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Blood Bank Mode
General
Valina O et al.
(2024) Transfus Med; online ahead of print:
Validation of the Sysmex XN analyser and Blood Bank mode for the quality and safety of donor blood and transfusion products.
Validation of the Sysmex XN analyser and Blood Bank mode for the quality and safety of donor blood and transfusion products.
Summary:
The XN analyser, equipped with a Blood Bank mode, demonstrated reliable performance when used for CBC blood donor evaluation and assessment of end blood products' quality (RBC, HCT, HGB, PLT) and safety (rWBC, rRBC and residual PLT) compared against manual method using counting chamber.
The XN analyser, equipped with a Blood Bank mode, demonstrated reliable performance when used for CBC blood donor evaluation and assessment of end blood products' quality (RBC, HCT, HGB, PLT) and safety (rWBC, rRBC and residual PLT) compared against manual method using counting chamber.
Rabcuka J et al.
(2022) Acta Haematol; 6(18): 5415:
Metabolic reprogramming under hypoxic storage preserves faster oxygen unloading from stored red blood cells.
Metabolic reprogramming under hypoxic storage preserves faster oxygen unloading from stored red blood cells.
Summary:
In this study, relative to standard blood bank storage protocols, hypoxic storage preserves faster O2 unloading from red blood cells in RBC units stored up to 35 days. The effect correlated with Sysmex XN RBC side-scatter (RET-RBC-Z) from RET channel.
In this study, relative to standard blood bank storage protocols, hypoxic storage preserves faster O2 unloading from red blood cells in RBC units stored up to 35 days. The effect correlated with Sysmex XN RBC side-scatter (RET-RBC-Z) from RET channel.
Arisawa F et al.
(2021) Sysmex J Int; 31(2): 18:
Evaluation of the Blood Bank mode Software of Sysmex XN-1000 Hematology Analyzer for Counting Residual Red Blood Cells and Platelets in Platelet concentrates, and Residual White Blood Cells in Leucocyte-Reduced Whole Blood
Evaluation of the Blood Bank mode Software of Sysmex XN-1000 Hematology Analyzer for Counting Residual Red Blood Cells and Platelets in Platelet concentrates, and Residual White Blood Cells in Leucocyte-Reduced Whole Blood
Summary:
The study investigated Blood Bank mode (XN-1000) analytical performance of rRBC (0-5000/µL), rWBC (0-30/µL) with standard blood components counting methods and the PLT correlation with XS-1000i. The authors suggested due to the comparable results that it is possible to measure rRBC, rWBC, and platelet counts for quality control in one sample using the Blood Bank mode.
The study investigated Blood Bank mode (XN-1000) analytical performance of rRBC (0-5000/µL), rWBC (0-30/µL) with standard blood components counting methods and the PLT correlation with XS-1000i. The authors suggested due to the comparable results that it is possible to measure rRBC, rWBC, and platelet counts for quality control in one sample using the Blood Bank mode.
Bell S et al.
(2021) Transfus Med 31(2): 94:
Comparison of four methods to measure haemoglobin concentrations in whole blood donors (COMPARE): A diagnostic accuracy study.
Comparison of four methods to measure haemoglobin concentrations in whole blood donors (COMPARE): A diagnostic accuracy study.
Summary:
Four haemoglobin measurement methods in 21.840 blood donors recruited from 10 NHSBT centres in England were investigated against reference (XN analyser). The proportion of donors who would have been inappropriately bled ranged from 2.2% to 18.9%. The proportion of donors who would have been deferred incorrectly with haemoglobin concentration above the minimum threshold ranged from 0.1% to 20.3%.
Four haemoglobin measurement methods in 21.840 blood donors recruited from 10 NHSBT centres in England were investigated against reference (XN analyser). The proportion of donors who would have been inappropriately bled ranged from 2.2% to 18.9%. The proportion of donors who would have been deferred incorrectly with haemoglobin concentration above the minimum threshold ranged from 0.1% to 20.3%.
Residual Red Blood Cells
Cavagnetto C et al.
(2021) Transfusion; 61(2): e258:
Residual red cells in blood components: A multisite study of fully automated enumeration using a hematology analyzer.
Residual red cells in blood components: A multisite study of fully automated enumeration using a hematology analyzer.
Summary:
In this study, the Blood Bank mode was tested at multiple sites and showed very good performance characteristics, with an LoD/LoQ of 6 RBC/µL and excellent linear correlation between expected and observed values in spiking experiments. Moreover, in a batch of routine manufactured blood components the Blood Bank mode identified all residual RBC contaminated samples correctly.
In this study, the Blood Bank mode was tested at multiple sites and showed very good performance characteristics, with an LoD/LoQ of 6 RBC/µL and excellent linear correlation between expected and observed values in spiking experiments. Moreover, in a batch of routine manufactured blood components the Blood Bank mode identified all residual RBC contaminated samples correctly.
Residual White Blood Cells
Genicco A et al.
(2023) La Rivista Italiana della Medicina di Laboratorio; 19(1): 30:
Verification of leukocyte contamination in leucodepleted blood components using Blood Bank mode of Sysmex XN-1000 haematology analyzer.
Verification of leukocyte contamination in leucodepleted blood components using Blood Bank mode of Sysmex XN-1000 haematology analyzer.
Summary:
The authors found that the residual WBC counting methods ADAM and the XN Blood Bank mode had an agreement of 100% for K2EDTA samples. Both methods exhibited excellent linearity and precision results and adequate limit of quantification values. The bias between XN BB mode and ADAM increased slightly over storage time. Performance of residual RBC count on XN BB mode was in agreement with results published by Cavagnetto et al. in 2021.
The authors found that the residual WBC counting methods ADAM and the XN Blood Bank mode had an agreement of 100% for K2EDTA samples. Both methods exhibited excellent linearity and precision results and adequate limit of quantification values. The bias between XN BB mode and ADAM increased slightly over storage time. Performance of residual RBC count on XN BB mode was in agreement with results published by Cavagnetto et al. in 2021.
Blanco RA et al.
(2020) Transfusion; 60(1): 155:
The use of a hematology analyzer with a new generation of software as an alternative to flow cytometry for enumerating residual white blood cells in blood components.
The use of a hematology analyzer with a new generation of software as an alternative to flow cytometry for enumerating residual white blood cells in blood components.
Summary:
In this study, the performance of the XN Blood Bank (BB) mode for residual WBC (rWBC) enumeration in blood components was analysed. In platelet, plasma and RBC components spiked with WBC, the BB mode demonstrated a LOQ of 2 WBC/μL and an excellent concordance with flow cytometry (FC) results. In components obtained from a routine blood bank, the BB mode successfully identified leukodepletion failures and met the guideline criteria of 90% of tested components containing less than 1x10^6 rWBC/unit, which was in agreement with FC results.
In this study, the performance of the XN Blood Bank (BB) mode for residual WBC (rWBC) enumeration in blood components was analysed. In platelet, plasma and RBC components spiked with WBC, the BB mode demonstrated a LOQ of 2 WBC/μL and an excellent concordance with flow cytometry (FC) results. In components obtained from a routine blood bank, the BB mode successfully identified leukodepletion failures and met the guideline criteria of 90% of tested components containing less than 1x10^6 rWBC/unit, which was in agreement with FC results.
Lagerberg JW et al.
(2020) Transfusion; 60(10): 2456:
Improved accuracy in counting residual white blood cells in red cell concentrates using new blood bank mode software of SYSMEX XN-1000 hematology analyzer.
Improved accuracy in counting residual white blood cells in red cell concentrates using new blood bank mode software of SYSMEX XN-1000 hematology analyzer.
Summary:
The authors re-calculated their results with the updated XN software for Blood Bank mode and observed a very good linear fit between expected and observed values for residual WBC in red cell concentrates (RCC). The previous underestimation of residual WBC in RCC (Blanco RA et al.) was solved with the updated XN software (XN IPU SW 22.15).
The authors re-calculated their results with the updated XN software for Blood Bank mode and observed a very good linear fit between expected and observed values for residual WBC in red cell concentrates (RCC). The previous underestimation of residual WBC in RCC (Blanco RA et al.) was solved with the updated XN software (XN IPU SW 22.15).
Mack S et al.
(2020) Transfusion; 60(1): 4:
Component residual white blood cell counting made easy?
Component residual white blood cell counting made easy?
Summary:
A short review on required detection levels for blood products in US and Europe, and currently used methods on residual white blood cell counting. An outlook is given based on the publication by Blanco et al. how XN-Series analysers could increase the efficiency and reduce costs in blood banks in the future.
A short review on required detection levels for blood products in US and Europe, and currently used methods on residual white blood cell counting. An outlook is given based on the publication by Blanco et al. how XN-Series analysers could increase the efficiency and reduce costs in blood banks in the future.
COVID-19
Attention - Please consider the following when assessing the literature regarding COVID-19 (SARS-CoV-2 infection)
Please consider the following when assessing the literature regarding COVID-19
(SARS-CoV-2 infection):
COVID-19 is an emerging, rapidly evolving pandemic.
Available literature is changing quickly and studies summarised here may not represent the latest status of knowledge. Please consider that conclusions of articles of this list may be based on low sample numbers or manuscripts that are not peer-reviewed yet (pre-prints).
COVID-19 is an emerging, rapidly evolving pandemic.
Available literature is changing quickly and studies summarised here may not represent the latest status of knowledge. Please consider that conclusions of articles of this list may be based on low sample numbers or manuscripts that are not peer-reviewed yet (pre-prints).
Original articles
Jha B et al.
(2023) Int J Lab Hematol; 45(3): 282:
Value of new advanced hematological parameters in early prediction of severity of COVID-19.
Value of new advanced hematological parameters in early prediction of severity of COVID-19.
Summary:
In this prospective observational study the intensive care infection score (ICIS) and the COVID-19 prognostic score showed similar performance in identifying critical illness in a cohort of COVID-19 positive patients (AUC 0.778 and 0.781). All EIP (except for NEUT-GI) exhibited significant differences in critically ill versus non critical patients and RE-LYMP# was found as independent risk factor.
In this prospective observational study the intensive care infection score (ICIS) and the COVID-19 prognostic score showed similar performance in identifying critical illness in a cohort of COVID-19 positive patients (AUC 0.778 and 0.781). All EIP (except for NEUT-GI) exhibited significant differences in critically ill versus non critical patients and RE-LYMP# was found as independent risk factor.
Boulanger M et al.
(2021) Am J Med; 134(8): 1029:
Peripheral Plasma Cells Associated with Mortality Benefit in Severe COVID-19: A Marker of Disease Resolution.
Peripheral Plasma Cells Associated with Mortality Benefit in Severe COVID-19: A Marker of Disease Resolution.
Summary:
This multicentric study investigated the association of plasma cells (HFLC) in peripheral blood of severe COVID-19 patients for morbidity. Retrospective analysis showed that patients exhibiting plasma cells were more likely to develop severe disease but also had a reduced risk of death. In most patients plasma cells appeared after progression to severe disease and, thus, will not serve as an early marker for severe disease.
This multicentric study investigated the association of plasma cells (HFLC) in peripheral blood of severe COVID-19 patients for morbidity. Retrospective analysis showed that patients exhibiting plasma cells were more likely to develop severe disease but also had a reduced risk of death. In most patients plasma cells appeared after progression to severe disease and, thus, will not serve as an early marker for severe disease.
Cohen A et al.
(2021) J Thromb Thrombolysis; 52(3): 708:
Immature platelets in patients with Covid‑19: association with disease severity.
Immature platelets in patients with Covid‑19: association with disease severity.
Summary:
In this study of patients with COVID-19 patients (56 mild cases, 80 severe) showed that immature platelet parameters (IPF, IPF# and maximal IPF#) were elevated in severe disease. Maximal IPF# was an independent prognostic factor for prolonged hospitalisation length.
In this study of patients with COVID-19 patients (56 mild cases, 80 severe) showed that immature platelet parameters (IPF, IPF# and maximal IPF#) were elevated in severe disease. Maximal IPF# was an independent prognostic factor for prolonged hospitalisation length.
Dennison D et al.
(2021) Int J Infect Dis; 106: 155:
Circulating activated neutrophils in COVID-19: An independent predictor for mechanical ventilation and death.
Circulating activated neutrophils in COVID-19: An independent predictor for mechanical ventilation and death.
Summary:
The authors found that in multivariable regression analyses NEUT-RI (OR = 1.22) was a statistically significant predictor at admission for a later need of mechanical ventilation and death in COVID-19 positive patients among others. NEUT-RI cut-off value for mechanical ventilation was 52 FI (44% sensitivity, 88% specificity; AUC= 0.67).
The authors found that in multivariable regression analyses NEUT-RI (OR = 1.22) was a statistically significant predictor at admission for a later need of mechanical ventilation and death in COVID-19 positive patients among others. NEUT-RI cut-off value for mechanical ventilation was 52 FI (44% sensitivity, 88% specificity; AUC= 0.67).
Incir S et al.
(2021) Turk J Biochem; 46(4): 359:
Immature platelet fraction: is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?
Immature platelet fraction: is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?
Summary:
This study of COVID-19 patients (110 non-severe cases, 44 severe) showed that IPF at admission was higher in severe disease. IPF was an independent predictor for disease severity with an AUC of 0.88 at a cut-off of > 9.5% (sensitivity 69.5% and specificity 92.4%).
This study of COVID-19 patients (110 non-severe cases, 44 severe) showed that IPF at admission was higher in severe disease. IPF was an independent predictor for disease severity with an AUC of 0.88 at a cut-off of > 9.5% (sensitivity 69.5% and specificity 92.4%).
Kilercik M et al.
(2021) PloS ONE; 16(8) e0254073:
A new haematocytometric index: Predicting severity and mortality risk value in COVID-19 patients.
A new haematocytometric index: Predicting severity and mortality risk value in COVID-19 patients.
Summary:
This retrospective analysis of 97 COVID-19 positive patients identified monocyte-to-neutrophil ratio (MNR), MCV, RDW, and PLT as independent risk factors for mortality. A mortality risk score comprised of MNR, neutrophil-to-lymphocyte ratio (NLR), RDW, and PLT achieved an AUC of 0.91 and a specificity of 0.94.
This retrospective analysis of 97 COVID-19 positive patients identified monocyte-to-neutrophil ratio (MNR), MCV, RDW, and PLT as independent risk factors for mortality. A mortality risk score comprised of MNR, neutrophil-to-lymphocyte ratio (NLR), RDW, and PLT achieved an AUC of 0.91 and a specificity of 0.94.
Martens R et al.
(2021) Clin Chem Lab Med; 59(4): 783:
Hemocytometric characteristics of COVID-19 patients with and without cytokine Storm syndrome on the Sysmex XN-10 hematology analyzer.
Hemocytometric characteristics of COVID-19 patients with and without cytokine Storm syndrome on the Sysmex XN-10 hematology analyzer.
Summary:
The study’s results on the haemocytometric characteristics of COVID-19 patients revealed that a cytokine-storm syndrome was associated with higher AS-LYMPH, RE-MONO and monocyte fluorescence.
The study’s results on the haemocytometric characteristics of COVID-19 patients revealed that a cytokine-storm syndrome was associated with higher AS-LYMPH, RE-MONO and monocyte fluorescence.
Urrechaga E et al.
(2021) Scand J Clin Lab Invest; 81(5): 394:
Leukocyte differential and reactive lymphocyte counts from Sysmex XN analyzer in the evaluation of SARS-CoV-2 infection.
Leukocyte differential and reactive lymphocyte counts from Sysmex XN analyzer in the evaluation of SARS-CoV-2 infection.
Summary:
This prospective observational study aimed to assess the diagnostic performance in distinguishing SARS-CoV-2 infections from other viral or bacterial infections in emergency room (ER) patients presenting with fever. NLR > 3.3 and RE-LYMP >0.6% correctly distinguished 95.6% of SARS-CoV-2 infection patients in the validation group (bacterial and viral infected ER patients).
This prospective observational study aimed to assess the diagnostic performance in distinguishing SARS-CoV-2 infections from other viral or bacterial infections in emergency room (ER) patients presenting with fever. NLR > 3.3 and RE-LYMP >0.6% correctly distinguished 95.6% of SARS-CoV-2 infection patients in the validation group (bacterial and viral infected ER patients).
Cohen A et al.
(2020) J Thromb Thrombolysis; 30: 1:
Immature platelets in patients hospitalized with Covid-19.
Immature platelets in patients hospitalized with Covid-19.
Summary:
Patients with COVID-19 have increased immature platelets parameters (IPF, IPF#) compared to stable patients with cardiovascular risk factors. As the disease progresses IPF and IPF# are increased also compared to acute myocardial infarction patients.
Patients with COVID-19 have increased immature platelets parameters (IPF, IPF#) compared to stable patients with cardiovascular risk factors. As the disease progresses IPF and IPF# are increased also compared to acute myocardial infarction patients.
Foy B et al.
(2020) JAMA Netw Open; 3(9): e2022058:
Association of Red Blood Cell Distribution Width With Mortality Risk in Hospitalized Adults With SARS-CoV-2 Infection.
Association of Red Blood Cell Distribution Width With Mortality Risk in Hospitalized Adults With SARS-CoV-2 Infection.
Summary:
A retrospective analysis from four US hospitals associated an elevated red cell distribution width (RDW) at admission and an increasing RDW during hospitalisation with increased mortality risk in COVID-19 patients, and identified RDW as an independent mortality risk factor.
A retrospective analysis from four US hospitals associated an elevated red cell distribution width (RDW) at admission and an increasing RDW during hospitalisation with increased mortality risk in COVID-19 patients, and identified RDW as an independent mortality risk factor.
Lapic I et al.
(2020) Int J Lab Hematol; 43(2): e64:
Cell population data: Could a routine hematology analyzer aid in the differential diagnosis of COVID-19.
Cell population data: Could a routine hematology analyzer aid in the differential diagnosis of COVID-19.
Summary:
This letter to the editor describes the detailed analysis of cell population data (CPD) from an XN-1000 in COVID-19 and non-COVID-19 patients. CBC parameters do not present with significant differences. The CPD parameters present with significant differences, with the most pronounced the elevated LY-WZ.
This letter to the editor describes the detailed analysis of cell population data (CPD) from an XN-1000 in COVID-19 and non-COVID-19 patients. CBC parameters do not present with significant differences. The CPD parameters present with significant differences, with the most pronounced the elevated LY-WZ.
Linssen J et al.
(2020) Elife; 9: e63195;:
A novel haemocytometric COVID-19 prognostic score developed and validated in an observational
multicentre European hospital-based study.
A novel haemocytometric COVID-19 prognostic score developed and validated in an observational
multicentre European hospital-based study.
Summary:
The intention of the prognostic score is to support the management of COVID-19 patients. In this study, score values generated within the first three days of hospital admission could predict clinical severity in COVID-19 patients over the next two weeks. The score performance was shown to be superior to single parameters or parameter ratios.
The intention of the prognostic score is to support the management of COVID-19 patients. In this study, score values generated within the first three days of hospital admission could predict clinical severity in COVID-19 patients over the next two weeks. The score performance was shown to be superior to single parameters or parameter ratios.
Osman J et al.
(2020) Br J Haematol; 190(5): 718:
Rapid Screening of COVID-19 Patients by White Blood Cells Scattergrams, a Study on 381 Patients.
Rapid Screening of COVID-19 Patients by White Blood Cells Scattergrams, a Study on 381 Patients.
Summary:
The authors of this study investigated a specific pattern of WDF scattergram, the “sandglass shape” pattern of lymphocyte population in a cohort of 381 patients. It exhibited a sensitivity and specificity of 85.9% and 83.5% for identifying COVID-19 infection, respectively.
The authors of this study investigated a specific pattern of WDF scattergram, the “sandglass shape” pattern of lymphocyte population in a cohort of 381 patients. It exhibited a sensitivity and specificity of 85.9% and 83.5% for identifying COVID-19 infection, respectively.
Rolla R et al.
(2020) Int J Lab Hematol; 43(1): e5:
Reduced activity of B lymphocytes, recognised by Sysmex XN-2000™ haematology analyser, predicts mortality in patients with coronavirus disease 2019.
Reduced activity of B lymphocytes, recognised by Sysmex XN-2000™ haematology analyser, predicts mortality in patients with coronavirus disease 2019.
Summary:
In this study, the antibody-synthesizing lymphocyte count (AS-LYMP#) together with age, C-reactive protein (CRP) and creatinine level was identified by the authors of this study as an independent predictor of in-hospital mortality in COVID-19 patients.
In this study, the antibody-synthesizing lymphocyte count (AS-LYMP#) together with age, C-reactive protein (CRP) and creatinine level was identified by the authors of this study as an independent predictor of in-hospital mortality in COVID-19 patients.
Santotoribio J et al.
(2020) Clin. Lab; 66(9):
Evaluation of Routine Blood Tests for Diagnosis of Suspected Coronavirus Disease 2019.
Evaluation of Routine Blood Tests for Diagnosis of Suspected Coronavirus Disease 2019.
Summary:
This descriptive diagnostic study evaluated several routine blood tests for the diagnosis of COVID-19 at hospital admission. Lymphocytes, eosinophils, ferritin, LDH, D-dimer and hsCRP were included in the diagnostic criteria that identified suspected COVID-19 patients with a sensitivity of 91% and a specificity of 47%.
This descriptive diagnostic study evaluated several routine blood tests for the diagnosis of COVID-19 at hospital admission. Lymphocytes, eosinophils, ferritin, LDH, D-dimer and hsCRP were included in the diagnostic criteria that identified suspected COVID-19 patients with a sensitivity of 91% and a specificity of 47%.
Urrechaga E et al.
(2020) Clin Chem Lab Med; 59(2): e57:
Complete blood counts and cell population data from Sysmex XN analyser in the detection of SARS-CoV-2 infection.
Complete blood counts and cell population data from Sysmex XN analyser in the detection of SARS-CoV-2 infection.
Summary:
This letter to the editor describes a categorisation of patients with infection/fever into distinct groups based on statistical analyses of complete blood count and cell population data (CPD) from an XN analyser. 93.5% of COVID-19 patients and 100% of non-COVID-19 patients were correctly classified. The authors suggested a flag for COVID-19 infection, based on the neutrophil-to-lymphocyte ratio (NLR) and CPD values.
This letter to the editor describes a categorisation of patients with infection/fever into distinct groups based on statistical analyses of complete blood count and cell population data (CPD) from an XN analyser. 93.5% of COVID-19 patients and 100% of non-COVID-19 patients were correctly classified. The authors suggested a flag for COVID-19 infection, based on the neutrophil-to-lymphocyte ratio (NLR) and CPD values.
Wang Z et al.
(2020) Br J Haematol; 190(2): e76:
High-fluorescent lymphocytes are increased in patients with COVID-19.
High-fluorescent lymphocytes are increased in patients with COVID-19.
Summary:
This retrospective analysis of patients from the epicentre of the COVID-19 outbreak in Wuhan, China showed that while lymphocyte (L) counts were progressively decreased as disease severity increased, high-fluorescent lymphocyte (HFL) count and HFL/L ratio were increased in mild and severe cases compared to healthy controls.
This retrospective analysis of patients from the epicentre of the COVID-19 outbreak in Wuhan, China showed that while lymphocyte (L) counts were progressively decreased as disease severity increased, high-fluorescent lymphocyte (HFL) count and HFL/L ratio were increased in mild and severe cases compared to healthy controls.
Yip CYC et al.
(2020) Br J Haematol; 190(1): 33:
Temporal changes in immune blood cell parameters in COVID‐19 infection and recovery from severe infection.
Temporal changes in immune blood cell parameters in COVID‐19 infection and recovery from severe infection.
Summary:
According to the results of this study, the authors indicate that CBC including extended parameters about activated lymphocytes may be a valuable tool to triage patients with COVID-19. AS-LYMP%L (as a percentage of lymphocytes) yielded the best area under the receiver operating characteristic curve for predicting severe disease.
According to the results of this study, the authors indicate that CBC including extended parameters about activated lymphocytes may be a valuable tool to triage patients with COVID-19. AS-LYMP%L (as a percentage of lymphocytes) yielded the best area under the receiver operating characteristic curve for predicting severe disease.
Zhang C et al.
(2020) Chem Lab Med; 58(7): 1152:
Decreased "WBC*LYM" was observed in SARS-CoV-2-infected patients from a fever clinic in Wuhan.
Decreased "WBC*LYM" was observed in SARS-CoV-2-infected patients from a fever clinic in Wuhan.
Summary:
Retrospective CBC+DIFF data analysis from a fever clinic in Wuhan from February 2020 (mid-Corona-pandemic in China) to evaluate the diagnostic value of haematologic parameters in suspected COVID-19 patients. The combination parameter of WBC and LYM (WBC*LYM) showed the best performance data for the quick evaluation of the patients disease severity and whether the patient is likely to have COVID-19 or not.
Retrospective CBC+DIFF data analysis from a fever clinic in Wuhan from February 2020 (mid-Corona-pandemic in China) to evaluate the diagnostic value of haematologic parameters in suspected COVID-19 patients. The combination parameter of WBC and LYM (WBC*LYM) showed the best performance data for the quick evaluation of the patients disease severity and whether the patient is likely to have COVID-19 or not.
