blood pictures in capillary blood and venous blood, in 25 premature babies and 50 term babies from birth to 7 days of age sequentially during the period of 6 monts from April 1980 to Sept. 1980. The results are summarized as follws; 1. As comparing blood pictures with term babies, premature babies showed somewhat lower values in erythrocyte, hemoglobin, hematocrit. MCV, MCH, leucocyte and platelet but somewhat higher values in reticulocyte and MCHC. 2. As comparing blood pictures with the venous blood, the capillary blood showed significantly higher values in erythrocyte, hemoglobin and hematocrit during the neonatal period in both premature babies and term babies, but showed somewhat lower values in MCV, MCH, MCHC, and platelet. 3. According to the time of clamping the umbilical cord after birth, there were significant differences of blood pictures between early and late clamping of the umbilical cord. 4. The highest mean erythrocyte counts in both term babies and premaature babies were 5,896,000/cub.mm and 5,542,000/cub.mm at 3-6 hours after birth. Those values were gradually decreased to 5,104,000/cub.mm and 4,753,000/cub.mm on the 6th-7the day of life. 5. The highest average hemoglobin levels in both term babies and premature babies were 21.1gm/dl and 19.5gm/dl at 3-6 hours after birth. Those values were gradually decreased to 18.1gm/dl and 17.1gm/dl on the 6th-7th day of life. 6. The mean values of hematocrit in both term babies and premature babies were higest, 64.5% and 59.9% at 3-6 hours after birth. Those values were gradually decreased to 54.8% and 50.2% on the 6th-7the of life. 7. The average total serum protein levels in both term babies and premature babies were 5.76gm/dl and 5.22gm/dl at birth. Those values were increased to 6.45gm/dl and 5.74gm/dl at 3- hours after birth. 8. The average MCV in both term babies and premature babies showed highest values, 114.2fl and 110.1fl at birth. Those values were gradually decreased to 107.0fl and 103.4fl on the 6th-7th day of life. 9. The average MCH in both term babies and premature babies showed highest values, 36.8pg and 35.3pg at birth. Those values were gradually decreased to 107.0fl and 103.4fl on the 6th-7th day of life. 10. The average MCHC in both term babies and premature babies showed constant levels, 31.3-32.0% and 32.2-33.1% from birth to 7the day of life. 11. The average platelet counts in both term babies and premature babies were 243,000/cub.mm and 229,000/cub.mm during the first 4 days of life. Those values were gradually increased to 283,000/cub.mm and 253,000/cub.mm on the 6th-7the day of life. 12. The highest reticulocyte counts in both term babies and premature babies were 3.1% and 3.6% at the age of 3-6 hours. Those values were rapidly dropped down from 4th day to 7th day of life, decreasing from 1.7% and 1.9% to 1.0% and 1.3%. 13. The highest llecucyte counts in both term babies and premature babies were 25,794/cub.mm and 23,363/cub.mm at the age of 3-6 hours. Both values were gradually decreased to 13,213/cub.mm and 11,870/cub.mm on the 6th-7th day of life.
Blood Platelets ; Capillaries ; Constriction ; Erythrocyte Count ; Erythrocytes ; Hematocrit ; Parturition ; Platelet Count ; Reticulocyte Count ; Reticulocytes ; Umbilical Cord

