Today's automated hematology analyzers capable of performing a full CBC and a differential leukocyte count (DLC) on whole blood, particularly in a closed tube system, using cytochemistry or impedance-based flow cytometry technology coupled with laser light scattering, conductivity and/or differential cell lysis, are here to stay. Their need and popularity among at least the large, cost and quality-conscious clinical laboratories have been growing for the past few years and will continue to do so in the years ahead. The efficiency and reliability of several of these analyzers in performing complete CBCD (CBC and DLC) and in flagging significant abnormalities have been tested and found acceptable with the need to review a stained blood smear or perform a manual DLC to confirm or obtain additional information on selected cases.
Automation ; Human ; Leukocyte Count/*methods

The aim of this study was to observe the difference in respect to the leukocyte reduction efficiency and quality of fresh-frozen plasma (FFP) from filtered whole blood between two types of in-line filters wherein only filter materials were surface modified by the two methods respectively. Whole blood was kept in refrigerator and filtered within 6 h of collection at ambient temperature. Samples were taken pre- and post filtration for analysis of WBC numbers, coagulation factors and complement activation (n = 8 for each type of filter). All filtered units contained < 2. 5 x 10(6) residual leucocytes. RBCs recovery was over 93%. No significant difference between group A and B was seen. But group B appeared to take longer time for filtration than did group A (9'29" vs. 8'01"). Neither group A nor group B showed statistically significant losses of total protein, album, IgG, IgM, fibrin, factors VIII, IX, vWF and C3 (P > 0.05). Factor V, XI and AT-III decreased significantly in two group filters. Group B showed more significant losses of IgA content and factor V activity than did group A, which appeared to be related to the difference in surface character between group A and group B filters. These two types of filters could remove leukocytes effectively, and no significant changes were observed in the quality of FFP from the filtered whole blood. It is presumed that the filter material with better bio-compatibility will give a high recovery of plasma protein and coagulation factors after filtration.
Blood Coagulation Factors ; metabolism ; Filtration ; instrumentation ; methods ; Humans ; Leukocyte Count ; Leukocyte Reduction Procedures ; instrumentation ; methods

A microscopic examination of an appropriately prepared and well-stained blood smear by a knowledgeable laboratory professional is necessary and clinically useful in a number of circumstances and for a variety of reasons. In this article, an attempt is made to delineate the purpose and criteria for blood smear examination in a variety of circumstances that are encountered in everyday laboratory hematology practice. A blood smear scan serves to at least (a) verify the flagged automated hematology results and (b) determine if a manual differential leukocyte count needs to be performed. Blood smear examination/manual differential leukocyte count with complete blood count (CBC) provides the complete hematologic picture of the case, at least from the morphologic standpoint. Blood smear review with or without interpretation serves to ensure that no clinically significant finding is missed, besides providing diagnosis or diagnostic clue(s), particularly if and when interpreted by a physician.
Blood Cell Count ; Hematologic Tests/*methods ; Humans ; Leukocyte Count ; Leukocytes/cytology ; Medical Laboratory Personnel/standards

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 flow-cytometry and Nageotte method for counting residual WBC in thrombocytaphoresis concentrates, their accuracies were determined by dilution studies separately; the repeatability was determined by measuring the interassay coefficient of variation for 14 replicates of a sample with known leukocyte concentration. 102 samples of leukocyte-depleted thrombocytaphoresis concentrates were detected by the above mentioned two methods, and the results were compared each other. The results showed that no difference was observed between two methods over a range of leukocyte concentrations from 0.8 to 10 WBC/microl (P > 0.05). In conclusion, flow-cytometry and Nageotte methods can be used for quality control of WBC-reduced blood components.
Blood Component Transfusion ; Evaluation Studies as Topic ; Flow Cytometry ; Humans ; Leukocyte Count ; methods ; Leukocyte Reduction Procedures ; methods ; Plateletpheresis

OBJECTIVETo evaluate the application of XT-4000i automatic blood cell analyzer in white cell count and classification of cerebrospinal fluid (CSF).

METHODSThe fluid model of XT-4000i automatic blood cell analyzer was directly used to detect the white cell count and classification in 200 samples of CSF, and compared with the results obtained by manually microscopic counting method. White blood cell classification was performed by manual method under microscope with Wright's staining,and instrumental method with fluorescence staining and flow cytometry.

RESULTSThere is no statistical difference between instrumental and manual method in detecting the absolute counting of WBC, RBC, mononuclear cell and multinucleate cells (P>0.05), and there is a good correlation between the two methods (r=0.987, 0.999, 0.981 and 0.983 for WBC, RBC, mononuclear cell and multinucleate cell counts). Tumor cells in the samples with high fluorescent staining by instrumental method can be identified with Wright's staining by microscope method, which were consistent with the clinical diagnosis.

CONCLUSIONThe fluid model of XT-4000i automatic blood cell analyzer was rapid and accurate in CSF white cell count and classification,and it also can provide preliminary information for tumor cells screening. The fluid model of XT-4000i automatic blood cell analyzer in white cell count and classification of CSF has the value of popularization in clinical application.