Review articles
Khartabil TA et al.
(2020) Crit Rev Clin Lab Sci; 57(6): 415:
A summary of the diagnostic and prognostic value of hemocytometry markers in COVID-19 patients.
A summary of the diagnostic and prognostic value of hemocytometry markers in COVID-19 patients.
Nokhostin F et al.
(2020) J Adv Med Biomed Res; 28(128): 171:
Evaluation of Prognostic/Diagnostic Value of Hematological Markers in the Detection of Inflammation in Coronavirus Disease: A Review Study.
Evaluation of Prognostic/Diagnostic Value of Hematological Markers in the Detection of Inflammation in Coronavirus Disease: A Review Study.
Single case reports
Fan BE et al.
(2020) Am J Hematol; 95(6): 723:
COVID-19 and mycoplasma pneumoniae coinfection.
COVID-19 and mycoplasma pneumoniae coinfection.
Foldes D et al.
(2020) Am J Hematol; 95(7): 861:
Plasmacytoid lymphocytes in SARS-CoV-2 infection (Covid-19).
Plasmacytoid lymphocytes in SARS-CoV-2 infection (Covid-19).
Gérard D et al.
(2020) Br J Haematol; 189(5): 845:
SARS-CoV-2: A New Aetiology for Atypical Lymphocytes.
SARS-CoV-2: A New Aetiology for Atypical Lymphocytes.
Mitra A et al.
(2020) Am J Hematol; 95(8): 999:
Leukoerythroblastic Reaction in a Patient With COVID-19 Infection.
Leukoerythroblastic Reaction in a Patient With COVID-19 Infection.
ZHANG B et al.
(2020) PLOS ONE. 15(7): e0235458:
Clinical characteristics of 82 cases of death from COVID-19.
Clinical characteristics of 82 cases of death from COVID-19.
Clinical Flow Cytometry
General
Sevestre J, Mayeur-Rousse C, Imbert S, Harrivel V, Letestu R, Baseggio L.
(2026) John Libbey:
Atlas d’images de cytométrie en flux : les syndromes lymphoprolifératifs – Complément d’images obtenues sur XF1600 [Flow cytometry image atlas: lymphoproliferative syndromes - Additional images obtained on the XF1600].
Ann Biol Clin (Paris). 2026 Jun 3;84(2):158-172. French. doi: 10.1684/abc.2026.2041. PMID: 42142314.
Flow cytometry image atlas: Lymphoproliferative syndromes – Additional images obtained on the XF1600
Atlas d’images de cytométrie en flux : les syndromes lymphoprolifératifs – Complément d’images obtenues sur XF1600 [Flow cytometry image atlas: lymphoproliferative syndromes - Additional images obtained on the XF1600].
Ann Biol Clin (Paris). 2026 Jun 3;84(2):158-172. French. doi: 10.1684/abc.2026.2041. PMID: 42142314.
Flow cytometry image atlas: Lymphoproliferative syndromes – Additional images obtained on the XF1600
Summary:
The aim of this atlas is to present ‘characteristic’ flow cytometry images of the main SLP-B and SLP-T subtypes obtained using an XF1600 flow cytometer, Sysmex at Poitiers University Hospital, using routine flow cytometry panels. It serves as a supplement to previously published atlases which presented images obtained on the BD Biosciences FACS Canto II, BD Biosciences LYRIC, and Beckman Coulter NAVIOS and DxFlex.
The aim of this atlas is to present ‘characteristic’ flow cytometry images of the main SLP-B and SLP-T subtypes obtained using an XF1600 flow cytometer, Sysmex at Poitiers University Hospital, using routine flow cytometry panels. It serves as a supplement to previously published atlases which presented images obtained on the BD Biosciences FACS Canto II, BD Biosciences LYRIC, and Beckman Coulter NAVIOS and DxFlex.
Weir C et al.
(2025) Biomed J Sci & Tech Res 60(5)-2025. BJSTR. MS.ID.009513:
Use of a Novel Flow Cytometry Platform Sysmex XF1600 in the Diagnosis of B- Cell Chronic Lymphocytic Leukaemia (B-CLL)
Use of a Novel Flow Cytometry Platform Sysmex XF1600 in the Diagnosis of B- Cell Chronic Lymphocytic Leukaemia (B-CLL)
Summary:
The study evaluates the Sysmex XF-1600, a 10-color flow cytometry platform, and its harmonized protocols for diagnosing B-cell chronic lymphocytic leukaemia (B-CLL). Analysis of 33 B-CLL samples across two international laboratories demonstrated that the XF-1600 consistently detected core B-CLL markers, with antigen detection rates and mean fluorescence intensity values showing statistical significance (p < 0.05). The harmonized Sysmex XF-1600 protocols included standardized antibody panels and instrument settings that were cloned across laboratories, thereby reducing inter-laboratory variability, and enhancing diagnostic accuracy compared to conventional laboratory-developed protocols.
The study evaluates the Sysmex XF-1600, a 10-color flow cytometry platform, and its harmonized protocols for diagnosing B-cell chronic lymphocytic leukaemia (B-CLL). Analysis of 33 B-CLL samples across two international laboratories demonstrated that the XF-1600 consistently detected core B-CLL markers, with antigen detection rates and mean fluorescence intensity values showing statistical significance (p < 0.05). The harmonized Sysmex XF-1600 protocols included standardized antibody panels and instrument settings that were cloned across laboratories, thereby reducing inter-laboratory variability, and enhancing diagnostic accuracy compared to conventional laboratory-developed protocols.
Salvia R et al.
(2024) Biomed J Sci & Tech Res 55(5)-2024. BJSTR. MS.ID.008774.:
Clinical Utility of the XF-1600 Flow Cytometer for MRD Assessment in Multiple Myeloma.
Clinical Utility of the XF-1600 Flow Cytometer for MRD Assessment in Multiple Myeloma.
Summary:
This study presents a standardized and a reproducible panel for MRD detection of multiple myeloma patients in the XF-1600. It shows a strong correlation between the MRD assessment in the XF-1600 versus DxFlex and Navios EX Flow Cytometers from Beckman Coulter.
This study presents a standardized and a reproducible panel for MRD detection of multiple myeloma patients in the XF-1600. It shows a strong correlation between the MRD assessment in the XF-1600 versus DxFlex and Navios EX Flow Cytometers from Beckman Coulter.
Al-Attar et al.
(2023) Cytometry B Clin Cytom. 2024 Jul;106(4):308-320. doi: 10.1002/cyto.b.22125. Epub 2023 May 13. PMID: 37178358.:
Automation in flow cytometry: Guidelines and review of systems.
Automation in flow cytometry: Guidelines and review of systems.
Summary:
This article compared the Sysmex sample preparation system PS-10 with two sample preparation systems from different manufacturers: the Beckman CellMek and the BD FACSDuet.
This article compared the Sysmex sample preparation system PS-10 with two sample preparation systems from different manufacturers: the Beckman CellMek and the BD FACSDuet.
Ward R et al.
(2023) Int J Lab Hematol. 2023 Dec 19. doi: 10.1111/ijlh.14219. Epub ahead of print.:
Can Metrological Traceability for Lymphocyte Subsets be achieved: A Technical Assessment of the Sysmex XF-1600.
Can Metrological Traceability for Lymphocyte Subsets be achieved: A Technical Assessment of the Sysmex XF-1600.
Summary:
This study compared a bead-based technique (BD Multitest™ 6-colour TBNK assay using Trucount™ tubes on a BD FACSLyric flow cytometer) with a volumetric method on the Sysmex XF-1600 flow cytometer using Exbio Kombitest 6-colour TBNK reagent. A high degree of correlation was found for results from both methodologies and observed bias was within the limits of clinical acceptability for all populations. The authors conclude that the metrologically traceable lymphocyte subset absolute counts produced by the Sysmex XF-1600 are robust within clinically required limits.
This study compared a bead-based technique (BD Multitest™ 6-colour TBNK assay using Trucount™ tubes on a BD FACSLyric flow cytometer) with a volumetric method on the Sysmex XF-1600 flow cytometer using Exbio Kombitest 6-colour TBNK reagent. A high degree of correlation was found for results from both methodologies and observed bias was within the limits of clinical acceptability for all populations. The authors conclude that the metrologically traceable lymphocyte subset absolute counts produced by the Sysmex XF-1600 are robust within clinically required limits.
Extended IPU
Biomedical Validation
Paridaens H et al.
(2019) Ann Biol Clin (Paris); 77(4): 422.:
Can the 72-hour rule based on "Blast/Abn Lymph" flag on Sysmex XN-10 optimize the workflow in hematology laboratory?
Can the 72-hour rule based on "Blast/Abn Lymph" flag on Sysmex XN-10 optimize the workflow in hematology laboratory?
Summary:
The authors verified GFHC rules for reducing unnecessary smears and even extended the rules for further smear reduction when using XN analysers. The very good sensitivity (93%) and specificity (94%) of the Blast/Abn Lympho? flag was confirmed in line with smear reduction of 5.7% and associated cost reduction.
The authors verified GFHC rules for reducing unnecessary smears and even extended the rules for further smear reduction when using XN analysers. The very good sensitivity (93%) and specificity (94%) of the Blast/Abn Lympho? flag was confirmed in line with smear reduction of 5.7% and associated cost reduction.
Ronez E et al.
(2017) Scand J Clin Lab Invest; 77(6): 406.:
Usefulness of thresholds for smear review of neutropenic samples analyzed with a Sysmex XN-10 analyzer.
Usefulness of thresholds for smear review of neutropenic samples analyzed with a Sysmex XN-10 analyzer.
Summary:
A multi-centre study showed that 1031 smear reviews triggered by isolated neutropenic samples (NEUT# < 1.5 G/L) resulted in the detection of only one positive sample (containing blasts). The authors recommend using a lower cutoff of 1.0 G/L for smear review.
A multi-centre study showed that 1031 smear reviews triggered by isolated neutropenic samples (NEUT# < 1.5 G/L) resulted in the detection of only one positive sample (containing blasts). The authors recommend using a lower cutoff of 1.0 G/L for smear review.
Cornet E et al.
(2016) Scand J Clin Lab Invest; 76(6): 465.:
Evaluation and optimization of the extended information process unit (E-IPU) validation module integrating the sysmex flag systems and the recommendations of the French-speaking cellular hematology group (GFHC).
Evaluation and optimization of the extended information process unit (E-IPU) validation module integrating the sysmex flag systems and the recommendations of the French-speaking cellular hematology group (GFHC).
Summary:
Using the biomedical validation criteria, 21.3% of samples triggered a smear review in this study cohort. Modification of four criteria by the authors reduced the number of smears from 21.3% to 15.0% without loss of clinical value.
Using the biomedical validation criteria, 21.3% of samples triggered a smear review in this study cohort. Modification of four criteria by the authors reduced the number of smears from 21.3% to 15.0% without loss of clinical value.
Genevieve F et al.
(2014) feuillets de Biologie; LVI 317: 1.:
Smear microscopy revision - propositions by the GFHC.
Smear microscopy revision - propositions by the GFHC.
Summary:
The GFHC reviewed in detail the criteria used within the CBC to generate blood smears and has decided on a number of minimum recommendations, defining threshold values and various situations in which the blood smear review is desirable.
The GFHC reviewed in detail the criteria used within the CBC to generate blood smears and has decided on a number of minimum recommendations, defining threshold values and various situations in which the blood smear review is desirable.
CBC-O
Nivaggioni V et al.
(2022) Int J Hematol; 44(2): e84.:
Detection of Southern Asian Ovalocytosis with Sysmex XN-10: A complement to the decision tree previously described.
Detection of Southern Asian Ovalocytosis with Sysmex XN-10: A complement to the decision tree previously described.
Summary:
The authors expanded the algorithm described in the Nivaggioni et al. 2020 publication with the addition of a step to detect Southeast Asian ovalocytosis (SAO) cases. All SAO samples were correctly classified using the Hypo-He/MicroR ratio, which achieved an AUC of 1.0.
The authors expanded the algorithm described in the Nivaggioni et al. 2020 publication with the addition of a step to detect Southeast Asian ovalocytosis (SAO) cases. All SAO samples were correctly classified using the Hypo-He/MicroR ratio, which achieved an AUC of 1.0.
Schillinger F et al.
(2021) Ann Biol Clin (Paris); 79(2): 181.:
Impact of hyperleucocytosis on erythrocytic parameters of cell blood count: management by Sysmex XN-10 RET analyzer.
Impact of hyperleucocytosis on erythrocytic parameters of cell blood count: management by Sysmex XN-10 RET analyzer.
Summary:
The study confirms the effect of hyperleukocytosis on RBC parameters. RBC and HCT are affected in lymphoid diseases (CLL, ALL). Haemoglobin is affected in myeloid diseases (CML, AML). Authors propose an algorithm to accurately correct the parameters based on the RET channel.
The study confirms the effect of hyperleukocytosis on RBC parameters. RBC and HCT are affected in lymphoid diseases (CLL, ALL). Haemoglobin is affected in myeloid diseases (CML, AML). Authors propose an algorithm to accurately correct the parameters based on the RET channel.
Berda-Haddad Y et al.
(2017) Int J Lab Hematol; 39(1): 32.:
Increased mean corpuscular haemoglobin concentration: artefact or pathological condition?
Increased mean corpuscular haemoglobin concentration: artefact or pathological condition?
Summary:
The use of the optical RBC parameters from the XN-Series saved time and helped in the determination of the cause of increased MCHC, in this study.
The use of the optical RBC parameters from the XN-Series saved time and helped in the determination of the cause of increased MCHC, in this study.
Haemoglobin variants
Bosma M et al.
(2025) Int J Lab Hematol; 47(4):748-749.:
Verification of an Algorithm for Detection of Unstable Haemoglobin Variants With Sysmex XN-10 Yielded a High Degree of False Positives
Verification of an Algorithm for Detection of Unstable Haemoglobin Variants With Sysmex XN-10 Yielded a High Degree of False Positives
Summary:
The authors suggested modifying the algorithm for unstable haemoglobin variant identification by Combaluzier et al. (2023), recommending the addition of cut-offs of neutrophils > 0.5 × 10⁹/L, lymphocytes > 0.1 × 10⁹/L, and patient age > 30 days in order to gain specificity.
The authors suggested modifying the algorithm for unstable haemoglobin variant identification by Combaluzier et al. (2023), recommending the addition of cut-offs of neutrophils > 0.5 × 10⁹/L, lymphocytes > 0.1 × 10⁹/L, and patient age > 30 days in order to gain specificity.
Combaluzier S et al.
(2023) Int J Lab Hematol; 45(2): e21.:
Detection of unstable haemoglobin variants with Sysmex XN-10.
Detection of unstable haemoglobin variants with Sysmex XN-10.
Summary:
WDF channel of XN analysers shows a decreased fluorescence signal in blood samples of patients with unstable haemoglobin variants causing an abnormal scattergram. The optimal threshold combination to specify unstable haemoglobin variants is LY-SFL < 42 and NE-SFL < 41.2 resulting in a sensitivity of 100% and specificity of 99.9%.
WDF channel of XN analysers shows a decreased fluorescence signal in blood samples of patients with unstable haemoglobin variants causing an abnormal scattergram. The optimal threshold combination to specify unstable haemoglobin variants is LY-SFL < 42 and NE-SFL < 41.2 resulting in a sensitivity of 100% and specificity of 99.9%.
Intensive Care Infection Score (ICIS RUO)
Deniz E et al.
(2025) Intensive Care Med Exp 13(1):58.:
Intensive care infection score: ICIS discriminates between infected and uninfected critically ill patients in routine intensive care unit practice
Intensive care infection score: ICIS discriminates between infected and uninfected critically ill patients in routine intensive care unit practice
Summary:
In a multicentre study of 115 ICU patients, ICIS RUO* (cut-off ≥ 3) outperformed CRP and PCT in distinguishing infection, with an AUC of 0.984, sensitivity of 90.7%, specificity of 97.5%, PPV of 98.6%, and NPV of 84.8%. The authors concluded that ICIS RUO* could support early infection assessment.
In a multicentre study of 115 ICU patients, ICIS RUO* (cut-off ≥ 3) outperformed CRP and PCT in distinguishing infection, with an AUC of 0.984, sensitivity of 90.7%, specificity of 97.5%, PPV of 98.6%, and NPV of 84.8%. The authors concluded that ICIS RUO* could support early infection assessment.
Nacke N et al.
(2025) A A Pract. 19(7):e02004:
Exploring The Potential of The Intensive Care Infection Score in Antimicrobial Stewardship: A Case Report
Exploring The Potential of The Intensive Care Infection Score in Antimicrobial Stewardship: A Case Report
Summary:
In a case series of three ICU patients, ICIS RUO* was used to retrospectively review antibiotic decisions.
• In the first case ICIS RUO* indicated a persistent infection and prompted therapy changes.
• In the second case it indicated ongoing infection despite declining CRP and PCT to guide treatment modification.
• In the third case an infection was ruled out despite elevated CRP and PCT. The authors concluded that ICIS RUO* could support antimicrobial stewardship and infection management beyond conventional markers in critically ill patients.
In a case series of three ICU patients, ICIS RUO* was used to retrospectively review antibiotic decisions.
• In the first case ICIS RUO* indicated a persistent infection and prompted therapy changes.
• In the second case it indicated ongoing infection despite declining CRP and PCT to guide treatment modification.
• In the third case an infection was ruled out despite elevated CRP and PCT. The authors concluded that ICIS RUO* could support antimicrobial stewardship and infection management beyond conventional markers in critically ill patients.
Vrbacký F et al.
(2025) Int J Lab Hematol. 47(4):707-712.:
Intensive Care Infection Score (ICIS) is an Early Marker for Infection in Time of Admission to Intensive Care Units
Intensive Care Infection Score (ICIS) is an Early Marker for Infection in Time of Admission to Intensive Care Units
Summary:
In this cohort of 102 adult ICU patients (n=30 infected, n=72 non-infected), ICIS RUO* demonstrated a diagnostic performance for early infection detection at admission, with an AUC of 0.958, outperforming CRP, PCT and IL6. An ICIS RUO* cut-off of ≥4 provided a high sensitivity and specificity (93.3% and 84.2%, respectively). Infected patients had significantly higher levels of NEUT-SFL, NEUT#, HFLC#, and IG# (p < 0.0031).
In this cohort of 102 adult ICU patients (n=30 infected, n=72 non-infected), ICIS RUO* demonstrated a diagnostic performance for early infection detection at admission, with an AUC of 0.958, outperforming CRP, PCT and IL6. An ICIS RUO* cut-off of ≥4 provided a high sensitivity and specificity (93.3% and 84.2%, respectively). Infected patients had significantly higher levels of NEUT-SFL, NEUT#, HFLC#, and IG# (p < 0.0031).
Van der Geest PJ et al.
(2016) Crit. Care 20(1):180.:
The intensive care infection score - a novel marker for the prediction of infection and its severity.
The intensive care infection score - a novel marker for the prediction of infection and its severity.
Summary:
ICIS RUO is potentially useful for the prediction of infections in critically ill patients and was shown to be non-inferior to CRP and PCT in this study.
ICIS RUO is potentially useful for the prediction of infections in critically ill patients and was shown to be non-inferior to CRP and PCT in this study.
Weimann K et al.
(2015) J. Int. Med. Res. 43(3):435-51.:
Intensive Care Infection Score--A new approach to distinguish between infectious and noninfectious processes in intensive care and medicosurgical patients.
Intensive Care Infection Score--A new approach to distinguish between infectious and noninfectious processes in intensive care and medicosurgical patients.
Summary:
In this study, ICIS RUO showed better discriminatory power than CRP and PCT for differentiating between infected and non-infected ICU patients, especially in post-operative patients, and could therefore be useful as a decision-making aid for antibiotic treatment.
In this study, ICIS RUO showed better discriminatory power than CRP and PCT for differentiating between infected and non-infected ICU patients, especially in post-operative patients, and could therefore be useful as a decision-making aid for antibiotic treatment.
Nierhaus A et al.
(2012) Inflamm. Allergy Drug Targets 11(2):109-15.:
Use of a Weighted, Automated Analysis of the Differential Blood Count to Differentiate Sepsis from Non-Infectious Systemic Inflammation: The Intensive Care Infection Score (ICIS).
Use of a Weighted, Automated Analysis of the Differential Blood Count to Differentiate Sepsis from Non-Infectious Systemic Inflammation: The Intensive Care Infection Score (ICIS).
Summary:
The Intensive Care Infection Score RUO (ICIS RUO) consists of multiple differential blood count parameters and provides promising potential for reliably and swiftly discriminating sepsis from systemic inflammation (SIRS) in the first critical hours at the ICU, in this study.
The Intensive Care Infection Score RUO (ICIS RUO) consists of multiple differential blood count parameters and provides promising potential for reliably and swiftly discriminating sepsis from systemic inflammation (SIRS) in the first critical hours at the ICU, in this study.
Monocytosis Workflow Optimisation (MWO)
Cornet E et al.
(2024) Int J Lab Hematol; 46:971-974.:
Applicability of mono dysplasia score on the new Sysmex XR analyzer range to predict diagnosis of chronic myelomonocytic leukaemia.
Applicability of mono dysplasia score on the new Sysmex XR analyzer range to predict diagnosis of chronic myelomonocytic leukaemia.
Summary:
A study of 316 patients with monocytosis showed that a mono-dysplasia score > 0.16 calculated on XR-Series could differentiate CMML samples (n=22) from reactive monocytosis cases (n=294) with an AUC of 0.994, sensitivity 100% and specificity of 95.2%.
A study of 316 patients with monocytosis showed that a mono-dysplasia score > 0.16 calculated on XR-Series could differentiate CMML samples (n=22) from reactive monocytosis cases (n=294) with an AUC of 0.994, sensitivity 100% and specificity of 95.2%.
Podvin B et al.
(2024) Int J Lab Hematol; 46(5): 969-970.:
Oligomonocytic chronic myelomonocytic leukemia is eligible to MDS-score and not Mono-dysplasia score.
Oligomonocytic chronic myelomonocytic leukemia is eligible to MDS-score and not Mono-dysplasia score.
Summary:
In this letter to the editor the authors evaluated the MDS-score and the monodysplasia score in a small cohort (n=31) of oligomonocytic chronic myelomonoctic leukaemia (OM-CMML) patients and identified 90.0% as positive for the MDS score and 29.0% positive for the monodysplasia score.
In this letter to the editor the authors evaluated the MDS-score and the monodysplasia score in a small cohort (n=31) of oligomonocytic chronic myelomonoctic leukaemia (OM-CMML) patients and identified 90.0% as positive for the MDS score and 29.0% positive for the monodysplasia score.
Bouriche L et al.
(2023) Int J Lab Hematol; 46(2): 286.:
Detection of dysplasia in peripheral blood: Proposal of an algorithm to detect myelodysplastic syndromes and chronic myelomonocytic leukemias on a high-speed technical platform using the Sysmex XN™ analyser.
Detection of dysplasia in peripheral blood: Proposal of an algorithm to detect myelodysplastic syndromes and chronic myelomonocytic leukemias on a high-speed technical platform using the Sysmex XN™ analyser.
Summary:
A decision tree utilising the MDS-CBC and mono-dysplasia scores had a 94.4% sensitivity and 91.4% specificity in identifying MDS (n=18) and CMML (n=18) samples within a cohort of 749. Routine implementation of the tree compared to using the recommended cytopenia or monocytosis criteria in over 25,000 samples significantly reduced the smear workload.
A decision tree utilising the MDS-CBC and mono-dysplasia scores had a 94.4% sensitivity and 91.4% specificity in identifying MDS (n=18) and CMML (n=18) samples within a cohort of 749. Routine implementation of the tree compared to using the recommended cytopenia or monocytosis criteria in over 25,000 samples significantly reduced the smear workload.
Podvin B et al.
(2023) Int J Lab Hematol; 45(5): 791.:
A new combination of monocytic scores to support diagnosis of chronic myelomonocytic leukemia according to novel classifications.
A new combination of monocytic scores to support diagnosis of chronic myelomonocytic leukemia according to novel classifications.
Summary:
A study of 76 patients with persistent monocytosis showed that a mono-dysplasia score > 0.16 and/or classical monocytes (MO1) > 94% could identify 46 out of 47 CMML samples (sensitivity 98%, specificity 79%, PPV: 88.5%, NPV: 95.8%) and differentiate them from reactive monocytosis (n=13) and other haemopathies (n=16).
A study of 76 patients with persistent monocytosis showed that a mono-dysplasia score > 0.16 and/or classical monocytes (MO1) > 94% could identify 46 out of 47 CMML samples (sensitivity 98%, specificity 79%, PPV: 88.5%, NPV: 95.8%) and differentiate them from reactive monocytosis (n=13) and other haemopathies (n=16).
Zhu J et al.
(2022) BMC Cancer; 22(1): 972.:
Machine learning-based improvement of MDS-CBC score brings platelets into the limelight to optimize smear review in the hematology laboratory.