BACKGROUND: The XN-series (Sysmex, Japan) is the new hematology analyzer from Sysmex, with new channels to improve the accuracy of differential leukocyte count and platelet count in the low cell count range. We evaluated the analytical performance and low white blood cell (WBC) mode of the XN-2000. METHODS: Precision, linearity, and carryover were evaluated for the analyzer. We analyzed the accordance of complete blood count (CBC), reticulocyte count, and differential leukocyte count between the XN-2000 and XE-2100 (Sysmex), using 200 samples from normal controls and patients. For 80 samples with a WBC count <1.5x10(9) cells/L, the low WBC mode was evaluated by comparing the automated count with a manual differential count as the reference. RESULTS: The coefficients of variation of precision were <5% for most CBC parameters and <10% for differential leukocyte count. All results obtained with the XN-2000 showed good correlation with those obtained with the XE-2100. The correlation coefficients (r) were >0.9800 for all CBC parameters except mean corpuscular hemoglobin concentration, mean platelet volume, and platelet distribution width, and >0.9900 for differential leukocyte count except monocytes and basophils. The low WBC mode provided accurate counts for neutrophils and lymphocytes, with r>0.9300 for samples with a WBC count of 0.1-1.5x10(9) cells/L. CONCLUSIONS: The XN-2000 showed good analytical performance and correlation with the existing model, the XE-2100. The XN-2000 provided accurate results for differential leukocyte count in samples with a WBC count of 0.1-1.5x10(9) cells/L, and reduced manual slide reviews.
Basophils ; Blood Cell Count ; Blood Platelets ; Cell Count ; Erythrocyte Indices ; Hematology* ; Humans ; Leukocyte Count* ; Leukocytes ; Lymphocytes ; Mean Platelet Volume ; Monocytes ; Neutrophils ; Platelet Count ; Reticulocyte Count

Erythrocyte Count ; Erythrocytes ; Longevity

The recent availability of recombinant human erythropoietin has opened new perspectives in the management of a variety of anemias. Clinical trials have been initiated in several countries using different approaches and methodology. We randomly assigned twelve premature infants(gestational age < 32 week) at high risk of requiring erythrocyte transfusion for anemia of prematurity with either subcutaneous recombinant human erythropoietin or a placebo. Treatment with rHuEPO was initiated at a dose of 100 units/kg day for 3 days a week. All patients were given supplemental oral iron therapy at a dose of 3 mg/kg per day, as tolerated and oral vitamin E at a dose of 25 units per day. Treated and control babies did not differ with respect to weight, hematocrit, overall mean reticulocyte count or rate of growth respectively. However, reticulocyte counts increased earlier in patients given rHuEPO. We conclude that rHuEPO administration is safe and feasible at the dose studied.
Anemia* ; Erythrocyte Transfusion ; Erythropoietin* ; Hematocrit ; Humans* ; Iron ; Pilot Projects* ; Reticulocyte Count ; Vitamin E ; Vitamins

BACKGROUND: Hereditary spherocytosis (HS) is a chronic hemolytic anemia characterized by microspherocytes in the peripheral blood and increased erythrocyte osmotic fragility (EOF). This study evaluated the cryohemolysis test (CHT); initial hemolysis (IH); immediate and incubated hemolysis percentage in 5.5 g/L NaCl (H5.5); mean corpuscular hemoglobin concentration (MCHC); red blood cell distribution width (RDW); and Hb/MCHC, Hb/RDW, and MCHC/RDW ratios for the diagnosis of HS. METHODS: Data from 13 patients with HS were evaluated at the Instituto de Bioquímica Aplicada and compared with data from 14 unaffected individuals and 11 patients with anemia due to another etiology. Total blood and reticulocyte counts, CHT, and immediate and incubated EOF were performed in all subjects; sensitivity, specificity, efficiency, and Youden index (YI) were calculated. RESULTS: Eight patients with HS had MCHC ≥345 g/L, 10 had RDW ≥14.5%, 12 had IH >5.0 g/L, 11 had immediate H5.5 ≥5%, and 13 had incubated H5.5 ≥50% (the cut-off value to consider HS). The efficiency and YI were: immediate H5.5 (0.94–0.85), incubated H5.5 (0.89–0.82), IH (0.89–0.78), MCHC (0.87–0.62), CHT (0.84–0.54), and Hb/MCHC (0.71–0.56), respectively. The calculated ratios could distinguish subjects with HS from unaffected individuals (P < 0.05), but not those with anemia of another etiology (P>0.05). CONCLUSION: Although the CHT and supplementary hematimetric indexes were useful to differentiate individuals with SH from healthy controls, they cannot distinguish from anemias of other etiology. CHT and MCHC, in addition to EOF, are recommended for diagnosing HS patients because of their low cost and efficiency.
Anemia ; Anemia, Hemolytic ; Diagnosis* ; Erythrocyte Indices ; Erythrocytes* ; Hemolysis ; Humans ; Osmotic Fragility* ; Reticulocyte Count ; Sensitivity and Specificity