Autoanalysis ; instrumentation ; methods ; Cerebrospinal Fluid ; cytology ; Humans ; Leukocyte Count ; instrumentation ; methods ; Leukocytes ; classification

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

BACKGROUND: A leukoreduction filter was recently developed in Korea to reduce various kinds of adverse transfusion reactions. The objective of this study was to propose a domestic evaluation system for leukoreduction filters and to apply this evaluation system to assess the newly developed leukoreduction filter. METHODS: We prepared packed red blood cells from 60 units of whole blood (400 mL) collected from 60 normal individuals and evaluated the efficacy of the newly developed filter (FINECELL, KOLON INDUSTRIES, Gumi, Korea) and a control filter (RCM1, Haemonetics, MA, USA). To verify the evaluation system, we assessed the filtration time, residual leukocyte count, RBC recovery, RBC hemolysis, hemoglobin concentration, and hematocrit using a control filter RCM1 and compared the results with those of an evaluation performed by the American Red Cross (ARC) in 2013. We then evaluated the efficacy of the test filter FINECELL using the methods established in this study and compared the results with those of the control filter RCM1. RESULTS: The results of the current study were similar to those of the ARC with the control filters. The test filters developed in Korea were not inferior to commonly used control filters regarding residual leukocyte count, RBC recovery, and RBC hemolysis at 35 days after filtration. All of the results in the evaluation satisfied the international standards. CONCLUSION: These results of this study showed that the efficacy of the newly developed domestic leukoreduction filter were satisfactory and will contribute to improvement of quality of blood components in Korea.
Erythrocytes ; Filtration ; Gyeongsangbuk-do ; Hematocrit ; Hemolysis ; Korea ; Leukocyte Count ; Methods* ; Red Cross ; Transfusion Reaction

OBJECTIVETo investigate the comparison method on internal control of hematology analyzer by using fresh blood.

METHODSThe hematology analyzer with well function was selected as the reference analyzer, fresh blood samples from healthy subjects were measured by reference analyzer and the values were used to calibrate compared hematology analyzers. The acceptable limits of relative deviation of WBC,RBC, HGB,HCT, PLT were established by comparative experiments during three months. The results of fresh blood samples from patients with low/medium/high levels measured by compared analyzer were compared with those from reference analyzer, the relative deviation of WBC, RBC, HGB, HCT, PLT was calculated respectively. The internal quality control charts in laboratory information system were established, with date as x-axis, relative deviation as y-axis. The acceptable relative deviation limits were set to be +/-2 s, and to be used for laboratory quality control.

RESULTThe relative deviation of WBC, RBC, HGB, HCT, PLT with high, medium, low levels were(0.75+/-2.964)%, (1.19+/-2.488)%,(1.43+/-2.439)%; (-0.39+/-1.327)%, (-0.26+/-1.297)%, (-0.35+/-1.095)%û(-0.43+/-1.393)%, (-0.17+/-1.139)%, (0.24+/-1.166)%û(-.43+/-1.362)%, (-0.36+/-1.381)%, (-0.57+/-1.299)%û(-0.93+/-4.330)%,(0.04+/-4.118)%, (-0.41+/-4.149)%, respectively in 2006. As the second instrument, the compared analyzer was involved in College of American Pathologists Proficiency Testing with satisfactory results, the bias of WBC,RBC, HGB, HCT, PLT were within (-0.5 approximately 5.1)%, (-1.0 approximately 1.6)%, (-1.7 approximately 1.4)%, (-1.5 approximately 1.3)%, (-4.5 approximately 7.4)%, respectively.

CONCLUSIONThe quality control on compared hematology analyzer can be effectively, conveniently and economically performed using this method.

Autoanalysis ; methods ; Blood ; Erythrocyte Count ; instrumentation ; Hematology ; instrumentation ; methods ; standards ; Hemoglobins ; analysis ; Humans ; Leukocyte Count ; instrumentation ; Platelet Count ; instrumentation ; Quality Control ; Reference Standards ; Weights and Measures

BACKGROUND: To enumerate leukocyte count in cerebrospinal fluid (CSF) is important for diagnosing bacterial meningitis. Using automated hematology analyzer for enumeration of leukocyte in CSF is below the sensitivity, so microscopic hemocytometric method is standard method. But this requires sufficient practical experience and has limitation of accuracy and stability. So we developed new manual method and evaluated it. METHODS: We designed new method using transparent ruler tape. We performed correlation, accuracy and precision test by counting leukocyte in diluted EDTA blood with three methods: new method, Neubauer and Nageotte hemocytometry. Twenty two CSF were used for stability test, which determines leukocyte count according to time (within one hour and after 2, 4 and 12 hr), by new method and Neubauer hemocytometry at room temperature. RESULTS: There was no clinical significant difference between three methods in correlation test, whereas Neubauer and Nageotte hemocytometry showed a bias to underestimation relative to the results obtained with new method in case with low leukocyte count. The new method showed the lowest CV and most accurate result. In stability test, leukocyte counts decreased being 44.4%, 72.1% of initial values after 2 hr, 14.8%, 31.1%, after 4 hr and 4.2%, 8.7%, after 12 hr, by Nageotte hemocytometry and new method, respectively. CONCLUSIONS: The new method we devised is simple, easy and applicable to use in a laboratory and offers advantages of improved precision and stability. It may be sufficient for replacing standard methods for leukocyte counting in CSF.
Cerebrospinal Fluid/*cytology ; Female ; Humans ; Leukocyte Count/instrumentation/*methods ; Male ; Regression Analysis ; Reproducibility of Results ; Sensitivity and Specificity ; Time Factors