Machine learning-based improvement of MDS-CBC score brings platelets into the limelight to optimize smear review in the hematology laboratory.
Summary:
A two-step algorithm, triggered by cytopenia, and utilising the MDS-CBC score and IPF, correctly separated myelodysplastic (MDS) samples (n=168) from other non-clonal cytopenic samples (n=357) with a sensitivity of 88.7% and a specificity of 95.8%. The algorithm had a 96.4% classification rate for MDS and 95.8% for the cytopenic controls in this study.
A two-step algorithm, triggered by cytopenia, and utilising the MDS-CBC score and IPF, correctly separated myelodysplastic (MDS) samples (n=168) from other non-clonal cytopenic samples (n=357) with a sensitivity of 88.7% and a specificity of 95.8%. The algorithm had a 96.4% classification rate for MDS and 95.8% for the cytopenic controls in this study.
Zhu J et al.
(2019) Int J Lab Hematol; 41(6): 782.:
A hierarchical approach in the diagnostic workflow of chronic myelomonocytic leukemia: Pivotal role of the "Mono-dysplasia-score" combined with flow cytometric quantification of monocyte subsets.
A hierarchical approach in the diagnostic workflow of chronic myelomonocytic leukemia: Pivotal role of the "Mono-dysplasia-score" combined with flow cytometric quantification of monocyte subsets.
Summary:
The authors set up a workflow for monocytosis samples including mono-dysplasia score, smear review and flow cytometry. The proposed mono-dysplasia score was shown to be a valuable filter for reducing the number of smears without losing sensitivity for CMML suspicious samples.
The authors set up a workflow for monocytosis samples including mono-dysplasia score, smear review and flow cytometry. The proposed mono-dysplasia score was shown to be a valuable filter for reducing the number of smears without losing sensitivity for CMML suspicious samples.
Boutault R et al.
(2018) Br J Haematol; 183(5): 736.:
A novel complete blood count-based score to screen for myelodysplastic syndrome in cytopenic patients.
A novel complete blood count-based score to screen for myelodysplastic syndrome in cytopenic patients.
Summary:
The authors suggested an MDS-CBC multiparametric score as a screening tool for MDS patients by combining absolute neutrophil count (ANC), mean corpuscular volume (MCV), and median neutrophil complexity width of dispersion (NE-WX). The score had a sensitivity of 86% and a specificity of 88% in the leading cohort.
The authors suggested an MDS-CBC multiparametric score as a screening tool for MDS patients by combining absolute neutrophil count (ANC), mean corpuscular volume (MCV), and median neutrophil complexity width of dispersion (NE-WX). The score had a sensitivity of 86% and a specificity of 88% in the leading cohort.
Schillinger F et al.
(2017) Scand J Clin Lab Invest; 78(3): 159.:
A new approach for diagnosing chronic myelomonocytic leukemia using structural parameters of Sysmex XN analyzers in routine laboratory practice.
A new approach for diagnosing chronic myelomonocytic leukemia using structural parameters of Sysmex XN analyzers in routine laboratory practice.
Summary:
The study presents a score derived from Sysmex XN parameters that identifies possible CMML samples by excluding reactive monocytes. This reduces the smear review workload.
The study presents a score derived from Sysmex XN parameters that identifies possible CMML samples by excluding reactive monocytes. This reduces the smear review workload.
RBC Defect Workflow Optimisation (RWO)
Nivaggioni V et al.
(2022) Int J Hematol; 44(2): e84.:
Detection of Southern Asian Ovalocytosis with Sysmex XN-10: A complement to the decision tree previously described.
Detection of Southern Asian Ovalocytosis with Sysmex XN-10: A complement to the decision tree previously described.
Summary:
The authors expanded the algorithm described in the Nivaggioni et al. 2020 publication with the addition of a step to detect Southeast Asian ovalocytosis (SAO) cases. All SAO samples were correctly classified using the Hypo-He/MicroR ratio, which achieved an AUC of 1.0.
The authors expanded the algorithm described in the Nivaggioni et al. 2020 publication with the addition of a step to detect Southeast Asian ovalocytosis (SAO) cases. All SAO samples were correctly classified using the Hypo-He/MicroR ratio, which achieved an AUC of 1.0.
Nivaggioni V et al.
(2020) Int J Lab Hematol; 42(6): 697.:
Use of Sysmex XN-10 red blood cell parameters for screening of hereditary red blood cell diseases and iron deficiency anaemia.
Use of Sysmex XN-10 red blood cell parameters for screening of hereditary red blood cell diseases and iron deficiency anaemia.
Summary:
The authors propose a two-step algorithm, based on the XN RBC and reticulocyte parameters, to differentiate patients with a hereditary RBC disease from iron deficiency anaemia and other patients. The published flowchart recommends how to manage MCHC < 36.5 g/dL (22.7 mmol/L) samples in addition to the CBC-O application to assist the diagnosis of RBC diseases. Overall, it reaches a very good classification rate of 99.4%, confirmed by an external cohort.
The authors propose a two-step algorithm, based on the XN RBC and reticulocyte parameters, to differentiate patients with a hereditary RBC disease from iron deficiency anaemia and other patients. The published flowchart recommends how to manage MCHC < 36.5 g/dL (22.7 mmol/L) samples in addition to the CBC-O application to assist the diagnosis of RBC diseases. Overall, it reaches a very good classification rate of 99.4%, confirmed by an external cohort.
HbA1c
HbA1C
Park MS et al.
(2019) Ann Lab Med; 39(3): 237:
Accurate and Rapid Measurement of Glycated Hemoglobin Using HLC-723 G11 Variant Mode.
Accurate and Rapid Measurement of Glycated Hemoglobin Using HLC-723 G11 Variant Mode.
Summary:
In this study, the authors concluded that G11vr shows adequate performance and rapid turnaround time in measuring HbA1c.
In this study, the authors concluded that G11vr shows adequate performance and rapid turnaround time in measuring HbA1c.
Danese E et al.
(2017) Clin Chem Lab Med; 55(11): e241:
Can we still trust hemoglobin A1c in all situations?
Can we still trust hemoglobin A1c in all situations?
Summary:
The measurement of the HbA1c haemoglobin is important for the early diagnosis and treatment monitoring in case of diabetes. Despite the accuracy of the parameter, the authors emphasise that there are a couple of clinical conditions where the HbA1c should be used with caution and the clinician should take under consideration the clinical condition of the patient.
The measurement of the HbA1c haemoglobin is important for the early diagnosis and treatment monitoring in case of diabetes. Despite the accuracy of the parameter, the authors emphasise that there are a couple of clinical conditions where the HbA1c should be used with caution and the clinician should take under consideration the clinical condition of the patient.
Lenters-Westra A et al.
(2017) Clin Chem Lab Med; 55(9): 1426:
Evaluating new HbA1c methods for adoption by the IFCC and NGSP reference networks using international quality targets.
Evaluating new HbA1c methods for adoption by the IFCC and NGSP reference networks using international quality targets.
Summary:
In this study, the Abbott Enzymatic method on the Architect c4000, the Roche Gen.3 HbA1c on the Cobas c513, and the Tosoh G11 method, officially certified IFCC and NGSP SRMPs in the IFCC and NGSP networks, performed well and were suitable for clinical application in the analysis of HbA1c. For all analysers the Sigma metrics quality criteria distinguished between good and excellent performance.
In this study, the Abbott Enzymatic method on the Architect c4000, the Roche Gen.3 HbA1c on the Cobas c513, and the Tosoh G11 method, officially certified IFCC and NGSP SRMPs in the IFCC and NGSP networks, performed well and were suitable for clinical application in the analysis of HbA1c. For all analysers the Sigma metrics quality criteria distinguished between good and excellent performance.
Kaiser P et al.
(2016) Clin Chem Lab Med 54(11): 1769:
HbA1c: EQA in Germany, Belgium and the Netherlands using fresh whole blood samples with target values assigned with the IFCC reference system HbA1c EQA in Germany Belgium and the Netherlands.
HbA1c: EQA in Germany, Belgium and the Netherlands using fresh whole blood samples with target values assigned with the IFCC reference system HbA1c EQA in Germany Belgium and the Netherlands.
Summary:
The authors were able to establish an external quality assessment scheme because the differences between the laboratories were minor.
The authors were able to establish an external quality assessment scheme because the differences between the laboratories were minor.
Platelets
Fluorescence platelets (PLT-F)
Zhou ZY et al.
(2024) Clin Lab; 70: 1014:
A Case of Pseudothrombocytopenia due to Pre-Analytical Issues Revealed by the Presence of Fibrin in a Blood Film.
A Case of Pseudothrombocytopenia due to Pre-Analytical Issues Revealed by the Presence of Fibrin in a Blood Film.
Summary:
In this clinical case the sample of a 68-year-old patient with a flag for PLT clumps and an abnormal scattergram from the PLT-F channel suggested the presence of platelet aggregation. On careful smear review, fibrin was observed at the feathered end of the blood film and a pseudothrombocytopenia due to pre-analytical issues was concluded.
In this clinical case the sample of a 68-year-old patient with a flag for PLT clumps and an abnormal scattergram from the PLT-F channel suggested the presence of platelet aggregation. On careful smear review, fibrin was observed at the feathered end of the blood film and a pseudothrombocytopenia due to pre-analytical issues was concluded.
Tantanate C et al.
(2019) Scand J Clin Lab Invest; 79(3):160:
Analytical performance of automated platelet counts and impact on platelet transfusion guidance in patients with acute leukemia.
Analytical performance of automated platelet counts and impact on platelet transfusion guidance in patients with acute leukemia.
Summary:
In this study the performance of impedance platelet counting using PLT-I, LH-750 (PLT-LH), as well as PLT-F was analysed in patients with acute leukaemia. PLT-F demonstrated an excellent performance for the identification of thrombocytopenia and had the lowest rate of under transfusion. Additionally, the authors found that a high blast count is associated with inaccurate PLT-LH and PLT-I counts.
In this study the performance of impedance platelet counting using PLT-I, LH-750 (PLT-LH), as well as PLT-F was analysed in patients with acute leukaemia. PLT-F demonstrated an excellent performance for the identification of thrombocytopenia and had the lowest rate of under transfusion. Additionally, the authors found that a high blast count is associated with inaccurate PLT-LH and PLT-I counts.
Tantanate C et al.
(2017) Arch Pathol Lab Med; 141(6): 830:
Performance Evaluation of Automated Impedance and Optical Fluorescence Platelet Counts Compared With International Reference Method in Patients With Thalassemia.
Performance Evaluation of Automated Impedance and Optical Fluorescence Platelet Counts Compared With International Reference Method in Patients With Thalassemia.
Summary:
PLT-I, PLT-O and PLT-F were compared with CD41/CD61 immune flow cytometry in thalassaemia patients. PLT-O and PLT-F had better correlations with flow cytometry than PLT-I and PLT-F had a better specificity for detection of PLT counts below 100,000/μL in this study.
PLT-I, PLT-O and PLT-F were compared with CD41/CD61 immune flow cytometry in thalassaemia patients. PLT-O and PLT-F had better correlations with flow cytometry than PLT-I and PLT-F had a better specificity for detection of PLT counts below 100,000/μL in this study.
Park SH et al.
(2015) Ann Lab Med; 34(6): 471:
The Sysmex XN-2000 Hematology Autoanalyzer Provides a Highly Accurate Platelet Count than the Former Sysmex XE-2100 System Based on Comparison with the CD41/CD61 Immunoplatelet Reference Method of Flow Cytometry.
The Sysmex XN-2000 Hematology Autoanalyzer Provides a Highly Accurate Platelet Count than the Former Sysmex XE-2100 System Based on Comparison with the CD41/CD61 Immunoplatelet Reference Method of Flow Cytometry.
Summary:
PLT-F counts from the XN-Series were more accurate than PLT-O counts from the XE-series when compared with the CD41/CD61 immunoplatelet reference method in this study.
PLT-F counts from the XN-Series were more accurate than PLT-O counts from the XE-series when compared with the CD41/CD61 immunoplatelet reference method in this study.
Wada A et al.
(2015) PLoS One; 10(10):
Accuracy of a New Platelet Count System (PLT-F) Depends on the Staining Property of Its Reagents.
Accuracy of a New Platelet Count System (PLT-F) Depends on the Staining Property of Its Reagents.
Summary:
The study showed that the PLT-F reagent labels intracellular structures within platelets and confirms previous findings that it strongly marks CD41/CD61-positive platelets.
The study showed that the PLT-F reagent labels intracellular structures within platelets and confirms previous findings that it strongly marks CD41/CD61-positive platelets.
Tailor H et al.
(2014) Hospital Health Care Europe (HHE); 2:181:
Evaluating platelet counting on a new automated analyser.
Evaluating platelet counting on a new automated analyser.
Summary:
The PLT-F channel of the XN-Series shows excellent precision and accuracy even in abnormal samples or samples with fragmented red cells, large platelets and low PLT counts when compared to the reference flow cytometric method in this evaluation study.
The PLT-F channel of the XN-Series shows excellent precision and accuracy even in abnormal samples or samples with fragmented red cells, large platelets and low PLT counts when compared to the reference flow cytometric method in this evaluation study.
Tanaka Y et al.
(2014) J Clin Lab Anal; 28(5): 341:
Performance Evaluation of Platelet Counting by Novel Fluorescent Dye Staining in the XN-Series Automated Hematology Analyzers.
Performance Evaluation of Platelet Counting by Novel Fluorescent Dye Staining in the XN-Series Automated Hematology Analyzers.
Summary:
Compared to PLT-I and PLT-O counts, PLT-F had the best correlation with CD61-immunoplatelet counts. PLT-F counts were not affected by WBC fragments in two acute leukaemia patients or by RBC fragments and microcytes in a burn injury patient.
Compared to PLT-I and PLT-O counts, PLT-F had the best correlation with CD61-immunoplatelet counts. PLT-F counts were not affected by WBC fragments in two acute leukaemia patients or by RBC fragments and microcytes in a burn injury patient.
Schoorl M et al.
(2013) Am J Clin Pathol;140: 495:
New fluorescent method (PLT-F) on Sysmex XN2000 hematology analyzer achieved higher accuracy
in low platelet counting.
New fluorescent method (PLT-F) on Sysmex XN2000 hematology analyzer achieved higher accuracy
in low platelet counting.
Summary:
The PLT-F method of the XN-2000 demonstrated excellent reproducibility in samples with low platelet counts. Therefore, the authors recommended it for making decisions about platelet transfusions.
The PLT-F method of the XN-2000 demonstrated excellent reproducibility in samples with low platelet counts. Therefore, the authors recommended it for making decisions about platelet transfusions.
General
Coussee A et al.
(2025) LabMed; 2(1): 5:
Evaluating the Performance of the New Sysmex XR-Series Haematology Analyser: A Comparative Study with the Sysmex XN-Series.
Evaluating the Performance of the New Sysmex XR-Series Haematology Analyser: A Comparative Study with the Sysmex XN-Series.
Summary:
In this comparative analytical performance study of the XR-Series and XN-Series analysers the authors demonstrated highly comparable precision, method comparison and flagging.
In this comparative analytical performance study of the XR-Series and XN-Series analysers the authors demonstrated highly comparable precision, method comparison and flagging.
Tabata M et al.
(2024) Clin Chem Lab Med; 62(12): 2461:
Performance evaluation and user experience of BT-50 transportation unit with automated and scheduled quality control measurements.
Performance evaluation and user experience of BT-50 transportation unit with automated and scheduled quality control measurements.
Summary:
The authors evaluated the performance of the BT-50 and the manual method using XN Check Levels 1, 2 and 3 and the results were equivalent. For PLT, BT-50 showed lower variability compared to the manual method. The BT-50 streamlined the workflow, reduced operator workload and provided standardised control measurements.
The authors evaluated the performance of the BT-50 and the manual method using XN Check Levels 1, 2 and 3 and the results were equivalent. For PLT, BT-50 showed lower variability compared to the manual method. The BT-50 streamlined the workflow, reduced operator workload and provided standardised control measurements.
Lunde HE et al.
(2022) Int J Lab Hematol; 44(5): 854:
The diagnostic accuracy of Sysmex XN for identification of pseudothrombocytopenia using various thresholds for definition of platelet aggregation.
The diagnostic accuracy of Sysmex XN for identification of pseudothrombocytopenia using various thresholds for definition of platelet aggregation.
Summary:
The diagnostic accuracy of the flag PLT Clumps from PLT-F channel for identification of pseudothrombocytopenia was very high (AUC = 0.97) and superior to the WNR/WDF channel (AUC = 0.57) in samples with platelet count <150 x 10^9/L and a moderate to high number of aggregates in the smear.
The diagnostic accuracy of the flag PLT Clumps from PLT-F channel for identification of pseudothrombocytopenia was very high (AUC = 0.97) and superior to the WNR/WDF channel (AUC = 0.57) in samples with platelet count <150 x 10^9/L and a moderate to high number of aggregates in the smear.
Shaikh MS et al.
(2021) Int J Lab Hematol; 43(3): e141:
Ensuing adequate mixing of blood samples before analysis—A proposed method for verification of satisfactory sample mixing by automated red blood cell count analyzers.
Ensuing adequate mixing of blood samples before analysis—A proposed method for verification of satisfactory sample mixing by automated red blood cell count analyzers.
Summary:
The authors report an excellent correlation (r value of 0.99) between manual and automated blood sample mixing with a minimal bias (0.009), proving an exceptional pre-analysis mixing of samples on the XN-1000 analyser.
The authors report an excellent correlation (r value of 0.99) between manual and automated blood sample mixing with a minimal bias (0.009), proving an exceptional pre-analysis mixing of samples on the XN-1000 analyser.
Ortiz A et al.
(2020) Sysmex J Int; 30(1): 9:
Performance Comparison of Sysmex Hematology Analyzers XN-550 and XN-10.
Performance Comparison of Sysmex Hematology Analyzers XN-550 and XN-10.
Summary:
The study concluded the XN-550 as highly reliable with functionality comparable to the XN-10. The device has shown high correlation coefficients and excellent comparative performance in all CBC, DIFF and RET parameters (except BASO%). The overall flagging comparison was excellent among the XN-10, the XN-550 and the manual differential.
The study concluded the XN-550 as highly reliable with functionality comparable to the XN-10. The device has shown high correlation coefficients and excellent comparative performance in all CBC, DIFF and RET parameters (except BASO%). The overall flagging comparison was excellent among the XN-10, the XN-550 and the manual differential.
Cao J et al.
(2017) Lab Med; 48(2): 188:
Establishing a Stand-Alone Laboratory Dedicated to the Care of Patients With Ebola Virus Disease.
Establishing a Stand-Alone Laboratory Dedicated to the Care of Patients With Ebola Virus Disease.
Summary:
The pocH-100i was used in a laboratory dedicated to detection of Ebola virus disease. Its accuracy was verified by comparison with the XE-2100 in the main laboratory, and precision and reportable range were also consistent with specifications by the manufacturer.
The pocH-100i was used in a laboratory dedicated to detection of Ebola virus disease. Its accuracy was verified by comparison with the XE-2100 in the main laboratory, and precision and reportable range were also consistent with specifications by the manufacturer.
Cornet E et al.
(2016) Scand J Clin Lab Invest; 76(6): 465:
Evaluation and optimization of the extended information process unit (E-IPU) validation module integrating the sysmex flag systems and the recommendations of the French-speaking cellular hematology group (GFHC).
Evaluation and optimization of the extended information process unit (E-IPU) validation module integrating the sysmex flag systems and the recommendations of the French-speaking cellular hematology group (GFHC).
Summary:
Using the biomedical validation criteria, 21.3% of samples triggered a smear review, in this study cohort. Modification of four criteria by the authors reduced the number of smears from 21.3% to 15.0% without loss of clinical value.
Using the biomedical validation criteria, 21.3% of samples triggered a smear review, in this study cohort. Modification of four criteria by the authors reduced the number of smears from 21.3% to 15.0% without loss of clinical value.
Van Dievoet MA et al.
(2016) Int J Lab Hematol; 38(5): 490:
Performance evaluation of the Sysmex® XP-300 in an oncology setting: evaluation and comparison of hematological parameters with the Sysmex® XN-3000.
Performance evaluation of the Sysmex® XP-300 in an oncology setting: evaluation and comparison of hematological parameters with the Sysmex® XN-3000.
Summary:
The XP-300 showed very good precision and linearity results in this study, comparable with the XN-3000 analyser.
The XP-300 showed very good precision and linearity results in this study, comparable with the XN-3000 analyser.
Arneth B et al.
(2015) J Clin Lab Anal; 29(3): 175:
Technology and New Fluorescence Flow Cytometry Parameters in Hematological Analyzers.
Technology and New Fluorescence Flow Cytometry Parameters in Hematological Analyzers.
Summary:
This paper gives an overview of the technology behind the XE-Series and the benefits of flow cytometry and automatic cell counting. In this study the XE-5000 delivers faster accurate results than older analysers.
This paper gives an overview of the technology behind the XE-Series and the benefits of flow cytometry and automatic cell counting. In this study the XE-5000 delivers faster accurate results than older analysers.
SEO JY et al.
(2015) Int J Lab Hematol; 37(2): 155:
Performance evaluation of the new hematology analyzer Sysmex XN-series.
Performance evaluation of the new hematology analyzer Sysmex XN-series.
Summary:
In this study, a good correlation was found between the XN-Series and XE-series for all parameters. The XN-Series dramatically reduced the smear rate (by 58 %). Even at counts below 500/μL the XN provided an accurate WBC count using the Low WBC mode.
In this study, a good correlation was found between the XN-Series and XE-series for all parameters. The XN-Series dramatically reduced the smear rate (by 58 %). Even at counts below 500/μL the XN provided an accurate WBC count using the Low WBC mode.
Genevieve F et al.
(2014) feuillets de Biologie; VOL LVI N° 317:
Smear microscopy revision: propositions by the GFHC.
Smear microscopy revision: propositions by the GFHC.
Summary:
The GFHC reviewed in detail the criteria used within the CBC to generate blood smears and has decided on a number of minimum recommendations, defining threshold values and various situations in which the blood smear review is desirable.
The GFHC reviewed in detail the criteria used within the CBC to generate blood smears and has decided on a number of minimum recommendations, defining threshold values and various situations in which the blood smear review is desirable.
Briggs C et al.
(2012) J Clin Pathol; 65:1024:
Performance evaluation of the Sysmex haematology XN modular system.
Performance evaluation of the Sysmex haematology XN modular system.
Summary:
The authors report about a reduced sample turnaround time and reduced number of blood film reviews on XN compared to XE-2100 without loss of sensitivity and with more precise and accurate results for both, platelets and low WBC counts.
The authors report about a reduced sample turnaround time and reduced number of blood film reviews on XN compared to XE-2100 without loss of sensitivity and with more precise and accurate results for both, platelets and low WBC counts.
Immature platelet fraction (IPF)
Ali U et al.
(2024) Scand J Clin Lab Invest; 84(2): 91:
Reproducibility and stability of the immature platelet fraction using Sysmex XN-10.
Reproducibility and stability of the immature platelet fraction using Sysmex XN-10.
Summary:
The sample reproducibility analysis (n = 45) of IPF and IPF# showed very good results with the range of mean CV% values between 1.3-8.9% and 1.7-10% respectively. When blood samples (n = 21) were stored at room temperature IPF and IPF# remained stable over a 24 h period. However, all samples exceeded stability CV% ≥ 10% before 72 h.
The sample reproducibility analysis (n = 45) of IPF and IPF# showed very good results with the range of mean CV% values between 1.3-8.9% and 1.7-10% respectively. When blood samples (n = 21) were stored at room temperature IPF and IPF# remained stable over a 24 h period. However, all samples exceeded stability CV% ≥ 10% before 72 h.
Anetsberger A et al.
(2023) Platelets; 34(1): 2185462:
Association of immature platelets with perioperative complications in neurosurgery.
Association of immature platelets with perioperative complications in neurosurgery.
Summary:
The study on 301 subjects revealed that increased levels of highly fluorescent immature platelets measured postoperatively (H-IPF ≥ 0.95%) are independently associated with an increased risk for serious complications after neurosurgical procedures (odds ratio: OR = 1.97).
The study on 301 subjects revealed that increased levels of highly fluorescent immature platelets measured postoperatively (H-IPF ≥ 0.95%) are independently associated with an increased risk for serious complications after neurosurgical procedures (odds ratio: OR = 1.97).
Bongiovanni D et al.
(2023) Arterioscler Thromb Vasc Biol; 43(2): e83:
Immature Platelet Fraction Predicts Adverse Events in Patients With Acute Coronary Syndrome: the ISAR-REACT 5 Reticulated Platelet Substudy.
Immature Platelet Fraction Predicts Adverse Events in Patients With Acute Coronary Syndrome: the ISAR-REACT 5 Reticulated Platelet Substudy.
Summary:
In acute coronary syndrome treated patients the incidence of the primary end point consisting of death, myocardial infarction or stroke was significantly higher in the IPF-high (IPF>3.6%) group compared to the IPF-low (IPF≤3.6%) group: 13.0% versus 7.2% regardless of the antiplatelet treatment used (prasugrel or ticagrelor).