BACKGROUND: The BC-6800 (Mindray, China) is a recently developed hematology analyzer that utilizes 'SF Cube Technology' to improve the reliability of complete blood counts (CBC), white blood cell (WBC) differentials, and erythroblast counts. In this study, we evaluated the performance of the BC-6800 for CBC, WBC differentials, reticulocyte counts, and erythroblast counts and analyzed the efficiency of its flag system. METHODS: Specimens from 100 healthy controls and 95 patients were used. We performed precision and correlation studies of CBC, WBC differentials, reticulocyte counts, and erythroblast counts. We also analyzed the efficiency of the flag system in detecting abnormal blood cells. RESULTS: The coefficients of variation (CVs) of precision were <2% for most CBC parameters and <5% for neutrophil, eosinophil, and reticulocyte counts. The results obtained using the BC-6800 were well correlated with those of the ADVIA 2120 (Siemens, USA) and LH 750 (Beckman Coulter Corporation, USA). The correlation coefficients (r) were >0.9800 for CBC except erythrocyte indices, and >0.9500 for WBC differentials except monocyte and basophil. The WBC differentials and erythroblast counts obtained using the BC-6800 were well correlated with those of manual counts. The efficiencies of the flag system were 77.9% for Blasts, 82.1% for Immature Gran, 86.3% for Atypical Lymph, and 92.6% for NRBC present. CONCLUSIONS: The BC-6800 showed good precision and correlation with pre-existing hematology analyzers. The flag systems were quite efficient for detecting abnormal blood cells. Our study demonstrated that the BC-6800 hematology analyzer exhibits suitable performance and is helpful in routine laboratories.
Basophils ; Blood Cell Count ; Blood Cells ; Eosinophils ; Erythroblasts ; Erythrocyte Indices ; Hematology ; Humans ; Leukocytes ; Monocytes ; Neutrophils ; Reticulocyte Count ; Statistics as Topic

BACKGROUND: The XN-20 (Sysmex, Japan) is a recently developed hematology analyser, which adopts new technologies to improve the accuracy of complete blood count (CBC) and white blood cell (WBC) differentials and the efficiency of the flag system. In this study, we evaluated the performance of the XN-20 for CBC, WBC differentials, and reticulocyte counts. We also analysed the efficiency of its flag system. METHODS: We evaluated the precision and linearity of CBC and reticulocyte counts. In the correlation study, the results of XN-20 were compared with those obtained using ADVIA 2120 (Siemens, USA). The performance was also evaluated in the 'low WBC mode.' We analysed the efficiency of the flag system in detecting abnormal blood cells using 43 abnormal samples. RESULTS: The CVs for precision were <2% for most of the CBC parameters. Linearity was good for WBC, red blood cell (RBC), Hb, Hct, and platelet. The results of XN-20 were well correlated with those of ADVIA 2120. The correlation coefficients (r) was >0.9800 for all CBC parameters except for erythrocyte indices, and it was >0.9500 for WBC differentials except for monocyte and basophil. In the 'low WBC mode,' XN-20 could reliably analyse the WBC differentials in samples with low WBC count. The efficiencies of the flag systems were 95.3% for blasts, 83.7% for left-shifted neutrophils, 97.7% for atypical lymphocytes, and 86.0% for nucleated RBCs. CONCLUSIONS: The XN-20 showed good precision and its results were well correlated with those obtained using ADVIA 2120. In particular, in the 'low WBC mode,' it could provide reliable WBC differentials for samples with low WBC counts, and the flag systems detected abnormal blood cells with high efficiency.
Basophils ; Blood Cell Count* ; Blood Cells ; Blood Platelets ; Erythrocyte Indices ; Erythrocytes ; Hematology ; Leukocyte Count ; Leukocytes ; Lymphocytes ; Monocytes ; Neutrophils ; Reticulocyte Count ; Statistics as Topic