In acute coronary syndrome treated patients the incidence of the primary end point consisting of death, myocardial infarction or stroke was significantly higher in the IPF-high (IPF>3.6%) group compared to the IPF-low (IPF≤3.6%) group: 13.0% versus 7.2% regardless of the antiplatelet treatment used (prasugrel or ticagrelor).
Kouno H et al.
(2023) Int J Lab Hematol; 45(5): 700:
Measurement of immature platelet fraction is useful in the differential diagnosis of MYH9 disorders.
Measurement of immature platelet fraction is useful in the differential diagnosis of MYH9 disorders.
Summary:
The study found that a median IPF of 48.7% in MYH9 disorders was significantly higher than in all other groups (ITP: 13.4%, MDS: 9.4%, control group: 2.6%). The authors concluded that IPF could be a useful supportive parameter in the differential diagnosis between MYH9 disorders and other types of thrombocytopenia.
The study found that a median IPF of 48.7% in MYH9 disorders was significantly higher than in all other groups (ITP: 13.4%, MDS: 9.4%, control group: 2.6%). The authors concluded that IPF could be a useful supportive parameter in the differential diagnosis between MYH9 disorders and other types of thrombocytopenia.
Bongiovanni D et al.
(2022) Arterioscler Thromb Vasc Biol; 42(5): 527:
Role of Reticulated Platelets in Cardiovascular Disease.
Role of Reticulated Platelets in Cardiovascular Disease.
Summary:
The authors present a structured overview of preclinical and clinical findings concerning the role of reticulated platelets in cardiovascular disease. They conclude that reticulated platelets with their prothrombic features are a new biomarker that helps to identify patients at high risk for adverse ischemic events.
The authors present a structured overview of preclinical and clinical findings concerning the role of reticulated platelets in cardiovascular disease. They conclude that reticulated platelets with their prothrombic features are a new biomarker that helps to identify patients at high risk for adverse ischemic events.
Jones N et al.
(2021) Platelets; 7: 32(7): 941:
Immature platelet indices alongside procalcitonin for sensitive and specific identification of bacteremia in the intensive care unit.
Immature platelet indices alongside procalcitonin for sensitive and specific identification of bacteremia in the intensive care unit.
Summary:
The study results demonstrate the predictive power of IPF and IPF# for identification of bacteremia in ICU patients as individual parameters and even more by calculating the change in these parameters between day 1 and 2 of ICU stay (ΔIPF, ΔIPF#). The use of a combination of ΔIPF (cut-off > 1.95%) and day 2 PCT (cut-off > 0.57 ng/ml) has a PPV of 100% and a NPV of 96.1% and thereby accurately ruling out patients from a diagnosis of bacteremia.
The study results demonstrate the predictive power of IPF and IPF# for identification of bacteremia in ICU patients as individual parameters and even more by calculating the change in these parameters between day 1 and 2 of ICU stay (ΔIPF, ΔIPF#). The use of a combination of ΔIPF (cut-off > 1.95%) and day 2 PCT (cut-off > 0.57 ng/ml) has a PPV of 100% and a NPV of 96.1% and thereby accurately ruling out patients from a diagnosis of bacteremia.
Looi K et al.
(2021) Int J Inf Dis; 110: 187:
Evaluation of immature platelet fraction as a marker of dengue fever progression.
Evaluation of immature platelet fraction as a marker of dengue fever progression.
Summary:
This study evaluated the trend of immature platelet fraction (IPF) as an early recovery indicator of platelets in dengue patients. Patients with severe dengue had higher IPF and stronger thrombocytopenia compared to non-severe dengue. The increase in IPF preceded platelet recovery by at least 3 days.
This study evaluated the trend of immature platelet fraction (IPF) as an early recovery indicator of platelets in dengue patients. Patients with severe dengue had higher IPF and stronger thrombocytopenia compared to non-severe dengue. The increase in IPF preceded platelet recovery by at least 3 days.
Benlachgar N et al.
(2020) Thromb Res; 195: 43:
Immature platelets: a review of the available evidence.
Immature platelets: a review of the available evidence.
Summary:
The authors summarized literature evidence about IPF%, # focussing on reference values, stability, correlation of IPF and MPV, and contribution of IPF to haematological and non-haematological disorders such as ITP, TTP, disseminated intravascular disorder, aplastic anaemia, MDS and cardiovascular disease, and on IPF in chemotherapy and stem cell transplantation.
The authors summarized literature evidence about IPF%, # focussing on reference values, stability, correlation of IPF and MPV, and contribution of IPF to haematological and non-haematological disorders such as ITP, TTP, disseminated intravascular disorder, aplastic anaemia, MDS and cardiovascular disease, and on IPF in chemotherapy and stem cell transplantation.
Buttarello M et al.
(2020) Int J Lab Hematol; 42(4): 363 (IPF):
Reticulated platelets and immature platelet fraction: Clinical applications and method limitations
Reticulated platelets and immature platelet fraction: Clinical applications and method limitations
Summary:
Thorough review about reticulated platelets and immature platelet fraction including overview of preanalytical and analytical limitations of methods and clinical applications.
Thorough review about reticulated platelets and immature platelet fraction including overview of preanalytical and analytical limitations of methods and clinical applications.
El-Gamal RA et al.
(2020) Indian J Hematol Blood Transfus; 36(2): 316:
Combined Immature Platelet Fraction and Schistocyte Count to Differentiate Pregnancy-Associated Thrombotic Thrombocytopenic Purpura from Severe Preeclampsia/Haemolysis, Elevated Liver Enzymes, and Low Platelet Syndrome (SPE/HELLP).
Combined Immature Platelet Fraction and Schistocyte Count to Differentiate Pregnancy-Associated Thrombotic Thrombocytopenic Purpura from Severe Preeclampsia/Haemolysis, Elevated Liver Enzymes, and Low Platelet Syndrome (SPE/HELLP).
Summary:
This study concluded that IPF and manual schistocyte counts can assist in differentiating pregnancy-associated severe pre-eclampsia/haemolysis, elevated liver enzymes and low platelet syndrome (SPE/HELLP) from thrombotic thrombocytopenic purpura (TTP). The model based on combination of parameters had a good predictive value to discriminate TTP from SPE/HELLP - sensitivity of 92.3%, specificity of 62.5% and AUC 0.827.
This study concluded that IPF and manual schistocyte counts can assist in differentiating pregnancy-associated severe pre-eclampsia/haemolysis, elevated liver enzymes and low platelet syndrome (SPE/HELLP) from thrombotic thrombocytopenic purpura (TTP). The model based on combination of parameters had a good predictive value to discriminate TTP from SPE/HELLP - sensitivity of 92.3%, specificity of 62.5% and AUC 0.827.
Jeon K et al.
(2020) Medicine (Baltimore); 99(7): e19096:
Immature platelet fraction: A useful marker for identifying the cause of thrombocytopenia and predicting platelet recovery.
Immature platelet fraction: A useful marker for identifying the cause of thrombocytopenia and predicting platelet recovery.
Summary:
The authors demonstrated that the IPF is an excellent marker for distinguishing hyperdestructive/consumptive from hypoproductive thrombocytopenia. Moreover, IPF is presented as a robust and reliable predictor of platelet recovery in patients with immune thrombocytopenia (ITP) and with malignancies undergoing chemotherapy.
The authors demonstrated that the IPF is an excellent marker for distinguishing hyperdestructive/consumptive from hypoproductive thrombocytopenia. Moreover, IPF is presented as a robust and reliable predictor of platelet recovery in patients with immune thrombocytopenia (ITP) and with malignancies undergoing chemotherapy.
Jeon MJ et al.
(2020) Korean J Intern Med; 35(4): 970:
Immature platelet fraction based diagnostic predictive scoring model for immune thrombocytopenia.
Immature platelet fraction based diagnostic predictive scoring model for immune thrombocytopenia.
Summary:
The authors concluded that immature platelet fraction (IPF) could be a useful parameter to distinguish immune thrombocytopenia (ITP) from other causes of thrombocytopenia. They developed the predictive scoring model that could predict ITP with high probability.
The authors concluded that immature platelet fraction (IPF) could be a useful parameter to distinguish immune thrombocytopenia (ITP) from other causes of thrombocytopenia. They developed the predictive scoring model that could predict ITP with high probability.
Zhao Y et al.
(2020) Front Cardiovasc Med; 7: 578041:
The Prognostic Value of Reticulated Platelets in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis.
The Prognostic Value of Reticulated Platelets in Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis.
Summary:
This comprehensive meta-analysis presents immature platelets as a potentially useful prognostic biomarker for adverse cardiovascular events in patients with coronary artery disease, even after adjustment for other prognostic factors.
This comprehensive meta-analysis presents immature platelets as a potentially useful prognostic biomarker for adverse cardiovascular events in patients with coronary artery disease, even after adjustment for other prognostic factors.
Ali I et al.
(2019) Exp Haematol; 78: 56:
Immature platelet fraction as a useful marker in the etiological determination of thrombocytopenia.
Immature platelet fraction as a useful marker in the etiological determination of thrombocytopenia.
Summary:
In this study, the IPF was assessed to determine the aetiology of thrombocytopenia, in a relatively large cohort (n=637). The IPF was significantly higher in cases of increased platelet consumption or pseudothrombocytopenia compared with the control, and was able to discriminate idiopathic thrombocytopenic purpura (ITP) (p<0.05) from other causes of increased platelet consumptive disorders (infection, haemorrhage).
In this study, the IPF was assessed to determine the aetiology of thrombocytopenia, in a relatively large cohort (n=637). The IPF was significantly higher in cases of increased platelet consumption or pseudothrombocytopenia compared with the control, and was able to discriminate idiopathic thrombocytopenic purpura (ITP) (p<0.05) from other causes of increased platelet consumptive disorders (infection, haemorrhage).
Bernstein U et al.
(2019) Arch Gynecol Obstet; 299(6): 1537:
The immature platelet fraction in hypertensive disease during pregnancy
The immature platelet fraction in hypertensive disease during pregnancy
Summary:
This study shows that IPF% can be used to identify hypertensive diseases in pregnancy. Moreover, the absolute number of IPF and platelets could help to differentiate preeclampsia and HELLP syndrome.
This study shows that IPF% can be used to identify hypertensive diseases in pregnancy. Moreover, the absolute number of IPF and platelets could help to differentiate preeclampsia and HELLP syndrome.
Johnson S et al.
(2019) Int J Lab Hematol; 41(2): 271:
A CBC algorithm combined with immature platelet fraction is able to identify JAK2 V617F mutation-positive polycythaemia vera patients.
A CBC algorithm combined with immature platelet fraction is able to identify JAK2 V617F mutation-positive polycythaemia vera patients.
Summary:
The study proposes an algorithm based on CBC and IPF# parameters that allows to identify a cohort of high-likelihood polycythaemia vera (PV) patients and refer them for haematological review. IPF# > 20 ×109/L in combination with positive CBC criteria can identify JAK2 V617F mutation-positive PV patients.
The study proposes an algorithm based on CBC and IPF# parameters that allows to identify a cohort of high-likelihood polycythaemia vera (PV) patients and refer them for haematological review. IPF# > 20 ×109/L in combination with positive CBC criteria can identify JAK2 V617F mutation-positive PV patients.
Perl L et al.
(2019) Platelets; 17:1:
Prognostic significance of reticulated platelet levels in diabetic patients with stable coronary artery disease.
Prognostic significance of reticulated platelet levels in diabetic patients with stable coronary artery disease.
Summary:
In stable coronary artery disease patients with diabetes the increased level of immature platelets (IPF) show an association with a higher risk of major adverse cardiovascular events and inversely correlated with the risk of bleeding.
In stable coronary artery disease patients with diabetes the increased level of immature platelets (IPF) show an association with a higher risk of major adverse cardiovascular events and inversely correlated with the risk of bleeding.
Thorup C et al.
(2019) Semin Thromb Hemost; 46(3): 320:
Immature Platelets As a Predictor of Disease Severity and Mortality in Sepsis and Septic Shock - A Systematic Review.
Immature Platelets As a Predictor of Disease Severity and Mortality in Sepsis and Septic Shock - A Systematic Review.
Summary:
Based on nine studies the review highlighted that an increased number of immature platelets is associated with increase disease severity and mortality in patients with sepsis and septic shock.
Based on nine studies the review highlighted that an increased number of immature platelets is associated with increase disease severity and mortality in patients with sepsis and septic shock.
van De Wyngaert Z et al.
(2019) Curr Res Transl Med; 68(1):37:
Immature platelet fraction (IPF): A reliable tool to predict peripheral thrombocytopenia.
Immature platelet fraction (IPF): A reliable tool to predict peripheral thrombocytopenia.
Summary:
This retrospective study found that IPF higher than 13 % is predictive of peripheral thrombocytopenia. In isolated thrombocytopenia bone marrow aspiration could have been avoided in 66 % of patients in this study cohort.
This retrospective study found that IPF higher than 13 % is predictive of peripheral thrombocytopenia. In isolated thrombocytopenia bone marrow aspiration could have been avoided in 66 % of patients in this study cohort.
Buoro S et al.
(2018) J Clin Pathol.; 71(4): 330:
Innovative haematological parameters for early diagnosis of sepsis in adult patients admitted in intensive care unit.
Innovative haematological parameters for early diagnosis of sepsis in adult patients admitted in intensive care unit.
Summary:
The authors concluded that a combination of an increased IPF# value and a decreased RET% value 24 hours before the onset of sepsis in ICU patients can be considered an early, rapid, cost-effective and widely available measure for sepsis prediction.
The authors concluded that a combination of an increased IPF# value and a decreased RET% value 24 hours before the onset of sepsis in ICU patients can be considered an early, rapid, cost-effective and widely available measure for sepsis prediction.
Hannawi B et al.
(2018) Thromb Haemost; 118(9): 1517:
Reticulated Platelets - Changing Focus from Basics to Outcomes.
Reticulated Platelets - Changing Focus from Basics to Outcomes.
Summary:
The authors discussed the role of reticulated platelets in coronary artery disease and in hypo responsiveness to the commonly used anti-platelet drugs. They concluded that reticulated platelets may be a useful marker for predicting worse cardiovascular outcome.
The authors discussed the role of reticulated platelets in coronary artery disease and in hypo responsiveness to the commonly used anti-platelet drugs. They concluded that reticulated platelets may be a useful marker for predicting worse cardiovascular outcome.
Sakuragi M et al.
(2018) Int J Hematol; 107(3): 320:
Immature platelet fraction (IPF) as a predictive value for thrombopoietic recovery after allogeneic stem cell transplantation.
Immature platelet fraction (IPF) as a predictive value for thrombopoietic recovery after allogeneic stem cell transplantation.
Summary:
In this study IPF was able to predict platelet recovery in patients after allogeneic haematopoietic stem cell transplantation in 5 out of 11 patients, while IPF# predicted recovery in 7 out of 11 patients, at cut-offs of 5.8 % and 200/μL, respectively.
In this study IPF was able to predict platelet recovery in patients after allogeneic haematopoietic stem cell transplantation in 5 out of 11 patients, while IPF# predicted recovery in 7 out of 11 patients, at cut-offs of 5.8 % and 200/μL, respectively.
Anetsberger A et al.
(2017) Thromb Haemost; 117(10): 1887:
Immature platelets as a novel biomarker for adverse cardiovascular events in patients after non-cardiac surgery.
Immature platelets as a novel biomarker for adverse cardiovascular events in patients after non-cardiac surgery.
Summary:
In this study, IPF presented as an independent predictor of serious adverse cardiovascular events, deep vein thrombosis or pulmonary embolism (modMACE) after non-cardiac surgery using the optimal cut-off value of > 5.4 % and improves risk stratification of surgical patients.
In this study, IPF presented as an independent predictor of serious adverse cardiovascular events, deep vein thrombosis or pulmonary embolism (modMACE) after non-cardiac surgery using the optimal cut-off value of > 5.4 % and improves risk stratification of surgical patients.
Buoro S et al.
(2017) Scand J Clin Lab Invest; 77(1): 73:
Abnormal leukocyte scattergrams and immature platelet fraction on Sysmex XN-9000 analyzer: a new diagnostic tool for altered megakaryopoiesis?
Abnormal leukocyte scattergrams and immature platelet fraction on Sysmex XN-9000 analyzer: a new diagnostic tool for altered megakaryopoiesis?
Summary:
This case report shows how a high IPF, combined with abnormal WNR, WDF and WPC scattergrams could be used as a marker of dysmegakaryopoiesis, and led to the diagnosis of MDS type 2-refractory anaemia with excess blasts (REAB-2) in a nine year-old girl.
This case report shows how a high IPF, combined with abnormal WNR, WDF and WPC scattergrams could be used as a marker of dysmegakaryopoiesis, and led to the diagnosis of MDS type 2-refractory anaemia with excess blasts (REAB-2) in a nine year-old girl.
Ferreira FLB et al.
(2017) Sci Rep; 7(1): 3355:
Evaluation of the immature platelet fraction contribute to the differential diagnosis of hereditary, immune and other acquired thrombocytopenias.
Evaluation of the immature platelet fraction contribute to the differential diagnosis of hereditary, immune and other acquired thrombocytopenias.
Summary:
The authors evaluated the use of IPF in the differential diagnosis between ITP and hereditary macrothrombocytopenia (HM). The IPF values were higher in HM than in ITP as already demonstrated by other studies.
The authors evaluated the use of IPF in the differential diagnosis between ITP and hereditary macrothrombocytopenia (HM). The IPF values were higher in HM than in ITP as already demonstrated by other studies.
Freynhofer MK et al.
(2017) Thromb Haemost; 117(5): 923:
Platelet turnover predicts outcome after coronary intervention.
Platelet turnover predicts outcome after coronary intervention.
Summary:
In this study an elevated platelet turnover independently predicted major adverse cardiovascular events after percutaneous coronary intervention. The optimal cut-off value was at IPF = 3.35 %.
In this study an elevated platelet turnover independently predicted major adverse cardiovascular events after percutaneous coronary intervention. The optimal cut-off value was at IPF = 3.35 %.
Pedersen OH et al.
(2017) Am J Case Rep; 18: 945:
Recurrent Cardiovascular Events Despite Antiplatelet Therapy in a Patient with Polycythemia Vera and Accelerated Platelet Turnover.
Recurrent Cardiovascular Events Despite Antiplatelet Therapy in a Patient with Polycythemia Vera and Accelerated Platelet Turnover.
Summary:
The case report illustrates that insufficient platelet inhibition with clopidogrel monotherapy in a patient with thrombocytosis may be associated with recurrent arterial thrombosis. A plausible explanation may be an accelerated platelet turnover reflected by an increased number of immature platelets.
The case report illustrates that insufficient platelet inhibition with clopidogrel monotherapy in a patient with thrombocytosis may be associated with recurrent arterial thrombosis. A plausible explanation may be an accelerated platelet turnover reflected by an increased number of immature platelets.
Cremer M et al.
(2016) Seminars in Fetal & Neonatal Medicine; 21(1): 10:
Thrombocytopenia and platelet transfusion in the neonate.
Thrombocytopenia and platelet transfusion in the neonate.
Summary:
The review summarises the pathophysiology and current management (including platelet transfusion thresholds) of neonatal thrombocytopenia. A novel index score for bleeding risk in thrombocytopenic neonates was proposed (including IPF#).
The review summarises the pathophysiology and current management (including platelet transfusion thresholds) of neonatal thrombocytopenia. A novel index score for bleeding risk in thrombocytopenic neonates was proposed (including IPF#).
Jaing TH et al.
(2016) Cell Transplant; 25: 1259:
Assessment of platelet activation and immature platelet fraction as predictors of platelet engraftment after hematopoietic stem cell transplantation.
Assessment of platelet activation and immature platelet fraction as predictors of platelet engraftment after hematopoietic stem cell transplantation.
Summary:
In this study IPF (XE-2100) was used to assess thrombopoietic recovery after stem cell transplantation. Patients in the cord blood group had a higher IPF than the peripheral blood group on day 56 and day 97 post-transplantation.
In this study IPF (XE-2100) was used to assess thrombopoietic recovery after stem cell transplantation. Patients in the cord blood group had a higher IPF than the peripheral blood group on day 56 and day 97 post-transplantation.
Moraes D et al.
(2016) Platelets; 27(4): 333:
Immature platelet fraction in hypertensive pregnancy.
Immature platelet fraction in hypertensive pregnancy.
Summary:
In this study IPF% measured on the XE-5000 exhibited higher values in pregnant women suffering hypertensive disorders than the control group.
In this study IPF% measured on the XE-5000 exhibited higher values in pregnant women suffering hypertensive disorders than the control group.
Adly AA et al.
(2015) Platelets; 26(7): 645:
Evaluation of the immature platelet fraction in the diagnosis and prognosis of childhood immune thrombocytopenia.
Evaluation of the immature platelet fraction in the diagnosis and prognosis of childhood immune thrombocytopenia.
Summary:
IPF% obtained from the XE-2100 was increased in immune thrombo-cytopenia patients but not in patients with haematological malignancies in this study. The authors therefore suggest using IPF% to evaluate the thrombopoietic state of the bone marrow.
IPF% obtained from the XE-2100 was increased in immune thrombo-cytopenia patients but not in patients with haematological malignancies in this study. The authors therefore suggest using IPF% to evaluate the thrombopoietic state of the bone marrow.
Greene LA et al.
(2015) Br J Haematol; 166(4): 592:
Beyond the platelet count: immature platelet fraction and thromboelastometry correlate with bleeding in patients with immune thrombocytopenia.
Beyond the platelet count: immature platelet fraction and thromboelastometry correlate with bleeding in patients with immune thrombocytopenia.
Summary:
In this study IPF# demonstrated stronger correlation with acute bleeding score than platelet counts. The strongest correlation was seen for paediatric patients with platelet counts <30 x109/L. High IPF# was associated with low bleeding score.
In this study IPF# demonstrated stronger correlation with acute bleeding score than platelet counts. The strongest correlation was seen for paediatric patients with platelet counts <30 x109/L. High IPF# was associated with low bleeding score.
Hong H et al.
(2015) Transfusion; 55(4): 756:
Absolute immature platelet count dynamics in diagnosing and monitoring the clinical course of thrombotic thrombocytopenic purpura.
Absolute immature platelet count dynamics in diagnosing and monitoring the clinical course of thrombotic thrombocytopenic purpura.
Summary:
In this study absolute IPF count (from XE-5000) was shown to be useful to diagnose and to monitor the clinical course of therapeutic plasma exchange in TTP patients. Routine analysis of absolute IPF count was recommended for diagnosis and to better assess the need for adjustment of treatment.
In this study absolute IPF count (from XE-5000) was shown to be useful to diagnose and to monitor the clinical course of therapeutic plasma exchange in TTP patients. Routine analysis of absolute IPF count was recommended for diagnosis and to better assess the need for adjustment of treatment.
Mao W et al.
(2015) Clin Res Hepatol Gastroenterol; 39(4): 469:
Immature platelet fraction values predict recovery of platelet counts following liver transplantation.
Immature platelet fraction values predict recovery of platelet counts following liver transplantation.
Summary:
In this study, the IPF percentage was shown to predict recovery of PLT numbers after liver transplantation. PLT counts reached the pre-transplant levels at 3-4 days after the IPF% peak value.
In this study, the IPF percentage was shown to predict recovery of PLT numbers after liver transplantation. PLT counts reached the pre-transplant levels at 3-4 days after the IPF% peak value.
Miyazaki K et al.
(2015) Hematology; 20(10): 587:
Immature platelet fraction measurement is influenced by platelet size and is a useful parameter for discrimination of macrothrombocytopenia.
Immature platelet fraction measurement is influenced by platelet size and is a useful parameter for discrimination of macrothrombocytopenia.
Summary:
The IPF% values were about five times higher in May-Hegglin disorders (IPF 48.6 ± 1.9 %) and about twice as high in other macrothrombocytopenias (IPF 18.4 ± 2.1 %) than in ITP patients with similar platelet counts (IPF 9.2 ± 0.3 %).
The IPF% values were about five times higher in May-Hegglin disorders (IPF 48.6 ± 1.9 %) and about twice as high in other macrothrombocytopenias (IPF 18.4 ± 2.1 %) than in ITP patients with similar platelet counts (IPF 9.2 ± 0.3 %).
Morkis IVC et al.
(2015) Int J Lab Hematol; 37(2): 259:
Assessment of immature platelet fraction and immature reticulocyte fraction as predictors of engraftment after hematopoietic stem cell transplantation.
Assessment of immature platelet fraction and immature reticulocyte fraction as predictors of engraftment after hematopoietic stem cell transplantation.
Summary:
In this cohort of 44 patients both IRF% and IPF% showed the potential to predict neutrophil and platelet recovery, respectively.
In this cohort of 44 patients both IRF% and IPF% showed the potential to predict neutrophil and platelet recovery, respectively.
Sakuragi M et al.
(2015) Int J Hematol; 101(4): 369:
Clinical significance of IPF% or RP% measurement in distinguishing primary immune thrombocytopenia from aplastic thrombocytopenic disorders.
Clinical significance of IPF% or RP% measurement in distinguishing primary immune thrombocytopenia from aplastic thrombocytopenic disorders.
Summary:
IPF% (XN-1000) and RP% (flow cytometry) exhibited comparable diagnostic accuracy in differentiating control patients, immune thrombocytopenia, and aplastic thrombocytopenia in this study.
IPF% (XN-1000) and RP% (flow cytometry) exhibited comparable diagnostic accuracy in differentiating control patients, immune thrombocytopenia, and aplastic thrombocytopenia in this study.
Dadu T et al.
(2014) Int J Lab Hematol; 36(5): 499:
Evaluation of the IPF as an indicator of PLT recovery in dengue patients.
Evaluation of the IPF as an indicator of PLT recovery in dengue patients.
Summary:
This study presents IPF as a useful parameter to monitor the thrombocytopenia in patients with dengue fever. Furthermore, it can predict the recovery of PLT and so avoid unnecessary blood transfusions.
This study presents IPF as a useful parameter to monitor the thrombocytopenia in patients with dengue fever. Furthermore, it can predict the recovery of PLT and so avoid unnecessary blood transfusions.
Everett TR et al.
(2014) Thromb Haemost; 111(6): 1177:
Immature platelet fraction analysis demonstrates a difference in thrombopoiesis between normotensive and preeclamptic pregnancies.
Immature platelet fraction analysis demonstrates a difference in thrombopoiesis between normotensive and preeclamptic pregnancies.
Summary:
The study illustrates the potential utility of IPF as a parameter to distinguish between normotensive and preeclamptic pregnant women. The authors suggest that IPF is a far better parameter than MPV, which has previously been suggested for this purpose, and can distinguish between the two groups even at normal platelet counts.
The study illustrates the potential utility of IPF as a parameter to distinguish between normotensive and preeclamptic pregnant women. The authors suggest that IPF is a far better parameter than MPV, which has previously been suggested for this purpose, and can distinguish between the two groups even at normal platelet counts.
Ibrahim H et al.
(2014) J Am Coll Cardiol; 64: 2122:
Association of Immature Platelets With Adverse Cardiovascular Outcomes.
Association of Immature Platelets With Adverse Cardiovascular Outcomes.
Summary:
According to this study IPF# (XE-2100) allows for stratification of patients with coronary artery disease in terms of risk for future adverse events. Patients with an IPF# level ≥ 7,632 /μL were more likely to experience an adverse event (hazard odds ratio: 4.65; p < 0.002).
According to this study IPF# (XE-2100) allows for stratification of patients with coronary artery disease in terms of risk for future adverse events. Patients with an IPF# level ≥ 7,632 /μL were more likely to experience an adverse event (hazard odds ratio: 4.65; p < 0.002).
Van der Linden N et al.
(2014) Eur J Haematol; 93(2): 150:
Immature platelet fraction (IPF) measured on the Sysmex XN haemocytometer predicts thrombopoietic recovery after autologous stem cell transplantation.
Immature platelet fraction (IPF) measured on the Sysmex XN haemocytometer predicts thrombopoietic recovery after autologous stem cell transplantation.
Summary:
Quote: 'IPF is a promising predictor of platelet recovery in patients after autologous SCT.' 'The proposed cut-off value of 5.3% can theoretically be used to decide whether or not to give a platelet transfusion.'
Quote: 'IPF is a promising predictor of platelet recovery in patients after autologous SCT.' 'The proposed cut-off value of 5.3% can theoretically be used to decide whether or not to give a platelet transfusion.'
Bat T et al.
(2013) Transfusion; 53(6): 1201:
Measurement of the absolute immature platelet number reflects marrow production and is not impacted by platelet transfusion.
Measurement of the absolute immature platelet number reflects marrow production and is not impacted by platelet transfusion.
Summary:
In this study, the IPF count was presented as a suitable parameter for assessing bone marrow activity in transfusion-dependent thrombocytopenic patients.
In this study, the IPF count was presented as a suitable parameter for assessing bone marrow activity in transfusion-dependent thrombocytopenic patients.
Cesari F et al.
(2013) Thrombosis and Haemostasis; 109: 846:
Reticulated platelets predict cardiovascular death in acute coronary syndrome patients. Insights from the AMI-Florence 2 Study.
Reticulated platelets predict cardiovascular death in acute coronary syndrome patients. Insights from the AMI-Florence 2 Study.
Summary:
In this study, reticulated (immature) platelets predicted cardiovascular death independently and improved risk stratification for acute coronary syndrome patients.
In this study, reticulated (immature) platelets predicted cardiovascular death independently and improved risk stratification for acute coronary syndrome patients.
Cremer M et al.
(2013) J Perinatol; 33(8): 622:
Low immature platelet fraction suggests decreased megakaryopoiesis in neonates with sepsis or necrotizing enterocolitis.
Low immature platelet fraction suggests decreased megakaryopoiesis in neonates with sepsis or necrotizing enterocolitis.
Summary:
Low absolute IPF values during the course of neonatal sepsis/necrotising enterocolitis suggest suppression of megakaryopoietic activity according to the study conclusions.
Low absolute IPF values during the course of neonatal sepsis/necrotising enterocolitis suggest suppression of megakaryopoietic activity according to the study conclusions.
Funck-Jensen K et al.
(2013) Platelets; 24(7): 528:
Increased platelet aggregation and turnover in the acute phase of ST-elevation myocardial infarction.
Increased platelet aggregation and turnover in the acute phase of ST-elevation myocardial infarction.
Summary:
Increased platelet turnover, indicated by IPF and MPV, was observed in the acute phase of ST-elevated myocardial infarction in this study and may partly explain reduced efficacy of oral antiplatelet drugs.
Increased platelet turnover, indicated by IPF and MPV, was observed in the acute phase of ST-elevated myocardial infarction in this study and may partly explain reduced efficacy of oral antiplatelet drugs.
Parco S et al.
(2012) OncoTargets and Therapy; 5: 1:
Application of reticulated platelets to transfusion management during autologous stem cell transplantation.
Application of reticulated platelets to transfusion management during autologous stem cell transplantation.
Summary:
The use of IPF-rich platelet transfusions reduced the number of transfusions and bleedings after stem cell transplantation in paediatric patients in this study.
The use of IPF-rich platelet transfusions reduced the number of transfusions and bleedings after stem cell transplantation in paediatric patients in this study.
Psaila B et al.
(2012) Blood; 119: 4066:
In vivo effects of eltrombopag on platelet function in immune thrombocytopenia: no evidence of platelet activation.
In vivo effects of eltrombopag on platelet function in immune thrombocytopenia: no evidence of platelet activation.
Summary:
IPF% was higher in patients with ITP than the controls, reflecting the increased platelet production. Treatment with eltrombopag led to increased platelet counts, platelet size, and absolute IPF, but no significant change in IPF%.
IPF% was higher in patients with ITP than the controls, reflecting the increased platelet production. Treatment with eltrombopag led to increased platelet counts, platelet size, and absolute IPF, but no significant change in IPF%.
Sinclair L
(2012) Aust J Med Sci; 33(2): 48:
The immature platelet fraction: an assessment of its application to a routine clinical laboratory.
The immature platelet fraction: an assessment of its application to a routine clinical laboratory.
Summary:
The purpose of the review is to assess the suitability of the IPF%
as a routine test. Productivity rather than clinical value is discussed. Reference ranges are given.
The purpose of the review is to assess the suitability of the IPF%
as a routine test. Productivity rather than clinical value is discussed. Reference ranges are given.
Sinclair L
(2012) Aust J Med Sci; 33(1): 10:
The immature platelet fraction: where is it now?
The immature platelet fraction: where is it now?
Summary:
A clear and concise review of 53 original publications concerning the clinical value of IPF. The diagnostic and prognostic potential of IPF in various conditions, and also advantages and limitations of IPF are described.
A clear and concise review of 53 original publications concerning the clinical value of IPF. The diagnostic and prognostic potential of IPF in various conditions, and also advantages and limitations of IPF are described.
Zucker ML et al.
(2012) Int J Lab Hematol; 34: 525:
Mechanism of thrombocytopenia in chronic hepatitis C as evaluated by the immature platelet fraction.
Mechanism of thrombocytopenia in chronic hepatitis C as evaluated by the immature platelet fraction.
Summary:
IPF% supported the differentiation between platelet destruction and bone marrow failure in hepatitis C patients in this study.
IPF% supported the differentiation between platelet destruction and bone marrow failure in hepatitis C patients in this study.
Barsam SJ et al.
(2011) Blood 117; 5723:
Platelet production and platelet destruction: assessing mechanisms of treatment effect in immune thrombocytopenia.
Platelet production and platelet destruction: assessing mechanisms of treatment effect in immune thrombocytopenia.
Summary:
In this study, absolute immature platelet count (IPF#) was shown to reflect the effect of different treatments of immune thrombocytopenia and was in such cases considered more useful than IPF%.
In this study, absolute immature platelet count (IPF#) was shown to reflect the effect of different treatments of immune thrombocytopenia and was in such cases considered more useful than IPF%.
Goncalo A et al.
(2011) Transplant Proc; 43: 241:
Predictive value of immature reticulocyte and platelet fractions in hematopoietic recovery of allograft patients.
Predictive value of immature reticulocyte and platelet fractions in hematopoietic recovery of allograft patients.
Summary:
In this study, immature platelet (IPF) and immature reticulocyte fraction (IRF) were presented as early and readily available assessment methods for post-transplant bone marrow recovery.
In this study, immature platelet (IPF) and immature reticulocyte fraction (IRF) were presented as early and readily available assessment methods for post-transplant bone marrow recovery.
Cesari F et al.
(2010) Thrombosis and Haemostasis; 104: 804:
High platelet turnover and reactivity in renal transplant recipients patients.
High platelet turnover and reactivity in renal transplant recipients patients.
Summary:
Renal transplant recipients showed significantly higher values of reticulated platelets (IPF) than healthy control subjects, especially in those not on aspirin treatment. An elevated IPF% value was shown to be an additional indication of a mechanism involved in the increased cardiovascular risk profile of those patients in this study.
Renal transplant recipients showed significantly higher values of reticulated platelets (IPF) than healthy control subjects, especially in those not on aspirin treatment. An elevated IPF% value was shown to be an additional indication of a mechanism involved in the increased cardiovascular risk profile of those patients in this study.
Strauss G et al.
(2010) Pediatr Blood Cancer; 57(4): 641:
Immature Platelet Count: A Simple Parameter for Distinguishing Thrombocytopenia in pediatric acute lymphocytic leukemia from immune thrombocytopenia.
Immature Platelet Count: A Simple Parameter for Distinguishing Thrombocytopenia in pediatric acute lymphocytic leukemia from immune thrombocytopenia.
Summary:
Quote: 'Both IPF% and IPF# parameters should become a standard for evaluating the respective pathophysiology’s underlying both congenital and acquired thrombocytopenias.'
Quote: 'Both IPF% and IPF# parameters should become a standard for evaluating the respective pathophysiology’s underlying both congenital and acquired thrombocytopenias.'
Yamaoka G et al.
(2010) Int J Lab Hematol; 32: e208:
The immature platelet fraction is a useful marker for predicting the timing of platelet recovery in patients with cancer after chemotherapy and hematopoietic stem cell transplantation.
The immature platelet fraction is a useful marker for predicting the timing of platelet recovery in patients with cancer after chemotherapy and hematopoietic stem cell transplantation.
Summary:
In this study, IPF above 10% was a useful marker for predicting the timing of platelet recovery after chemotherapy and haematopoietic stem cell transplantation and could allow optimised platelet transfusion.
In this study, IPF above 10% was a useful marker for predicting the timing of platelet recovery after chemotherapy and haematopoietic stem cell transplantation and could allow optimised platelet transfusion.
Cremer M et al.
(2009) Br J Haematol 144: 619:
Immature platelet fraction as novel laboratory parameter predicting the course of neonatal thrombocytopenia.
Immature platelet fraction as novel laboratory parameter predicting the course of neonatal thrombocytopenia.
Summary:
In this study, thrombocytopenic neonates were more likely to recover when IPF levels were high.
In this study, thrombocytopenic neonates were more likely to recover when IPF levels were high.
Hong KH et al.
(2009) Blood Coag and Fibrinolysis; 20(6): 409:
Prognostic value of immature platelet fraction and plasma thrombopoietin in disseminated intravascular coagulation
Prognostic value of immature platelet fraction and plasma thrombopoietin in disseminated intravascular coagulation
Summary:
The authors demonstrated that the IPF is an excellent marker for distinguishing hyperdestructive/consumptive from hypoproductive thrombocytopenia. Moreover, IPF was a robust and reliable predictor of platelet recovery in patients with immune thrombocytopenia (ITP) and with malignancies undergoing chemotherapy.
The authors demonstrated that the IPF is an excellent marker for distinguishing hyperdestructive/consumptive from hypoproductive thrombocytopenia. Moreover, IPF was a robust and reliable predictor of platelet recovery in patients with immune thrombocytopenia (ITP) and with malignancies undergoing chemotherapy.
Takami A et al.
(2007) Bone Marrow Transplant; 39: 501:
Immature platelet fraction for prediction of platelet engraftment after allogeneic stem cell transplantation.
Immature platelet fraction for prediction of platelet engraftment after allogeneic stem cell transplantation.
Summary:
In this study, IPF was presented as an easily available marker for the engraftment after stem cell transplantation, especially regarding thrombopoietic activity.
In this study, IPF was presented as an easily available marker for the engraftment after stem cell transplantation, especially regarding thrombopoietic activity.
Abe Y et al.
(2006) Thromb Res; 118: 463:
A simple technique to determine thrombopoiesis level using immature platelet fraction (IPF).
A simple technique to determine thrombopoiesis level using immature platelet fraction (IPF).
Summary:
The results of this study showed that the IPF reflects the pathology of thrombocytopenic disorders (i.e. consumptive versus productive). Measurement of IPF was concluded to be useful for the differential diagnosis and analysis of platelet kinetics and significantly more so than the mean platelet volume (MPV).
The results of this study showed that the IPF reflects the pathology of thrombocytopenic disorders (i.e. consumptive versus productive). Measurement of IPF was concluded to be useful for the differential diagnosis and analysis of platelet kinetics and significantly more so than the mean platelet volume (MPV).
Briggs C et al.
(2006) Transfus Med; 16: 101:
Immature platelet fraction measurement: a future guide to platelet transfusion requirement after haematopoietic stem cell transplantation.
Immature platelet fraction measurement: a future guide to platelet transfusion requirement after haematopoietic stem cell transplantation.
Summary:
Automated IPF was presented as a useful parameter in the clinical evaluation of thrombocytopenic patients and the authors saw a potential to optimise transfusion management.
Automated IPF was presented as a useful parameter in the clinical evaluation of thrombocytopenic patients and the authors saw a potential to optimise transfusion management.
Kickler T et al.
(2006) Am J Clin Pathol; 125: 282:
A Clinical Evaluation of High Fluorescent Platelet Fraction Percentage in Thrombocytopenia
A Clinical Evaluation of High Fluorescent Platelet Fraction Percentage in Thrombocytopenia
Summary:
In this study, IPF (here named HFPF for ‘high fluorescence platelet fraction’) was predictive in the evaluation of thrombocytopenia. Elevated IPF values were found in case of increased platelet production, associated with peripheral platelet destruction. In disorders associated with decreased platelet production IPF was found normal.
In this study, IPF (here named HFPF for ‘high fluorescence platelet fraction’) was predictive in the evaluation of thrombocytopenia. Elevated IPF values were found in case of increased platelet production, associated with peripheral platelet destruction. In disorders associated with decreased platelet production IPF was found normal.
Briggs C et al.
(2004) Br J Haematol; 126: 93:
Assessment of an immature platelet fraction (IPF) in peripheral thrombocytopenia.
Assessment of an immature platelet fraction (IPF) in peripheral thrombocytopenia.
Summary:
The authors recommend automated IPF% as a standard parameter in evaluating the thrombocytopenic patient.
The authors recommend automated IPF% as a standard parameter in evaluating the thrombocytopenic patient.
Optical platelets (PLT-O)
Briggs C et al.
(2004) Clin Lab Haematol; 26:157:
The most accurate platelet count on the Sysmex XE-2100. Optical or impedance?
The most accurate platelet count on the Sysmex XE-2100. Optical or impedance?
Summary:
In this study different options for counting platelets on XE-2100 were compared using chemotherapy samples. The accuracy of XE-2100 platelet counting was excellent on low-count samples when the switching algorithm was applied.
In this study different options for counting platelets on XE-2100 were compared using chemotherapy samples. The accuracy of XE-2100 platelet counting was excellent on low-count samples when the switching algorithm was applied.
Reference intervals
Laugesen K et al.
(2024) Clin Chem Lab Med; 63(4): 812:
Paediatric reference intervals for haematology parameters analysed on Sysmex XN-9000: a comparison of methods in the framework of indirect sampling.
Paediatric reference intervals for haematology parameters analysed on Sysmex XN-9000: a comparison of methods in the framework of indirect sampling.
Summary:
The study presents indirectly determined reference intervals (RI) of 13 CBC parameters for paediatric patients (0-18 years) in a Caucasian population (n=10,199) on XN-9000. Data were stratified by age and sex where statistically necessary (except for < 1 year). Comparing to a direct method (Bohn et al.) as a verification the authors found only minor differences.
The study presents indirectly determined reference intervals (RI) of 13 CBC parameters for paediatric patients (0-18 years) in a Caucasian population (n=10,199) on XN-9000. Data were stratified by age and sex where statistically necessary (except for < 1 year). Comparing to a direct method (Bohn et al.) as a verification the authors found only minor differences.
Bildirici A et al.
(2023) Turk J Biochem; 48(4): 388:
Determination of reference intervals of hemogram with advanced clinical parameters by indirect method on Sysmex XN-1000.
Determination of reference intervals of hemogram with advanced clinical parameters by indirect method on Sysmex XN-1000.
Summary:
This publication presents CBC+DIFF reference intervals of 68 316 patients aged 18–65 years as determined by the indirect method using the non-parametric percentage estimation in the Turkish Kastamonu Training and Research Hospital.
This publication presents CBC+DIFF reference intervals of 68 316 patients aged 18–65 years as determined by the indirect method using the non-parametric percentage estimation in the Turkish Kastamonu Training and Research Hospital.
Becker M et al.
(2022) Int J Lab Hematol; 44(4): 729:
Differences between capillary and venous blood counts in children - A data mining approach.
Differences between capillary and venous blood counts in children - A data mining approach.
Summary:
In this multicentric study the differences between capillary and venous bloods were investigated in paediatric samples specifying a delta for the CBC parameters dependant on measurement range of the parameter value, time difference in sampling and age of the patient.
In this multicentric study the differences between capillary and venous bloods were investigated in paediatric samples specifying a delta for the CBC parameters dependant on measurement range of the parameter value, time difference in sampling and age of the patient.
L van Pelt J et al.
(2022) Clin Chem Lab Med; 60(6): 907:
Reference intervals for Sysmex XN hematological parameters as assessed in the Dutch Lifelines cohort.
Reference intervals for Sysmex XN hematological parameters as assessed in the Dutch Lifelines cohort.
Summary:
The publication provides reference intervals for 105 XN parameters (incl. functional and cell activation parameters) based on data of 15,803 healthy individuals from the Lifelines cohort in the Netherlands. The reference intervals were calculated in accordance to the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) recommended statistical methods.
The publication provides reference intervals for 105 XN parameters (incl. functional and cell activation parameters) based on data of 15,803 healthy individuals from the Lifelines cohort in the Netherlands. The reference intervals were calculated in accordance to the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) recommended statistical methods.
Angelo A et al.
(2021) BMC Pediatrics; 21: 275:
Umbilical cord blood hematological parameters reference interval for newborns from Addis Ababa, Ethiopia.
Umbilical cord blood hematological parameters reference interval for newborns from Addis Ababa, Ethiopia.
Summary:
This pilot study enrolled 139 umbilical cord blood samples from healthy newborns to establish reference values for the KX-21N. For WBC, RBC, and NEUT significant differences were found between caesarean and natural birth.
This pilot study enrolled 139 umbilical cord blood samples from healthy newborns to establish reference values for the KX-21N. For WBC, RBC, and NEUT significant differences were found between caesarean and natural birth.
Mrosewski I et al.
(2021) Clin Chem Lab Med; 60(3): 408:
Indirectly determined hematology reference intervals for pediatric patients in Berlin and Brandenburg.
Indirectly determined hematology reference intervals for pediatric patients in Berlin and Brandenburg.
Summary:
The study presents indirectly determined CBC reference intervals (RI) for paediatric patients (0-18 years) in Berlin and Brandenburg area in Germany.
The study presents indirectly determined CBC reference intervals (RI) for paediatric patients (0-18 years) in Berlin and Brandenburg area in Germany.
Song MY et al.
(2021) Int J Lab Hematol; 43(6): 1363:
Establishment of pediatric reference intervals for complete blood count parameters in capillary blood in Beijing.
Establishment of pediatric reference intervals for complete blood count parameters in capillary blood in Beijing.
Summary:
The authors established reference intervals for 22 CBC+DIFF parameters from capillary blood in 6,799 children aged 3 months to 18 years from Beijing area in China.
The authors established reference intervals for 22 CBC+DIFF parameters from capillary blood in 6,799 children aged 3 months to 18 years from Beijing area in China.
Wilson S et al.
(2021) Int J Lab Hematol; 43(6): 1394:
Continuous reference curves for common hematology markers in the CALIPER cohort of healthy children and adolescents on the Sysmex XN-3000 system.
Continuous reference curves for common hematology markers in the CALIPER cohort of healthy children and adolescents on the Sysmex XN-3000 system.
Summary:
This is the first study published on continuous reference intervals (curves) of healthy children and adolescents for 19 haematological XN parameters. Seven parameters required sex-specific reference curves. Continuous reference intervals were found to be accurate estimate of haematological reference ranges over the paediatric age range.
This is the first study published on continuous reference intervals (curves) of healthy children and adolescents for 19 haematological XN parameters. Seven parameters required sex-specific reference curves. Continuous reference intervals were found to be accurate estimate of haematological reference ranges over the paediatric age range.
Bohn MK et al.
(2020) Int J Lab Hematol; 42(6): 750:
Complex biological patterns of hematology parameters in childhood necessitating age- and sex-specific reference intervals for evidence-based clinical interpretation.
Complex biological patterns of hematology parameters in childhood necessitating age- and sex-specific reference intervals for evidence-based clinical interpretation.
Summary:
The study establishes a comprehensive paediatric (birth to 21 years) reference intervals for haematology parameters using the XN analyser. The data highlight the dynamic haematological profiles observed in healthy children and adolescents and the need for reference interval stratification by age and sex.
The study establishes a comprehensive paediatric (birth to 21 years) reference intervals for haematology parameters using the XN analyser. The data highlight the dynamic haematological profiles observed in healthy children and adolescents and the need for reference interval stratification by age and sex.
Florin L et al.
(2020) Int J Lab Hematol; 42(3): e110:
Establishment of common reference intervals for hematology parameters in adults, measured in a multicenter study on the Sysmex XN-series analyzer.
Establishment of common reference intervals for hematology parameters in adults, measured in a multicenter study on the Sysmex XN-series analyzer.
Summary:
The study provides reference intervals (CBC+DIFF+RET) that could serve as reference values for haematology parameters in adults for laboratories that use the XN-Series analysers.
The study provides reference intervals (CBC+DIFF+RET) that could serve as reference values for haematology parameters in adults for laboratories that use the XN-Series analysers.
Ianni B et al.
(2020) Arch Pathol Lab Med; 145(1):66:
Defining Normal Healthy Term Newborn Automated Hematologic Reference Intervals at 24 Hours of Life Arch Pathol Lab Med; Online ahead of print.
Defining Normal Healthy Term Newborn Automated Hematologic Reference Intervals at 24 Hours of Life Arch Pathol Lab Med; Online ahead of print.
Summary:
The authors established prospectively reference intervals on Sysmex XN-Series for normal healthy term new-borns at 23-25 hours of life for CBC, IG%, IG#, IRF, RET-He, IPF and IPF#.
The authors established prospectively reference intervals on Sysmex XN-Series for normal healthy term new-borns at 23-25 hours of life for CBC, IG%, IG#, IRF, RET-He, IPF and IPF#.
Zierk J et al.
(2019) Clin Chem Lab Med; 57(10): 159548:
Next-generation reference intervals for pediatric hematology.
Next-generation reference intervals for pediatric hematology.
Summary:
The authors determined percentile charts and z-scores for CBC reference intervals from birth to adulthood. A total of 9,576,910 specimens were gathered from ten German facilities and analysed using predominantly Sysmex X-Class and XN-Class analysers and one Beckman Coulter DxH800 analyser.
The authors determined percentile charts and z-scores for CBC reference intervals from birth to adulthood. A total of 9,576,910 specimens were gathered from ten German facilities and analysed using predominantly Sysmex X-Class and XN-Class analysers and one Beckman Coulter DxH800 analyser.