BACKGROUND: The XN-20 (Sysmex, Japan) is a recently developed hematology analyser, which adopts new technologies to improve the accuracy of complete blood count (CBC) and white blood cell (WBC) differentials and the efficiency of the flag system. In this study, we evaluated the performance of the XN-20 for CBC, WBC differentials, and reticulocyte counts. We also analysed the efficiency of its flag system. METHODS: We evaluated the precision and linearity of CBC and reticulocyte counts. In the correlation study, the results of XN-20 were compared with those obtained using ADVIA 2120 (Siemens, USA). The performance was also evaluated in the 'low WBC mode.' We analysed the efficiency of the flag system in detecting abnormal blood cells using 43 abnormal samples. RESULTS: The CVs for precision were <2% for most of the CBC parameters. Linearity was good for WBC, red blood cell (RBC), Hb, Hct, and platelet. The results of XN-20 were well correlated with those of ADVIA 2120. The correlation coefficients (r) was >0.9800 for all CBC parameters except for erythrocyte indices, and it was >0.9500 for WBC differentials except for monocyte and basophil. In the 'low WBC mode,' XN-20 could reliably analyse the WBC differentials in samples with low WBC count. The efficiencies of the flag systems were 95.3% for blasts, 83.7% for left-shifted neutrophils, 97.7% for atypical lymphocytes, and 86.0% for nucleated RBCs. CONCLUSIONS: The XN-20 showed good precision and its results were well correlated with those obtained using ADVIA 2120. In particular, in the 'low WBC mode,' it could provide reliable WBC differentials for samples with low WBC counts, and the flag systems detected abnormal blood cells with high efficiency.
Basophils ; Blood Cell Count* ; Blood Cells ; Blood Platelets ; Erythrocyte Indices ; Erythrocytes ; Hematology ; Leukocyte Count ; Leukocytes ; Lymphocytes ; Monocytes ; Neutrophils ; Reticulocyte Count ; Statistics as Topic

PURPOSE: We conducted randomized study to determine whether high doses (6mg/kg/ day) of iron would exert a more supplemental effect than low doses (3mg/kg/day), and which regimen of recombinant human erythropoietin (rHuEPO) and iron would be more beneficial in the prophylactic treatment of anemia of prematurity. METHODS: We randomly assigned 38 sick premature infants who were more likely than symptom-free premature infants requiring erythrocyte transfusions for infants with anemia of prematurity to receive rHuEPO, 100unit/kg, tiw, subcutaneously, plus iron, 3mg/kg/day, po, daily from the second day of life (group 1), 100unit/kg and 6mg/kg/ day (group 2), 200unit/kg and 3mg/kg/day (group 3), and 200unit/kg and 6mg/kg/day (group 4), respectively. RESULTS: There were no significant differences of hemoglobin levels and iron balances during treatment among all 4 groups. The rates of increase in reticulocyte counts were greater in group 4 and group 2 compared with group 3 and group 1, respectively, though these rates were statistically not significant. The blood volume differences (volume of phlebotomies-volume of transfusions) during treatment were higher in group 4 compared with group 1 (p<0.05). CONCLUSIONS: High doses of iron may be more effective in rapidly increasing reticulocyte counts, and 200unit/kg, tiw of rHuEPO plus 6mg/kg/day of iron is more beneficial in reducing the need for blood transfusions than any other regimen. Therefore the prophylactic treatment of anemia of prematurity and acute blood loss from frequent blood sampling in risky premature infants with rHuEPO, 200unit/kg, tiw, subcutaneously, plus iron 6mg/kg/day, po, daily from the second day of life is effective in reducing the number of blood transfusions. Additional controlled trials utilizing high doses of iron with rHuEPO and larger numbers of patients are justified.
Anemia* ; Blood Transfusion ; Blood Volume ; Erythrocyte Transfusion ; Erythropoietin* ; Humans* ; Infant ; Infant, Newborn ; Infant, Premature ; Iron* ; Reticulocyte Count