Arbiol-Roca A et al.
(2018) EJIFCC; 29(1): 48:
Reference intervals for a complete blood count on an automated haematology analyser Sysmex XN in healthy adults from the southern metropolitan area of Barcelona.
Reference intervals for a complete blood count on an automated haematology analyser Sysmex XN in healthy adults from the southern metropolitan area of Barcelona.
Summary:
The aim of the study was to establish reference intervals for CBC, DIFF and reticulocytes for a Spanish population. Significant gender differences were found for RBC, PLT, HCT and HGB.
The aim of the study was to establish reference intervals for CBC, DIFF and reticulocytes for a Spanish population. Significant gender differences were found for RBC, PLT, HCT and HGB.
MacQueen BC et al.
(2017) J Perinatol; 37(7): 834:
The immature platelet fraction: creating neonatal reference intervals and using these to categorize neonatal thrombocytopenias.
The immature platelet fraction: creating neonatal reference intervals and using these to categorize neonatal thrombocytopenias.
Summary:
Neonatal reference intervals for IPF and IPF# were reported according to gestational age, and during the first 90 days after birth. Moreover, neonates with hyporegenerative thrombocytopenias had lower IPF and IPF# than neonates with consumptive ones.
Neonatal reference intervals for IPF and IPF# were reported according to gestational age, and during the first 90 days after birth. Moreover, neonates with hyporegenerative thrombocytopenias had lower IPF and IPF# than neonates with consumptive ones.
Ozarda Y et al.
(2017) Biochem Med (Zagreb); 27(2): 350:
A nationwide multicentre study in Turkey for establishing reference intervals of haematological parameters with novel use of a panel of whole blood.
A nationwide multicentre study in Turkey for establishing reference intervals of haematological parameters with novel use of a panel of whole blood.
Summary:
The authors used the Cell Dyn and Ruby (Abbott), LH780 (Beckman Coulter) and XT-2000i (Sysmex) analysers to obtain Turkish reference intervals for CBC-DIFF parameters. Analyser-specific reference intervals were reported for BASO%, BASO#, MCHC, RDW, and MPV.
The authors used the Cell Dyn and Ruby (Abbott), LH780 (Beckman Coulter) and XT-2000i (Sysmex) analysers to obtain Turkish reference intervals for CBC-DIFF parameters. Analyser-specific reference intervals were reported for BASO%, BASO#, MCHC, RDW, and MPV.
Ko Y et al.
(2015) Clin Chem Lab Med; 53(7): 1091:
Reference interval for immature platelet fraction on Sysmex XN hematology analyzer: a comparison study with Sysmex XE-2100.
Reference interval for immature platelet fraction on Sysmex XN hematology analyzer: a comparison study with Sysmex XE-2100.
Summary:
Reference intervals for PLT, IPF% and IPF# were established on the XE- and XN-Series. It was found that the values measured on the XN were higher than on the XE-2100.
Reference intervals for PLT, IPF% and IPF# were established on the XE- and XN-Series. It was found that the values measured on the XN were higher than on the XE-2100.
Ko Y et al.
(2013) Int J Lab Hematol; 35(5): 528:
Establishment of reference interval for immature platelet fraction.
Establishment of reference interval for immature platelet fraction.
Summary:
The study provides reference intervals for PLT, IPF% and absolute IPF from more than 2,000 healthy individuals and from umbilical cord blood, according to the CLSI guideline. These results could be used as fundamental data for clinical use as well as future research.
The study provides reference intervals for PLT, IPF% and absolute IPF from more than 2,000 healthy individuals and from umbilical cord blood, according to the CLSI guideline. These results could be used as fundamental data for clinical use as well as future research.
White Blood Cells
Flagging
Ramiah J L et al.
(2023) Afr J Lab Med; 12(1): 2140:
Performance of the automated Sysmex XN-3000 analyser for detecting white blood cell abnormalities in South Africa.
Performance of the automated Sysmex XN-3000 analyser for detecting white blood cell abnormalities in South Africa.
Summary:
A comparison study between WBC flagging and microscopic evaluation in 250 samples (45% haematologic malignancies) showed that 'Blasts?' and 'Abn Lympho?' had a sensitivity of 96.3% and 90% respectively, and a specificity of 84.9% and 96.3%. Low WBC count, chemotherapy, presence of malignancy and/or infection were factors that were associated with discrepant results between flagging and microscopy.
A comparison study between WBC flagging and microscopic evaluation in 250 samples (45% haematologic malignancies) showed that 'Blasts?' and 'Abn Lympho?' had a sensitivity of 96.3% and 90% respectively, and a specificity of 84.9% and 96.3%. Low WBC count, chemotherapy, presence of malignancy and/or infection were factors that were associated with discrepant results between flagging and microscopy.
Dedeene L et al.
(2022) Int J Lab Hematol; 44(4): e153:
"Smart” WPC reflex testing enables optimal use of the WPC channel in the detection of malignant blood samples using Sysmex XN-9100.
"Smart” WPC reflex testing enables optimal use of the WPC channel in the detection of malignant blood samples using Sysmex XN-9100.
Summary:
In this follow-up publication of Blomme S et al. 2021, the authors have adjusted the criteria for WPC reflex testing. The revised workflow resulted overall in a 40% reduction in the number of WPC reflex tests and a 16% reduction in smear reviewing in a routine set-up.
In this follow-up publication of Blomme S et al. 2021, the authors have adjusted the criteria for WPC reflex testing. The revised workflow resulted overall in a 40% reduction in the number of WPC reflex tests and a 16% reduction in smear reviewing in a routine set-up.
Blomme S et al.
(2021) Int J Lab Hematol; 43(2): 191:
The integration of Sysmex XN-9100’ WPC channel reflex testing in the detection of reactive versus malignant blood samples.
The integration of Sysmex XN-9100’ WPC channel reflex testing in the detection of reactive versus malignant blood samples.
Summary:
In this study the WPC reflex testing showed excellent sensitivity (99%), but low specificity (29%). Using reflex WPC to the WDF channel resulted in a 12% reduction of the smear review rate. The authors suggested workflow for the optimal use of the WPC channel in a routine setting.
In this study the WPC reflex testing showed excellent sensitivity (99%), but low specificity (29%). Using reflex WPC to the WDF channel resulted in a 12% reduction of the smear review rate. The authors suggested workflow for the optimal use of the WPC channel in a routine setting.
Moioli V et al.
(2020) Scand J Clin Lab Invest; 80(1): 55:
A specific abnormal scattergram of peripheral blood leukocytes suggestive for the presence of proerythroblast.
A specific abnormal scattergram of peripheral blood leukocytes suggestive for the presence of proerythroblast.
Summary:
In this publication two cases of myeloproliferative disorder patients are described. Abnormal cell clusters in the WNR, WDF and WPC scattergrams were present. In oncological patients, this likely indicates the presence of proerythroblasts as a symptom of an erythroid leukaemia and therefore the XN scattergrams were suggested to support a rapid stratification.
In this publication two cases of myeloproliferative disorder patients are described. Abnormal cell clusters in the WNR, WDF and WPC scattergrams were present. In oncological patients, this likely indicates the presence of proerythroblasts as a symptom of an erythroid leukaemia and therefore the XN scattergrams were suggested to support a rapid stratification.
Paridaens H et al.
(2019) Ann Biol Clin (Paris); 77(4): 422:
Can the 72-hour rule based on "Blast/Abn Lymph" flag on Sysmex XN-10 optimize the workflow in hematology laboratory?
Can the 72-hour rule based on "Blast/Abn Lymph" flag on Sysmex XN-10 optimize the workflow in hematology laboratory?
Summary:
The authors verified GFHC rules for reducing unnecessary smears and even extended the rules for further smear reduction when using XN analysers. The very good sensitivity (93%) and specificity (94%) of the 'Blast/Abn Lympho?' flag was confirmed in line with smear reduction of 5.7% and associated cost reduction.
The authors verified GFHC rules for reducing unnecessary smears and even extended the rules for further smear reduction when using XN analysers. The very good sensitivity (93%) and specificity (94%) of the 'Blast/Abn Lympho?' flag was confirmed in line with smear reduction of 5.7% and associated cost reduction.
Schuff-Werner P et al.
(2016) Clin Chem Lab Med; 54(9): 1503:
Performance of the XN-2000 WPC channel-flagging to differentiate reactive and neoplastic leucocytosis.
Performance of the XN-2000 WPC channel-flagging to differentiate reactive and neoplastic leucocytosis.
Summary:
The XN-1000 demonstrated an excellent performance for differentiation between neoplastic and reactive leukocytosis in this study.
The XN-1000 demonstrated an excellent performance for differentiation between neoplastic and reactive leukocytosis in this study.
Ulset R J et al.
(2014) Clin Lab; 60(12): 1961:
“Aged Sample” Software on Automated Routine Hematology Analyzer Enables Differentiation Between Pathological and Non-Pathological WBC Flagging in Aging Samples.
“Aged Sample” Software on Automated Routine Hematology Analyzer Enables Differentiation Between Pathological and Non-Pathological WBC Flagging in Aging Samples.
Summary:
The authors concluded that 'Aged Sample Identifier' software not only detects and labels samples that are ageing or were stored under suboptimal conditions, but also prevents false positive flagging.
The authors concluded that 'Aged Sample Identifier' software not only detects and labels samples that are ageing or were stored under suboptimal conditions, but also prevents false positive flagging.
Hotton J et al.
(2013) Am J Clin Pathol; 140: 845:
Performance and Abnormal Cell Flagging Comparisons of Three Automated Blood Cell Counters: Cell-Dyn Sapphire, DxH-800, and XN-2000.
Performance and Abnormal Cell Flagging Comparisons of Three Automated Blood Cell Counters: Cell-Dyn Sapphire, DxH-800, and XN-2000.
Summary:
In this performance study repeatability, linearity and carryover was judged as good for all tested analysers, and correlation between the analysers was also good for HGB, MCV, PLT, and WBC.
Quotes: ‘The XN showed a higher sensitivity than the SAPH and DxH for all flags of interest.’ ’For the first time, we have decreased the slide review for our laboratory from 20% with the SAPH to 9.3% with the XN.’
In this performance study repeatability, linearity and carryover was judged as good for all tested analysers, and correlation between the analysers was also good for HGB, MCV, PLT, and WBC.
Quotes: ‘The XN showed a higher sensitivity than the SAPH and DxH for all flags of interest.’ ’For the first time, we have decreased the slide review for our laboratory from 20% with the SAPH to 9.3% with the XN.’
General WBC
Coussee A et al.
(2025) LabMed; 2(1): 5:
Evaluating the Performance of the New Sysmex XR-Series Haematology Analyser: A Comparative Study with the Sysmex XN-Series.
Evaluating the Performance of the New Sysmex XR-Series Haematology Analyser: A Comparative Study with the Sysmex XN-Series.
Summary:
In this comparative analytical performance study of the XR-Series and XN-Series analysers the authors demonstrated highly comparable precision, method comparison and flagging.
In this comparative analytical performance study of the XR-Series and XN-Series analysers the authors demonstrated highly comparable precision, method comparison and flagging.
Egger M et al.
(2025) Clin Chem Lab Med; online ahead of print:
Impact of biological and genetic features of leukemic cells on the occurrence of “shark fins” in the WPC channel scattergrams of the Sysmex XN hematology analyzers in patients with chronic lymphocytic leukemia.
Impact of biological and genetic features of leukemic cells on the occurrence of “shark fins” in the WPC channel scattergrams of the Sysmex XN hematology analyzers in patients with chronic lymphocytic leukemia.
Summary:
A study in 95 chronic lymphocytic leukaemia samples evaluated the correlation of certain genetic features with the appearance of a 'shark fin' area in the WPC scattergram. High lymphocyte count along with the presence of an IGHV mutation, the absence of del(17p), an unmutated TP53 or high percentage of smudge cells in the smear correlated with the presence of cells in that area.
A study in 95 chronic lymphocytic leukaemia samples evaluated the correlation of certain genetic features with the appearance of a 'shark fin' area in the WPC scattergram. High lymphocyte count along with the presence of an IGHV mutation, the absence of del(17p), an unmutated TP53 or high percentage of smudge cells in the smear correlated with the presence of cells in that area.
Mardia AI et al.
(2025) Int J Rheum Dis; 27(12): e15449:
The Potential Role of Neutrophil Reactivity Intensity and Reactive Lymphocytes as Extended Hematological Parameters to Detect Active Systemic Lupus Erythematosus.
The Potential Role of Neutrophil Reactivity Intensity and Reactive Lymphocytes as Extended Hematological Parameters to Detect Active Systemic Lupus Erythematosus.
Summary:
In this study, patients with active systemic lupus erythematosus (SLE) exhibited significantly higher NEUT-RI values (51.5 vs. 49.6 FL, p=0.004) and significantly lower RE-LYMP values (0.09 vs. 0.14 × 10^3/mm^3, p=0.024) and higher NEUT-RI/RE-LYMP ratio (0.52 vs. 0.35, p=0.012) between active and inactive SLE patients.
In this study, patients with active systemic lupus erythematosus (SLE) exhibited significantly higher NEUT-RI values (51.5 vs. 49.6 FL, p=0.004) and significantly lower RE-LYMP values (0.09 vs. 0.14 × 10^3/mm^3, p=0.024) and higher NEUT-RI/RE-LYMP ratio (0.52 vs. 0.35, p=0.012) between active and inactive SLE patients.
Coutaz C et al.
(2024) J Clin Lab Anal; 38(4): e25017:
Evaluation of the Sysmex XQ-320 three-part differential haematology analyser and its flagging capabilities.
Evaluation of the Sysmex XQ-320 three-part differential haematology analyser and its flagging capabilities.
Summary:
The authors found an excellent analytical performance for XQ-320 in selected categories. A method comparison with XN-9000 and XP-300 in a cohort of 493 samples enriched with abnormalities showed correlation values greater than 0.94 for the majority of the 20 reportable parameters, with better results than XP-300. Specific parameter patterns on XQ-320 could differentiate abnormal samples that were only identified by the extensive XN-9000 flagging algorithms.
The authors found an excellent analytical performance for XQ-320 in selected categories. A method comparison with XN-9000 and XP-300 in a cohort of 493 samples enriched with abnormalities showed correlation values greater than 0.94 for the majority of the 20 reportable parameters, with better results than XP-300. Specific parameter patterns on XQ-320 could differentiate abnormal samples that were only identified by the extensive XN-9000 flagging algorithms.
Fujimaki K et al.
(2024) Pract Lab Med; 39: e00370:
Performance evaluation of the new Sysmex XR-Series haematology analyser.
Performance evaluation of the new Sysmex XR-Series haematology analyser.
Summary:
In this study, the XR analyser had very good analytical performance, and highly comparable results to the predecessor XN analyser in all investigated parameters, flags and workflow aspects. The correlation coefficients between the two systems for the parameters tested were greater than 0.909. High sensitivities for the detection of abnormal cells were observed for the ‘Blasts/Abn Lympho?’ flag (XN: 100%, XR: 99.0%) and WPC abnormal flags (‘Blasts?’ or ‘Abn Lympho?‘) (XN: 97.0%, XR: 96.0%).
In this study, the XR analyser had very good analytical performance, and highly comparable results to the predecessor XN analyser in all investigated parameters, flags and workflow aspects. The correlation coefficients between the two systems for the parameters tested were greater than 0.909. High sensitivities for the detection of abnormal cells were observed for the ‘Blasts/Abn Lympho?’ flag (XN: 100%, XR: 99.0%) and WPC abnormal flags (‘Blasts?’ or ‘Abn Lympho?‘) (XN: 97.0%, XR: 96.0%).
Herawati S et al.
(2024) Diagnostics; 14(9): 956:
Integrating Routine Hematological and Extended Inflammatory Parameters as a Novel Approach for Timely Diagnosis and Prognosis in Sepsis Management.
Integrating Routine Hematological and Extended Inflammatory Parameters as a Novel Approach for Timely Diagnosis and Prognosis in Sepsis Management.
Summary:
A study in 78 hospitalised patients showed that patients with sepsis (n=39) had increased WBC, NEUT#/%, IG#, NEUT-RI, NEUT-GI, AS-LYMP# and RE-LYMP# compared to non-sepsis (n=39) at day of admission. A regression model with WBC, IG# and the EIP had an AUC of 0.924 to distinguish sepsis from non-sepsis patients and an AUC of 0.991 to distinguish sepsis patients from healthy controls (n=33).
A study in 78 hospitalised patients showed that patients with sepsis (n=39) had increased WBC, NEUT#/%, IG#, NEUT-RI, NEUT-GI, AS-LYMP# and RE-LYMP# compared to non-sepsis (n=39) at day of admission. A regression model with WBC, IG# and the EIP had an AUC of 0.924 to distinguish sepsis from non-sepsis patients and an AUC of 0.991 to distinguish sepsis patients from healthy controls (n=33).
Kaneda M et al.
(2024) J Infect Chemother; 30(10): 983:
Time-dependent changes in cell population data obtained using Sysmex XN-series hematology analyzer in bacterial infections.
Time-dependent changes in cell population data obtained using Sysmex XN-series hematology analyzer in bacterial infections.
Summary:
A study in patients with acute bacterial infection that developed sepsis (n=25) showed that NE-WY peaked on d0, the starting point of antibiotic treatment, and was then gradually decreasing on d1 and d3, when all patients improved. NE-WY also correlated with the blood bacterial load on d0 and d1 in PCR-proven infections irrespective of the sepsis status (n=22).
A study in patients with acute bacterial infection that developed sepsis (n=25) showed that NE-WY peaked on d0, the starting point of antibiotic treatment, and was then gradually decreasing on d1 and d3, when all patients improved. NE-WY also correlated with the blood bacterial load on d0 and d1 in PCR-proven infections irrespective of the sepsis status (n=22).
Kowalska-Kępczyńska A et al.
(2024) Int J Inflam; 2024: 3786206:
Extended Inflammation Parameters (EIP) as Markers of Inflammation in Systemic Sclerosis.
Extended Inflammation Parameters (EIP) as Markers of Inflammation in Systemic Sclerosis.
Summary:
A study in patients with systemic sclerosis (n=28), an autoimmune disease characterised by chronic systemic inflammation, showed that NEUT-RI, NEUT-GI, RE-LYMP# and IL-6 were increased compared to healthy controls (n=29). RE-LYMP# correlated with IL-6 (r=0.45) and ESR (r=0.53).
A study in patients with systemic sclerosis (n=28), an autoimmune disease characterised by chronic systemic inflammation, showed that NEUT-RI, NEUT-GI, RE-LYMP# and IL-6 were increased compared to healthy controls (n=29). RE-LYMP# correlated with IL-6 (r=0.45) and ESR (r=0.53).
Tabata M et al.
(2024) Clin Chem Lab Med; 62(12): 2461:
Performance evaluation and user experience of BT-50 transportation unit with automated and scheduled quality control measurements.
Performance evaluation and user experience of BT-50 transportation unit with automated and scheduled quality control measurements.
Summary:
The authors evaluated the performance of the BT-50 and the manual method using XN Check Levels 1, 2 and 3 and the results were equivalent. For PLT, BT-50 showed lower variability compared to the manual method. The BT-50 streamlined the workflow, reduced operator workload and provided standardised control measurements.
The authors evaluated the performance of the BT-50 and the manual method using XN Check Levels 1, 2 and 3 and the results were equivalent. For PLT, BT-50 showed lower variability compared to the manual method. The BT-50 streamlined the workflow, reduced operator workload and provided standardised control measurements.
Akbari P et al.
(2023) Nat Commun; 14(1): 5023:
A genome-wide association study of blood cell morphology identifies cellular proteins implicated in disease aetiology.
A genome-wide association study of blood cell morphology identifies cellular proteins implicated in disease aetiology.
Summary:
The authors performed the first genome-wide association study to investigate the genetic basis of 63 blood cell morphological traits (Sysmex parameters). They identified key cellular proteins associated with disease aetiologies (e.g. multiple sclerosis) and highlighted the importance of genetic factors in influencing blood cell parameters (e.g. ZFPM2 gene expression for platelet granularity).
The authors performed the first genome-wide association study to investigate the genetic basis of 63 blood cell morphological traits (Sysmex parameters). They identified key cellular proteins associated with disease aetiologies (e.g. multiple sclerosis) and highlighted the importance of genetic factors in influencing blood cell parameters (e.g. ZFPM2 gene expression for platelet granularity).
Bouriche L et al.
(2023) Int J Lab Hematol; 46(2): 286:
Detection of dysplasia in peripheral blood: Proposal of an algorithm to detect myelodysplastic syndromes and chronic myelomonocytic leukemias on a high-speed technical platform using the Sysmex XN™ analyser.
Detection of dysplasia in peripheral blood: Proposal of an algorithm to detect myelodysplastic syndromes and chronic myelomonocytic leukemias on a high-speed technical platform using the Sysmex XN™ analyser.
Summary:
A decision tree utilising the MDS-CBC and mono-dysplasia scores had a 94.4% sensitivity and 91.4% specificity in identifying MDS (n=18) and CMML (n=18) samples within a cohort of 749. The authors showed that routine implementation of the tree compared to using the recommended cytopenia or monocytosis criteria in over 25,000 samples significantly reduced the smear workload.
A decision tree utilising the MDS-CBC and mono-dysplasia scores had a 94.4% sensitivity and 91.4% specificity in identifying MDS (n=18) and CMML (n=18) samples within a cohort of 749. The authors showed that routine implementation of the tree compared to using the recommended cytopenia or monocytosis criteria in over 25,000 samples significantly reduced the smear workload.
Dai Q et al.
(2023) Clin Chem Lab Med; 61(7): e131:
Spurious low WBC count in the WNR channel of Sysmex XN-9000 hematology analyzer in a case with leukocyte aggregation.
Spurious low WBC count in the WNR channel of Sysmex XN-9000 hematology analyzer in a case with leukocyte aggregation.
Summary:
In this case study a sample of an 11-year-old girl infected with Cryptococcus neoformans led to discrepancies between WNR and WDF channel results, correctly identified by the XN-9000, due to excessive hyaluronic acid produced from the pathogen.
In this case study a sample of an 11-year-old girl infected with Cryptococcus neoformans led to discrepancies between WNR and WDF channel results, correctly identified by the XN-9000, due to excessive hyaluronic acid produced from the pathogen.
Ho SF et al.
(2023) Diagnostics (Basel); 13(14): 2445:
Exploring Extended White Blood Cell Parameters for the Evaluation of Sepsis among Patients Admitted to Intensive Care Units.
Exploring Extended White Blood Cell Parameters for the Evaluation of Sepsis among Patients Admitted to Intensive Care Units.
Summary:
The authors observed a specific pattern of CBC parameters (including EIP) and biochemical parameters (CRP, PCT and IL-6) in a small cohort of sepsis (n=30) and non-sepsis (n=23) ICU patients. The combination of certain CBC parameters and EIP was effective in predicting worse outcome. The AUC for the combined parameters (AUC=0.918) was highest compared to the classical markers (SOFA Score = 0.631; CRP = 0.611; PCT= 0.639; IL-6= 0.531).
The authors observed a specific pattern of CBC parameters (including EIP) and biochemical parameters (CRP, PCT and IL-6) in a small cohort of sepsis (n=30) and non-sepsis (n=23) ICU patients. The combination of certain CBC parameters and EIP was effective in predicting worse outcome. The AUC for the combined parameters (AUC=0.918) was highest compared to the classical markers (SOFA Score = 0.631; CRP = 0.611; PCT= 0.639; IL-6= 0.531).
Vanrenterghem M et al.
(2023) Int J Lab Hematol; 45(5): 625:
Carcinocythemia in metastatic breast cancer detected by high fluorescent signals on an automated Sysmex XN-9100 hematological cell counter.
Carcinocythemia in metastatic breast cancer detected by high fluorescent signals on an automated Sysmex XN-9100 hematological cell counter.
Summary:
This case report describes a patient with suspected microangiopathic haemolytic anaemia (prominence of NRBC, RET# 0.379 x 10^12/L), 4-5% schistocytes, elevated LDH (1823 U/L)) together with suspicious high fluorescence cells. Smear results and other tests have proven the presence of circulating non-haematological malignant tumour cells, a rare phenomenon called carcinocythaemia.
This case report describes a patient with suspected microangiopathic haemolytic anaemia (prominence of NRBC, RET# 0.379 x 10^12/L), 4-5% schistocytes, elevated LDH (1823 U/L)) together with suspicious high fluorescence cells. Smear results and other tests have proven the presence of circulating non-haematological malignant tumour cells, a rare phenomenon called carcinocythaemia.
Pozdnyakova O et al.
(2022) J Clin Pathol; 76(9): 624:
Beyond the routine CBC: machine learning and statistical analyses identify research CBC parameter associations with myelodysplastic syndromes and specific underlying pathogenic variants.
Beyond the routine CBC: machine learning and statistical analyses identify research CBC parameter associations with myelodysplastic syndromes and specific underlying pathogenic variants.
Summary:
The authors created a predictive model to identify myelodysplastic syndrome (MDS) samples (n=102) from cytopenic (n=145) or other control samples (n=484) by using haematology parameters. The model had AUC 0.98, sensitivity 90%, specificity 96% and NPV 99%. Neutrophil parameters and IPF were found to have high predictive value for the model.
The authors created a predictive model to identify myelodysplastic syndrome (MDS) samples (n=102) from cytopenic (n=145) or other control samples (n=484) by using haematology parameters. The model had AUC 0.98, sensitivity 90%, specificity 96% and NPV 99%. Neutrophil parameters and IPF were found to have high predictive value for the model.
Zhu J et al.
(2022) BMC Cancer; 22(1): 972:
Machine learning-based improvement of MDS-CBC score brings platelets into the limelight to optimize smear review in the hematology laboratory.
Machine learning-based improvement of MDS-CBC score brings platelets into the limelight to optimize smear review in the hematology laboratory.
Summary:
A two-step algorithm, triggered by cytopenia, and utilising the MDS-CBC score and IPF, correctly separated myelodysplastic (MDS) samples (n=168) from other non-clonal cytopenic samples (n=357) with a sensitivity of 88.7% and a specificity of 95.8%. The algorithm had a 96.4% classification rate for MDS and 95.8% for the cytopenic controls, in this study.
A two-step algorithm, triggered by cytopenia, and utilising the MDS-CBC score and IPF, correctly separated myelodysplastic (MDS) samples (n=168) from other non-clonal cytopenic samples (n=357) with a sensitivity of 88.7% and a specificity of 95.8%. The algorithm had a 96.4% classification rate for MDS and 95.8% for the cytopenic controls, in this study.
Comar SR et al.
(2021) Int J Lab Hematol; 43(6): e280:
Early detection of Candida parapsilosis sepsis in peripheral blood as a result of cytografic changes on the Sysmex XN-3000 hematology analyzer.
Early detection of Candida parapsilosis sepsis in peripheral blood as a result of cytografic changes on the Sysmex XN-3000 hematology analyzer.
Summary:
A case review that describes specific WNR and WDF scattergram patterns of a patient with Candida parapsilopsis sepsis. The authors propose careful overall observation of all information provided by the automated blood count including thorough analysis of scattergrams that might enable early diagnosis of invasive fungal infection.
A case review that describes specific WNR and WDF scattergram patterns of a patient with Candida parapsilopsis sepsis. The authors propose careful overall observation of all information provided by the automated blood count including thorough analysis of scattergrams that might enable early diagnosis of invasive fungal infection.
Debus J et al.
(2021) Clin Chem Lab Med; 59(7): e285:
A case of methaemoglobinaemia interference on the WDF channel on Sysmex XN-Series analysers.
A case of methaemoglobinaemia interference on the WDF channel on Sysmex XN-Series analysers.
Summary:
This report is about a case of acquired methaemoglobinaemia resulting in 'WDF Abn Scattergram' flagging on XN-1000 and XE-2100. Interferences were shown to be reduced in the course of therapy. The authors suggested interferences with the reagent reaction in line with existing literature.
This report is about a case of acquired methaemoglobinaemia resulting in 'WDF Abn Scattergram' flagging on XN-1000 and XE-2100. Interferences were shown to be reduced in the course of therapy. The authors suggested interferences with the reagent reaction in line with existing literature.
Post A et al.
(2021) PLoS Negl Trop Dis; 15(3): e0009187:
Infection Manager System (IMS) as a new hemocytometry-based bacteremia detection tool: A diagnostic accuracy study in a malaria-endemic area of Burkina Faso.
Infection Manager System (IMS) as a new hemocytometry-based bacteremia detection tool: A diagnostic accuracy study in a malaria-endemic area of Burkina Faso.
Summary:
A study in 914 patients with acute febrile illness showed that the Infection Manager System (IMS) detected the presence of bacteraemia with a sensitivity of 92.2% and a specificity of 70.9%.
The performance varied dependant on age group and concurrent malaria infection. IMS outperformed C-reactive protein (CRP) and procalcitonin (PCT) in detecting bacteraemia.
A study in 914 patients with acute febrile illness showed that the Infection Manager System (IMS) detected the presence of bacteraemia with a sensitivity of 92.2% and a specificity of 70.9%.
The performance varied dependant on age group and concurrent malaria infection. IMS outperformed C-reactive protein (CRP) and procalcitonin (PCT) in detecting bacteraemia.
Shaikh MS et al.
(2021) Int J Lab Hematol; 43(3): e141:
Ensuing adequate mixing of blood samples before analysis—A proposed method for verification of satisfactory sample mixing by automated red blood cell count analyzers.
Ensuing adequate mixing of blood samples before analysis—A proposed method for verification of satisfactory sample mixing by automated red blood cell count analyzers.
Summary:
The authors report an excellent correlation (r value of 0.99) between manual and automated blood sample mixing with a minimal bias (0.009), proving an exceptional pre-analysis mixing of samples on the XN-1000 analyser.
The authors report an excellent correlation (r value of 0.99) between manual and automated blood sample mixing with a minimal bias (0.009), proving an exceptional pre-analysis mixing of samples on the XN-1000 analyser.
Ortiz A et al.
(2020) Sysmex J Int; 30(1): 9:
Performance Comparison of Sysmex Hematology Analyzers XN-550 and XN-10.
Performance Comparison of Sysmex Hematology Analyzers XN-550 and XN-10.
Summary:
The study concluded the XN-550 as highly reliable with functionality comparable to the XN-10. The device has shown high correlation coefficients and excellent comparative performance in all CBC, DIFF and RET parameters (except BASO%). The overall flagging comparison was excellent among the XN-10, the XN-550 and the manual differential.
The study concluded the XN-550 as highly reliable with functionality comparable to the XN-10. The device has shown high correlation coefficients and excellent comparative performance in all CBC, DIFF and RET parameters (except BASO%). The overall flagging comparison was excellent among the XN-10, the XN-550 and the manual differential.
Boutault R et al.
(2018) Br J Haematol; 183(5): 736:
A novel complete blood count-based score to screen for myelodysplastic syndrome in cytopenic patients.
A novel complete blood count-based score to screen for myelodysplastic syndrome in cytopenic patients.
Summary:
The authors suggested an MDS-CBC multiparametric score as a screening tool for MDS patients by combining absolute neutrophil count (ANC), mean corpuscular volume (MCV), and median neutrophil complexity width of dispersion (NE-WX). The score had a sensitivity of 86% and a specificity of 88% in the leading cohort.
The authors suggested an MDS-CBC multiparametric score as a screening tool for MDS patients by combining absolute neutrophil count (ANC), mean corpuscular volume (MCV), and median neutrophil complexity width of dispersion (NE-WX). The score had a sensitivity of 86% and a specificity of 88% in the leading cohort.
Urrechaga E et al.
(2018) J Clin Pathol; 71(3): 259:
Role of leucocytes cell population data in the early detection of sepsis.
Role of leucocytes cell population data in the early detection of sepsis.
Summary:
Cell population data (CPD) were different between control and sepsis patients in both study (n=719) and validation (n=272) groups. The authors calculated the NEMO score (NE-SFL, MO-X) and classified three statistically significant risk groups (mild (≤3), moderate (4≤NEMO≤5) and high (≥6) risk of sepsis) with an AUC of 0.98 in the study and 0.955 in the validation group.
Cell population data (CPD) were different between control and sepsis patients in both study (n=719) and validation (n=272) groups. The authors calculated the NEMO score (NE-SFL, MO-X) and classified three statistically significant risk groups (mild (≤3), moderate (4≤NEMO≤5) and high (≥6) risk of sepsis) with an AUC of 0.98 in the study and 0.955 in the validation group.
Cao J et al.
(2017) Lab Med; 48(2): 188:
Establishing a Stand-Alone Laboratory Dedicated to the Care of Patients With Ebola Virus Disease.
Establishing a Stand-Alone Laboratory Dedicated to the Care of Patients With Ebola Virus Disease.
Summary:
The pocH-100i was used in a laboratory dedicated to detection of Ebola virus disease. Its accuracy was verified by comparison with the XE-2100 in the main laboratory, and its precision and reportable range were also consistent with Sysmex's specifications.
The pocH-100i was used in a laboratory dedicated to detection of Ebola virus disease. Its accuracy was verified by comparison with the XE-2100 in the main laboratory, and its precision and reportable range were also consistent with Sysmex's specifications.
Cornet E et al.
(2016) Scand J Clin Lab Invest; 76(6): 465:
Evaluation and optimization of the extended information process unit (E-IPU) validation module integrating the sysmex flag systems and the recommendations of the French-speaking cellular hematology group (GFHC).
Evaluation and optimization of the extended information process unit (E-IPU) validation module integrating the sysmex flag systems and the recommendations of the French-speaking cellular hematology group (GFHC).
Summary:
Using the biomedical validation criteria, 21.3% of samples triggered a smear review, in this study cohort. Modification of four criteria by the authors reduced the number of smears from 21.3% to 15.0% without loss of clinical value.
Using the biomedical validation criteria, 21.3% of samples triggered a smear review, in this study cohort. Modification of four criteria by the authors reduced the number of smears from 21.3% to 15.0% without loss of clinical value.
Van Dievoet MA et al.
(2016) Int J Lab Hematol; 38(5): 490:
Performance evaluation of the Sysmex® XP-300 in an oncology setting: evaluation and comparison of hematological parameters with the Sysmex® XN-3000. Int J Lab Hematol early online
Performance evaluation of the Sysmex® XP-300 in an oncology setting: evaluation and comparison of hematological parameters with the Sysmex® XN-3000. Int J Lab Hematol early online
Summary:
The XP-300 showed very good precision and linearity results in this study, comparable with the XN-3000 analyser.
The XP-300 showed very good precision and linearity results in this study, comparable with the XN-3000 analyser.
Arneth B et al.
(2015) J Clin Lab Anal; 29(3): 175:
Technology and New Fluorescence Flow Cytometry Parameters in Hematological Analyzers.
Technology and New Fluorescence Flow Cytometry Parameters in Hematological Analyzers.
Summary:
This paper gives an overview of the technology behind the XE-Series and the benefits of flow cytometry and automatic cell counting. In this study the XE-5000 delivers faster accurate results than older analysers.
This paper gives an overview of the technology behind the XE-Series and the benefits of flow cytometry and automatic cell counting. In this study the XE-5000 delivers faster accurate results than older analysers.
Bruegel M et al.
(2015) Clin Chem Lab Med 53(7): 1057:
Comparison of five automated hematology analyzers in a university hospital setting: Abbott Cell-Dyn Sapphire, Beckman Coulter DxH 800, Siemens Advia 2120i, Sysmex XE-5000, and Sysmex XN-2000.
Comparison of five automated hematology analyzers in a university hospital setting: Abbott Cell-Dyn Sapphire, Beckman Coulter DxH 800, Siemens Advia 2120i, Sysmex XE-5000, and Sysmex XN-2000.
Summary:
A comparison study of Abbott, Beckman Coulter, Siemens and Sysmex analysers found superior flagging performance of the XN-2000, especially for blasts and variant lymphocytes. Otherwise, the analysers were comparable.
A comparison study of Abbott, Beckman Coulter, Siemens and Sysmex analysers found superior flagging performance of the XN-2000, especially for blasts and variant lymphocytes. Otherwise, the analysers were comparable.
Tabe Y et al.
(2015) Clin Chem Lab Med; 53(2): 281:
Performance evaluation of the digital cell imaging analyzer DI-60 integrated into the fully automated Sysmex XN hematology analyzer system.
Performance evaluation of the digital cell imaging analyzer DI-60 integrated into the fully automated Sysmex XN hematology analyzer system.
Summary:
In this performance evaluation of the digital imaging analyser DI-60 showed a good agreement between results from the DI-60 and manual microscopy. In addition, blasts were correctly classified with 95% sensitivity and 99% specificity.
In this performance evaluation of the digital imaging analyser DI-60 showed a good agreement between results from the DI-60 and manual microscopy. In addition, blasts were correctly classified with 95% sensitivity and 99% specificity.
Takagi Y et al.
(2015) Microscopy (Oxf); 64(5): 305:
Comparison of optical data from flow cytometry and microscopy of leukocytes after exposure to specific reagents.
Comparison of optical data from flow cytometry and microscopy of leukocytes after exposure to specific reagents.
Summary:
The authors used flow cytometry software and electron microscopy methods to confirm the positions and fluorescence intensity of WBC populations in the XN-WDF scattergram.
The authors used flow cytometry software and electron microscopy methods to confirm the positions and fluorescence intensity of WBC populations in the XN-WDF scattergram.
Genevieve F et al.
(2014) Feuillets de Biologie VOL LVI N° 317:
Smear microscopy revision: propositions by the GFHC.
Smear microscopy revision: propositions by the GFHC.
Summary:
The GFHC reviewed in detail the criteria used within the CBC to generate blood smears and has decided on a number of minimum recommendations, defining threshold values and various situations in which the blood smear review is desirable.
The GFHC reviewed in detail the criteria used within the CBC to generate blood smears and has decided on a number of minimum recommendations, defining threshold values and various situations in which the blood smear review is desirable.
Kawauchi S et al.
(2013) Sysmex J Int; 23(1): 1:
The Positions of Normal Leukocytes on the Scattergram of the Newly Developed Abnormal Cell-detection Channel of the XN-Series Multi-parameter Automated Hematology Analyzers.
The Positions of Normal Leukocytes on the Scattergram of the Newly Developed Abnormal Cell-detection Channel of the XN-Series Multi-parameter Automated Hematology Analyzers.
Summary:
Using purified leukocyte populations, the paper confirms the position of those populations within the WPC scattergrams. Interestingly, two populations of lymphocytes with a different resistance to WPC reagents were found.
Using purified leukocyte populations, the paper confirms the position of those populations within the WPC scattergrams. Interestingly, two populations of lymphocytes with a different resistance to WPC reagents were found.
Briggs C et al.
(2012) J Clin Pathol; 65: 1024:
Performance evaluation of the Sysmex haematology XN modular system.
Performance evaluation of the Sysmex haematology XN modular system.
Summary:
The authors report about a reduced sample turnaround time and reduced number of blood film reviews on XN compared to XE-2100 without loss of sensitivity and with more precise and accurate results for both, platelets and low WBC counts.
The authors report about a reduced sample turnaround time and reduced number of blood film reviews on XN compared to XE-2100 without loss of sensitivity and with more precise and accurate results for both, platelets and low WBC counts.
Van Hecke I et al.
(2010) Acta Clin Belg; 65: 248:
Evaluation of the Sysmex pocH-1001 haematology analyser in an outdoor oncology service.
Evaluation of the Sysmex pocH-1001 haematology analyser in an outdoor oncology service.
Summary:
In this study, Sysmex pocH-100i produces reliable results in the normal and in the lower ranges. The authors concluded that in a well-controlled management plan the Sysmex pocH-100i is suitable for near patient testing in oncology.
In this study, Sysmex pocH-100i produces reliable results in the normal and in the lower ranges. The authors concluded that in a well-controlled management plan the Sysmex pocH-100i is suitable for near patient testing in oncology.
Whisler S et al.
(2005) Lab Hematol; 11: 107:
Performance Evaluation of the Sysmex pocH-100i Automated Hematology Analyzer.
Performance Evaluation of the Sysmex pocH-100i Automated Hematology Analyzer.
Summary:
In this performance evaluation of the poch-100i and comparison with KX-21N and XE-2100 showed excellent results in this study. A reference range for a healthy population was also established by the authors.
In this performance evaluation of the poch-100i and comparison with KX-21N and XE-2100 showed excellent results in this study. A reference range for a healthy population was also established by the authors.
Briggs C et al.
(2003) Lab Hematol; 9(4): 225:
Performance evaluation of a New Compact Hematology Analyzer, the Sysmex pocH-100i.
Performance evaluation of a New Compact Hematology Analyzer, the Sysmex pocH-100i.
Summary:
In this performance evaluation of the pocH-100i and comparison with KX-21N showed excellent results. This study illustrates the clinical potential for use for accurate CBC results in a low-volume laboratory or in near-patient testing environment.
In this performance evaluation of the pocH-100i and comparison with KX-21N showed excellent results. This study illustrates the clinical potential for use for accurate CBC results in a low-volume laboratory or in near-patient testing environment.
Granulocytes
Costa RM et al.
(2024) Clin Chem Lab Med; 62(8): e178:
Early diagnosis of severe illness in an outpatient – the Sysmex XN’s neutrophil reactivity parameter.
Early diagnosis of severe illness in an outpatient – the Sysmex XN’s neutrophil reactivity parameter.
Summary:
In this case report from a patient with lung cancer, routine CBC results were in line with patient history, except for a high NEUT-RI value. Further investigation revealed early-stage peritonitis, which was asymptomatic likely due to cancer medication.
In this case report from a patient with lung cancer, routine CBC results were in line with patient history, except for a high NEUT-RI value. Further investigation revealed early-stage peritonitis, which was asymptomatic likely due to cancer medication.
Kutnik P et al.
(2024) Anaesthesiol Intensive Ther; 56(1): 77:
Nutritional responsiveness affects novel neutrophil parameters and reduces in-hospital mortality and costs in elective cancer oesophagectomy – a single‑centre, prospective, observational study.
Nutritional responsiveness affects novel neutrophil parameters and reduces in-hospital mortality and costs in elective cancer oesophagectomy – a single‑centre, prospective, observational study.
Summary:
In this observational study the parameters NEUT-RI and NEUT-GI were correlated with the nutritional status of patients (n=25), who were scheduled for elective oesophagectomy due to cancer. Statistically significant differences in the preoperative NEUT-RI (48.6 vs. 53.4, p=0.03) and NEUT-GI (154.6 vs. 159.3, p=0.02) values were observed between patients who responded to nutritional intervention (n=18) and patients who did not (n=7).
In this observational study the parameters NEUT-RI and NEUT-GI were correlated with the nutritional status of patients (n=25), who were scheduled for elective oesophagectomy due to cancer. Statistically significant differences in the preoperative NEUT-RI (48.6 vs. 53.4, p=0.03) and NEUT-GI (154.6 vs. 159.3, p=0.02) values were observed between patients who responded to nutritional intervention (n=18) and patients who did not (n=7).
Fedorov K et al.
(2023) Life (Basel); 13(3): 623:
Identifying Neutrophil Extracellular Traps (NETs) in Blood Samples Using Peripheral Smear Autoanalyzers.
Identifying Neutrophil Extracellular Traps (NETs) in Blood Samples Using Peripheral Smear Autoanalyzers.
Summary:
The authors revealed that the smudge cell category of CellaVision may contain two distinct populations of leukocytes: degenerated lymphocytes and neutrophils exhibiting Neutrophil Extracellular Traps (NETs). This study suggests NET-like smudge cells are not an artifact of smear preparation, are identified in the high SFL area of the WNR scattergram, and express NETs markers identifiable with immunohistochemistry and flow cytometry.
The authors revealed that the smudge cell category of CellaVision may contain two distinct populations of leukocytes: degenerated lymphocytes and neutrophils exhibiting Neutrophil Extracellular Traps (NETs). This study suggests NET-like smudge cells are not an artifact of smear preparation, are identified in the high SFL area of the WNR scattergram, and express NETs markers identifiable with immunohistochemistry and flow cytometry.
Mantovani EMA et al.
(2023) Diagnostics (Basel); 13(10): 1781:
The Potential Role of Neutrophil-Reactive Intensity (NEUT-RI) in the Diagnosis of Sepsis in Critically Ill Patients: A Retrospective Cohort Study.
The Potential Role of Neutrophil-Reactive Intensity (NEUT-RI) in the Diagnosis of Sepsis in Critically Ill Patients: A Retrospective Cohort Study.
Summary:
In this study, NEUT-RI showed an AUC of 0.826 in differentiating septic (n=46) from nonseptic (n=50) patients on admission to the ICU. Its negative predictive value (87.4%) was superior to that of PCT (83.9%) and CRP (86.6%) but not significantly influenced by renal failure. The authors concluded that NEUT-RI values, together with clinical signs and currently used inflammatory biomarkers, could be useful in the early diagnosis of sepsis.
In this study, NEUT-RI showed an AUC of 0.826 in differentiating septic (n=46) from nonseptic (n=50) patients on admission to the ICU. Its negative predictive value (87.4%) was superior to that of PCT (83.9%) and CRP (86.6%) but not significantly influenced by renal failure. The authors concluded that NEUT-RI values, together with clinical signs and currently used inflammatory biomarkers, could be useful in the early diagnosis of sepsis.
Bhansaly P et al.
(2022) Indian J Crit Care Med; 26(2): 216:
Evaluation of Immature Granulocyte Count as the Earliest Biomarker for Sepsis.
Evaluation of Immature Granulocyte Count as the Earliest Biomarker for Sepsis.
Summary:
The authors found that IG% and IG# gave an earlier indication of the onset of sepsis than serum procalcitonin and lactate. An increase in IG%/# was found in patients up to 24h before the onset of sepsis according to Sepsis-3 criteria.
The authors found that IG% and IG# gave an earlier indication of the onset of sepsis than serum procalcitonin and lactate. An increase in IG%/# was found in patients up to 24h before the onset of sepsis according to Sepsis-3 criteria.
Cetin N et al.
(2022) Pediatr Nephrol; 38(1): 219:
Immature granulocytes as biomarkers of inflammation in children with predialysis chronic kidney disease.
Immature granulocytes as biomarkers of inflammation in children with predialysis chronic kidney disease.
Summary:
A retrospective analysis in 57 children with predialysis chronic kidney disease (CKD) showed that IG%, IG#, WBC#, NEUT#, and NLR were higher compared to healthy children. IG parameters were also higher in stage 4 CDK compared to stage 2 and 3. IG% and IG# could predict the presence of inflammation with an AUC of 0.838 (sensitivity 74.2%) and 0.799 (sensitivity 70.8%) respectively in this cohort.
A retrospective analysis in 57 children with predialysis chronic kidney disease (CKD) showed that IG%, IG#, WBC#, NEUT#, and NLR were higher compared to healthy children. IG parameters were also higher in stage 4 CDK compared to stage 2 and 3. IG% and IG# could predict the presence of inflammation with an AUC of 0.838 (sensitivity 74.2%) and 0.799 (sensitivity 70.8%) respectively in this cohort.
Lemkus L et al.
(2022) PLoS ONE; 17(2): e0262938:
The utility of extended differential parameters as a biomarker of bacteremia at a tertiary academic hospital in persons with and without HIV infection in South Africa.
The utility of extended differential parameters as a biomarker of bacteremia at a tertiary academic hospital in persons with and without HIV infection in South Africa.
Summary:
In a cohort of bacterial infection patients NE-SFL presented as the best extended differential parameter in identifying bacteraemia in HIV positive patients (AUC = 1) whilst in HIV negative patients IG% performed best (AUC = 0.79). The study revealed a significant correlation to neutrophil CD64 expression which adds scientific validity to NE-SFL as a marker for neutrophil activation.
In a cohort of bacterial infection patients NE-SFL presented as the best extended differential parameter in identifying bacteraemia in HIV positive patients (AUC = 1) whilst in HIV negative patients IG% performed best (AUC = 0.79). The study revealed a significant correlation to neutrophil CD64 expression which adds scientific validity to NE-SFL as a marker for neutrophil activation.
Li S et al.
(2022) BMC Pulm Med; 22(1): 107:
Neutrophil side fluorescence: a new indicator for predicting the severity of patients with bronchiectasis.
Neutrophil side fluorescence: a new indicator for predicting the severity of patients with bronchiectasis.
Summary:
Unlike NEUT# and PCT, NEUT-SFL correlates significantly with Bronchiectasis Severity Index score in this study. The cut-off 42.15 FI for NEUT-SFL presents an AUC of 0.813 with a sensitivity of 67.1% and a specificity of 82.1%.
Unlike NEUT# and PCT, NEUT-SFL correlates significantly with Bronchiectasis Severity Index score in this study. The cut-off 42.15 FI for NEUT-SFL presents an AUC of 0.813 with a sensitivity of 67.1% and a specificity of 82.1%.
Lu Q et al.
(2022) J Hemat; 15(1): 1:
Evaluation of immature granulocyte parameters in myeloid neoplasms assayed by Sysmex XN hematology analyzer.
Evaluation of immature granulocyte parameters in myeloid neoplasms assayed by Sysmex XN hematology analyzer.
Summary:
In this study, an analysis of 1,412 blood samples showed that IG% from an XN-Series analyser correlated well with manual microscopy in both myeloid neoplasms (n=388, r=0.83) and non-haematopoietic neoplasms (n=524, r=0.86). IG parameters correctly indicated the presence of immature granulocytes in myeloid neoplasm patients (sensitivity 75% for IG# and 81% for IG%).
In this study, an analysis of 1,412 blood samples showed that IG% from an XN-Series analyser correlated well with manual microscopy in both myeloid neoplasms (n=388, r=0.83) and non-haematopoietic neoplasms (n=524, r=0.86). IG parameters correctly indicated the presence of immature granulocytes in myeloid neoplasm patients (sensitivity 75% for IG# and 81% for IG%).
Güngör A et al.
(2021) Postgrad Med;133(7):817:
Utility of biomarkers in predicting complicated appendicitis: can immature granulocyte percentage and C-reactive protein be used?
Utility of biomarkers in predicting complicated appendicitis: can immature granulocyte percentage and C-reactive protein be used?
Summary:
In this study, the best parameters for prediction of complicated appendicitis were found to be IG% (cutoff > 0.35, AUC 0.82, sensitivity 85.4, specificity 61.5) and CRP (cutoff > 33.9, AUC 0.82, sensitivity 75.7, specificity 73.0).
In this study, the best parameters for prediction of complicated appendicitis were found to be IG% (cutoff > 0.35, AUC 0.82, sensitivity 85.4, specificity 61.5) and CRP (cutoff > 33.9, AUC 0.82, sensitivity 75.7, specificity 73.0).
Kim H et al.
(2021) Int J Lab Hematol; 43(2): e54:
Screening of myelodysplastic syndrome using cell population data obtained from an automatic hematology analyzer.
Screening of myelodysplastic syndrome using cell population data obtained from an automatic hematology analyzer.
Summary:
In a study of 63 patients with myelodysplastic syndrome (MDS), RBC, PLT, NE-FSC and NE-SSC exhibited the highest correlation with the disease (AUC from 0.87 to 0.94). The authors propose a combined interpretation of these four parameters for identifying MDS (one out of four cutoff criteria had to be fulfilled).
In a study of 63 patients with myelodysplastic syndrome (MDS), RBC, PLT, NE-FSC and NE-SSC exhibited the highest correlation with the disease (AUC from 0.87 to 0.94). The authors propose a combined interpretation of these four parameters for identifying MDS (one out of four cutoff criteria had to be fulfilled).
Huang Y et al.
(2019) J Crit Care; 50: 303:
Immature granulocytes: A novel biomarker of acute respiratory distress syndrome in patients with acute pancreatitis.
Immature granulocytes: A novel biomarker of acute respiratory distress syndrome in patients with acute pancreatitis.
Summary:
In patients with acute pancreatitis, immature granulocytes (IG%) could facilitate the identification of patients with a high risk for developing acute respiratory distress syndrome (ARDS). The authors present IG% as a potential indicator of ARDS incidence with predictive power similar to (or greater than) other biomarkers.
In patients with acute pancreatitis, immature granulocytes (IG%) could facilitate the identification of patients with a high risk for developing acute respiratory distress syndrome (ARDS). The authors present IG% as a potential indicator of ARDS incidence with predictive power similar to (or greater than) other biomarkers.
Porizka M et al.
(2019) Interact Cardiovasc Thorac Surg; 28(6): 845:
Immature granulocytes as a sepsis predictor in patients undergoing cardiac surgery.
Immature granulocytes as a sepsis predictor in patients undergoing cardiac surgery.
Summary:
Porizka et al. investigated the ability of IG, Procalcitonin (PCT), WBC, body temperature and combinations in a cohort of cardiac surgery patients for the ability to identify sepsis. IG and PCT exhibited an AUC of 0.71 and 0.72, whereas in combination AUC increased to 0.8. IG is presented as a valuable additional parameter to PCT that improves sepsis identification in this special patient cohort.
Porizka et al. investigated the ability of IG, Procalcitonin (PCT), WBC, body temperature and combinations in a cohort of cardiac surgery patients for the ability to identify sepsis. IG and PCT exhibited an AUC of 0.71 and 0.72, whereas in combination AUC increased to 0.8. IG is presented as a valuable additional parameter to PCT that improves sepsis identification in this special patient cohort.
Stiel L et al.
(2019) Thromb Res; 183: 153:
First visualization of circulating neutrophil extracellular traps using cell fluorescence during human septic shock-induced disseminated intravascular coagulation.
First visualization of circulating neutrophil extracellular traps using cell fluorescence during human septic shock-induced disseminated intravascular coagulation.
Summary:
The authors reported direct visualisation of circulating neutrophils extracellular traps (NETs) in patients with septic shock induced disseminated intravascular coagulation (DIC). The previously reported in vivo relevance of NEUT-SFL in NETosis was confirmed.
The authors reported direct visualisation of circulating neutrophils extracellular traps (NETs) in patients with septic shock induced disseminated intravascular coagulation (DIC). The previously reported in vivo relevance of NEUT-SFL in NETosis was confirmed.
Ustyantseva M et al.
(2019) Sysmex Journal International; 29(1): 8:
Innovative Technologies in the Evaluation of the Neutrophil Functional Activity in Sepsis.
* Free online after free registration
Innovative Technologies in the Evaluation of the Neutrophil Functional Activity in Sepsis.
* Free online after free registration
Summary:
The study revealed significantly higher values of neutrophil fluorescence intensity (NEUT-RI) in critically ill patients with sepsis (NEUT-RI = 70 FI) compared to the non-septic control group (NEUT-RI = 53 FI). Furthermore, strong correlations between the levels of NEUT-RI and generally recognized biomarkers of sepsis (PCT, CRP) were found.
The study revealed significantly higher values of neutrophil fluorescence intensity (NEUT-RI) in critically ill patients with sepsis (NEUT-RI = 70 FI) compared to the non-septic control group (NEUT-RI = 53 FI). Furthermore, strong correlations between the levels of NEUT-RI and generally recognized biomarkers of sepsis (PCT, CRP) were found.
Ünal Y et al.
(2018) Ulus Travma Acil Cerrahi Derg; 24(5): 434:
A new and early marker in the diagnosis of acute complicated appendicitis: immature granulocytes.
A new and early marker in the diagnosis of acute complicated appendicitis: immature granulocytes.
Summary:
In this study, WBC, neutrophil-to-lymphocyte ratio (NLR), IG# and IG% showed significant changes in patients with acute appendicitis compared to simple appendicitis, while changes in IG# were most prominent.
In this study, WBC, neutrophil-to-lymphocyte ratio (NLR), IG# and IG% showed significant changes in patients with acute appendicitis compared to simple appendicitis, while changes in IG# were most prominent.
Delabranche X et al.
(2017) J Crit Care; 47(3): 313:
Evidence of Netosis in Septic Shock-Induced Disseminated Intravascular Coagulation.
Evidence of Netosis in Septic Shock-Induced Disseminated Intravascular Coagulation.
Summary:
In this study neutrophil fluorescence intensity (NEUT-RI) in blood samples of patients with septic shock exhibited significantly higher values in septic shock-induced disseminated intravascular coagulation (DIC) patients compared to non-DIC septic shock patients (70.0 vs. 50.7 FI).
In this study neutrophil fluorescence intensity (NEUT-RI) in blood samples of patients with septic shock exhibited significantly higher values in septic shock-induced disseminated intravascular coagulation (DIC) patients compared to non-DIC septic shock patients (70.0 vs. 50.7 FI).
Hampson P et al.
(2017) Ann Surg; 265(6): 1241:
Neutrophil Dysfunction, Immature Granulocytes, and Cell-free DNA are Early Biomarkers of Sepsis in Burn-injured Patients: A Prospective Observational Cohort Study.
Neutrophil Dysfunction, Immature Granulocytes, and Cell-free DNA are Early Biomarkers of Sepsis in Burn-injured Patients: A Prospective Observational Cohort Study.
Summary:
Neutrophil and IG counts correlated with sepsis risk in burn patients. The authors propose the interpretation considering also other markers such as the phagocytic index and cell free DNA.
Neutrophil and IG counts correlated with sepsis risk in burn patients. The authors propose the interpretation considering also other markers such as the phagocytic index and cell free DNA.
Ronez E et al.
(2017) Scand J Clin Lab Invest; 77(6): 406:
Usefulness of thresholds for smear review of neutropenic samples analyzed with a Sysmex XN-10 analyzer.
Usefulness of thresholds for smear review of neutropenic samples analyzed with a Sysmex XN-10 analyzer.
Summary:
A multi-center study showed that 1031 smear reviews triggered by isolated neutropenic samples (NEUT# < 1.5 G/L) resulted in the detection of only one positive sample (containing blasts). The authors recommend using a lower cutoff of 1.0 G/L for smear review.
A multi-center study showed that 1031 smear reviews triggered by isolated neutropenic samples (NEUT# < 1.5 G/L) resulted in the detection of only one positive sample (containing blasts). The authors recommend using a lower cutoff of 1.0 G/L for smear review.
Stiel L et al.
(2016) Crit Care Med; 44(11): e1132:
Neutrophil Fluorescence: A New Indicator of Cell Activation During Septic Shock-Induced Disseminated Intravascular Coagulation.
Neutrophil Fluorescence: A New Indicator of Cell Activation During Septic Shock-Induced Disseminated Intravascular Coagulation.
Summary:
In this study neutrophil fluorescence (NEUT-RI) above 57.3 FI demonstrated a sensitivity of 90.9 % and a specificity of 80.6 % for disseminated intravascular coagulation in patients with septic shock.
In this study neutrophil fluorescence (NEUT-RI) above 57.3 FI demonstrated a sensitivity of 90.9 % and a specificity of 80.6 % for disseminated intravascular coagulation in patients with septic shock.
Ha SO et al.
(2015) Scand J Clin Lab Invest; 75(1): 36:
Fraction of immature granulocytes reflects severity but not mortality in sepsis.
Fraction of immature granulocytes reflects severity but not mortality in sepsis.
Summary:
In this study cohort sepsis patients with an IG count on the XE-2100 of more than 0.5 % were more likely to suffer from severe sepsis or septic shock, while WBC, CRP and PCT did not correlate with sepsis severity.
In this study cohort sepsis patients with an IG count on the XE-2100 of more than 0.5 % were more likely to suffer from severe sepsis or septic shock, while WBC, CRP and PCT did not correlate with sepsis severity.
Park SH et al.
(2015) Int J Lab Hematol; 37(2): 190:
Sepsis affects most routine and cell population data (CPD) obtained using the Sysmex XN-2000 blood cell analyzer: neutrophil-related CPD NE-SFL and NE-WY provide useful information for detecting sepsis.
Sepsis affects most routine and cell population data (CPD) obtained using the Sysmex XN-2000 blood cell analyzer: neutrophil-related CPD NE-SFL and NE-WY provide useful information for detecting sepsis.
Summary:
NE-SFL and NE-WY parameters showed significantly increased values in sepsis patients compared to the normal control group of this study.
NE-SFL and NE-WY parameters showed significantly increased values in sepsis patients compared to the normal control group of this study.
Wiland EL et al.
(2014) Acta Paediatr; 103(5): 494:
Adult and child automated immature granulocyte norms are inappropriate for evaluating early-onset sepsis in newborns.
Adult and child automated immature granulocyte norms are inappropriate for evaluating early-onset sepsis in newborns.
Summary:
A study on the XE-5000 showed that IG counts were increased during the first 2 days after birth. Therefore, the authors conclude that the use of adult and child norms for IG% is not appropriate for newborns as supportive information in the diagnosis of sepsis.
A study on the XE-5000 showed that IG counts were increased during the first 2 days after birth. Therefore, the authors conclude that the use of adult and child norms for IG% is not appropriate for newborns as supportive information in the diagnosis of sepsis.
Nierhaus A et al.
(2013) BMC Immunology 14: 8:
Revisiting the white blood cell count: immature granulocytes count as a diagnostic marker to discriminate between SIRS and sepsis - a prospective, observational study.
Revisiting the white blood cell count: immature granulocytes count as a diagnostic marker to discriminate between SIRS and sepsis - a prospective, observational study.
Summary:
"Direct quote: Our findings demonstrate that sepsis is associated with an increased immature granulocyte count. The IG count can differentiate between patients with an infection and those who are not infected, particularly within the first critical hours after an initial SIRS alert. Using ROC analysis we found the IG count a superior biomarker for sepsis compared to C-reactive protein, lipopolysaccharide binding protein and interleukin-6."
"Direct quote: Our findings demonstrate that sepsis is associated with an increased immature granulocyte count. The IG count can differentiate between patients with an infection and those who are not infected, particularly within the first critical hours after an initial SIRS alert. Using ROC analysis we found the IG count a superior biomarker for sepsis compared to C-reactive protein, lipopolysaccharide binding protein and interleukin-6."
Zimmermann M et al.
(2011) Clin Chem Lab Med; 49: 1193:
Granularity Index of the SYSMEX XE-5000 hematology analyzer as a replacement for manual microscopy of toxic granulation neutrophils in patients with inflammatory diseases.
Granularity Index of the SYSMEX XE-5000 hematology analyzer as a replacement for manual microscopy of toxic granulation neutrophils in patients with inflammatory diseases.
Summary:
The Granularity Index (GI) was shown to correlate well with the degree of toxic granulation of neutrophils, in this study. The GI is a parameter calculated from automated, standardised measurements. The authors suggest that it should replace the time-consuming and subjective microscopic procedure.
The Granularity Index (GI) was shown to correlate well with the degree of toxic granulation of neutrophils, in this study. The GI is a parameter calculated from automated, standardised measurements. The authors suggest that it should replace the time-consuming and subjective microscopic procedure.
Furundarena J et al.
(2010) Int J Lab Hematol; 32: 360:
The utility of the Sysmex XE-2100 analyzer's NEUT-X and NEUT-Y parameters for detecting neutrophil dysplasia in myelodysplastic syndromes.
The utility of the Sysmex XE-2100 analyzer's NEUT-X and NEUT-Y parameters for detecting neutrophil dysplasia in myelodysplastic syndromes.
Summary:
In this study the parameters NEUT-X and NEUT-Y were used to detect neutrophil dysplasia arising from MDS and chronic myelomonocytic leukaemia (CMML).
In this study the parameters NEUT-X and NEUT-Y were used to detect neutrophil dysplasia arising from MDS and chronic myelomonocytic leukaemia (CMML).
Le Roux G et al.
(2010) Int J Lab Hematol; 32: e237:
Routine diagnostic procedures of myelodysplastic syndromes: value of a structural blood cell parameter (NEUT-X) determined by the Sysmex XE-2100™.
Routine diagnostic procedures of myelodysplastic syndromes: value of a structural blood cell parameter (NEUT-X) determined by the Sysmex XE-2100™.
Summary:
The authors present NEUT-X and the calculated granularity index GI as helpful in the screening for myelodysplastic syndromes (MDS) with increased sensitivity without increasing unnecessary smears.
The authors present NEUT-X and the calculated granularity index GI as helpful in the screening for myelodysplastic syndromes (MDS) with increased sensitivity without increasing unnecessary smears.
Linssen J et al.
(2008) Cytometry B (Clin Cytometry); 74: 295:
Automation and validation of a rapid method to assess neutrophil and monocyte activation by routine fluorescence flow cytometry in vitro.
Automation and validation of a rapid method to assess neutrophil and monocyte activation by routine fluorescence flow cytometry in vitro.
Summary:
In this study fluorescence flow cytometry was shown to measure activation steps of monocytes and polymorphonuclear neutrophils to defined external stimuli. This may potentially be applied as a screening and surveillance method for inflammatory diseases.
In this study fluorescence flow cytometry was shown to measure activation steps of monocytes and polymorphonuclear neutrophils to defined external stimuli. This may potentially be applied as a screening and surveillance method for inflammatory diseases.
Fernandes B
(2007) Am J Clin Pathol; 128: 454:
Automated enumeration of immature granulocytes.
Automated enumeration of immature granulocytes.
Summary:
The result of this study indicates that the automated IG count can replace the manual morphology count and is superior to it.
The result of this study indicates that the automated IG count can replace the manual morphology count and is superior to it.
Ansari-Lari A et al.
(2003) Am J Clin Pathol 120: 795:
Immature granulocyte measurement using the Sysmex XE-2100. Relationship to infection and sepsis.
Immature granulocyte measurement using the Sysmex XE-2100. Relationship to infection and sepsis.
Summary:
In this study the automated IG count matched the manual IG count very well. At significantly elevated levels, it is was shown to be a very specific predictor of sepsis. Multiparameter algorithms might be more successful at lower concentrations.
In this study the automated IG count matched the manual IG count very well. At significantly elevated levels, it is was shown to be a very specific predictor of sepsis. Multiparameter algorithms might be more successful at lower concentrations.
Briggs C et al.
(2000) Clin Lab Haematol; 22: 345:
New quantitative parameters on a recently introduced automated blood cell counter – the XE 2100.
New quantitative parameters on a recently introduced automated blood cell counter – the XE 2100.
Summary:
The authors found that IG count correlated with visual counts thus potentially improving screening and monitoring of various pathological conditions and reducing turnaround time.
The authors found that IG count correlated with visual counts thus potentially improving screening and monitoring of various pathological conditions and reducing turnaround time.
Haematopoietic Progenitor Cells (HPC)
Brochier A et al.
(2024) Clin Chem Lab Med; 62(7): e160:
The added value of automated HPC count: detecting clinically important interferences on the flow cytometric CD34+ cell count.
The added value of automated HPC count: detecting clinically important interferences on the flow cytometric CD34+ cell count.
Summary:
This case report of a peripheral T-cell lymphoma patient describes discrepancies between CD34+ flow count results and HPC count. The clinician decided to initiate apheresis due to increasing HPC counts, because the CD34+ was zero. Investigation of the discrepancy revealed background staining from the patient's plasma in the flow cytometric CD34+ cell count, obscuring the CD34+ stem cells. The authors emphasised the added value of the HPC as complementary method to flow cytometry.
This case report of a peripheral T-cell lymphoma patient describes discrepancies between CD34+ flow count results and HPC count. The clinician decided to initiate apheresis due to increasing HPC counts, because the CD34+ was zero. Investigation of the discrepancy revealed background staining from the patient's plasma in the flow cytometric CD34+ cell count, obscuring the CD34+ stem cells. The authors emphasised the added value of the HPC as complementary method to flow cytometry.
Hagenkötter M et al.
(2024) J Clin Apher; 39(3): e22114:
Comparison of peripheral blood automated hematopoietic progenitor cell count and flow cytometric CD34+ cell count.
Comparison of peripheral blood automated hematopoietic progenitor cell count and flow cytometric CD34+ cell count.
Summary:
A study in 41 patients that underwent apheresis for autologous stem cell transplantation showed that HPC had a very good correlation with CD34+ (r=0.884 in 143 measurements) in mobilised peripheral blood. The correlation in multiple myeloma (r=0.840 in 78 measurements) was lower than in non-myeloma patients (r=0.934 in 65 measurements).
A study in 41 patients that underwent apheresis for autologous stem cell transplantation showed that HPC had a very good correlation with CD34+ (r=0.884 in 143 measurements) in mobilised peripheral blood. The correlation in multiple myeloma (r=0.840 in 78 measurements) was lower than in non-myeloma patients (r=0.934 in 65 measurements).
Lavalleye T et al.
(2024) Transfusion; 64(9): 1743:
Method comparison between hematopoietic progenitor cell and CD34+ cell counts in hematopoietic stem cell collection.
Method comparison between hematopoietic progenitor cell and CD34+ cell counts in hematopoietic stem cell collection.
Summary:
A study in allogeneic and autologous stem cell transplantation donors (n=133 samples) showed that HPC had a varying performance to predict the optimal apheresis starting point (AUC from 0.737 to 0.954). By applying a positive and a negative cut-off for adequate or inadequate stem cell mobilisation respectively, 81% of CD34+ flow cytometry measurements would have been saved in healthy donors, 63% in lymphoma patients, and 24% in multiple myeloma patients.
A study in allogeneic and autologous stem cell transplantation donors (n=133 samples) showed that HPC had a varying performance to predict the optimal apheresis starting point (AUC from 0.737 to 0.954). By applying a positive and a negative cut-off for adequate or inadequate stem cell mobilisation respectively, 81% of CD34+ flow cytometry measurements would have been saved in healthy donors, 63% in lymphoma patients, and 24% in multiple myeloma patients.
Reberšek K et al.
(2021) J Clin Apher; 36(6): 870:
Hematopoietic progenitor cell counting can optimize peripheral blood stem cell apheresis process.
Hematopoietic progenitor cell counting can optimize peripheral blood stem cell apheresis process.
Summary:
This study in autologous and allogeneic stem cell donors showed that HPC correlated well with CD34+ cell count, had a very good diagnostic accuracy to identify the apheresis starting point (AUC 0.852), and to predict both an insufficient (AUC 0.884) or sufficient (AUC 0.769) harvest.
This study in autologous and allogeneic stem cell donors showed that HPC correlated well with CD34+ cell count, had a very good diagnostic accuracy to identify the apheresis starting point (AUC 0.852), and to predict both an insufficient (AUC 0.884) or sufficient (AUC 0.769) harvest.
Dima F et al.
(2020) Blood Transfus; 18(1): 67:
Assessment of haematopoietic progenitor cell counting with the Sysmex® XN-1000 to guide timing of apheresis of peripheral blood stem cells.
Assessment of haematopoietic progenitor cell counting with the Sysmex® XN-1000 to guide timing of apheresis of peripheral blood stem cells.
Summary:
The HPC mode was shown to assess the timing of apheresis and thus improve the apheresis workflow by reducing CD34 tests. The parameter demonstrates excellent diagnostic accuracy in different donor subsets, high precision and a very good correlation with CD34, in this study.
The HPC mode was shown to assess the timing of apheresis and thus improve the apheresis workflow by reducing CD34 tests. The parameter demonstrates excellent diagnostic accuracy in different donor subsets, high precision and a very good correlation with CD34, in this study.
Furundarena JR et al.
(2020) Int J Lab Hematol; 42(2): 170:
Evaluation of the predictive value of the hematopoietic progenitor cell count using an automated hematology analyzer for CD34+ stem cell mobilization and apheresis product yield.
Evaluation of the predictive value of the hematopoietic progenitor cell count using an automated hematology analyzer for CD34+ stem cell mobilization and apheresis product yield.
Summary:
The authors established two decision trees using haematopoietic progenitor cells count for decision making in autologous transplants. One for optimising the rational use of plerixafor in poor mobilisers and the second for decision on the optimal starting point of apheresis.
The authors established two decision trees using haematopoietic progenitor cells count for decision making in autologous transplants. One for optimising the rational use of plerixafor in poor mobilisers and the second for decision on the optimal starting point of apheresis.
Mishra S et al.
(2020) Int J Lab Hematol; 43(1): 76:
A study to compare Hematopoietic Progenitor Cell count determined on a next-generation automated cell counter with flow cytometric CD34 count in peripheral blood and the harvested peripheral blood stem cell graft from autologous and allogenic donors.
A study to compare Hematopoietic Progenitor Cell count determined on a next-generation automated cell counter with flow cytometric CD34 count in peripheral blood and the harvested peripheral blood stem cell graft from autologous and allogenic donors.
Summary:
A study on allogeneic and autologous donors showed that HPC had a very good correlation with CD34+ count in peripheral blood and in the final harvest product, and was an efficient predictor for the optimal time of harvesting of stem cells.
A study on allogeneic and autologous donors showed that HPC had a very good correlation with CD34+ count in peripheral blood and in the final harvest product, and was an efficient predictor for the optimal time of harvesting of stem cells.
Grommé M et al.
(2017) Transfusion; 57(8): 1949:
Multicenter study to evaluate a new enumeration method for hematopoietic stem cell collection management.
Multicenter study to evaluate a new enumeration method for hematopoietic stem cell collection management.
Summary:
In this study, HPC correlates well with the gold standard of CD34 flow cytometry during stem cell mobilisation phase to determine apheresis start time, during apheresis for real-time monitoring and for QC of the final stem cell harvest.
In this study, HPC correlates well with the gold standard of CD34 flow cytometry during stem cell mobilisation phase to determine apheresis start time, during apheresis for real-time monitoring and for QC of the final stem cell harvest.
Park SH et al.
(2015) Ann Lab Med; 35(1): 146:
The New Sysmex XN-2000 Automated Blood Cell Analyzer More Accurately Measures the Absolute Number and the Proportion of Hematopoietic Stem and Progenitor Cells Than XE-2100 When Compared to Flow Cytometric Enumeration of CD34(+) Cells.
The New Sysmex XN-2000 Automated Blood Cell Analyzer More Accurately Measures the Absolute Number and the Proportion of Hematopoietic Stem and Progenitor Cells Than XE-2100 When Compared to Flow Cytometric Enumeration of CD34(+) Cells.
Summary:
In this study, HPC counts from the XN-Series were more accurate than counts from the XE-Series when compared to CD34 flow cytometry.
In this study, HPC counts from the XN-Series were more accurate than counts from the XE-Series when compared to CD34 flow cytometry.
Peerschke El et al.
(2015) Transfusion; 55(8): 2001:
Evaluation of new automated hematopoietic progenitor cell analysis in the clinical management of peripheral blood stem cell collections.
Evaluation of new automated hematopoietic progenitor cell analysis in the clinical management of peripheral blood stem cell collections.
Summary:
In this study, automated haematopoietic progenitor cell analysis was presented as a functional equivalent of CD34 analysis and may be a surrogate for CD34 analysis to predict optimal timing of stem cell collections from mobilised peripheral blood.
In this study, automated haematopoietic progenitor cell analysis was presented as a functional equivalent of CD34 analysis and may be a surrogate for CD34 analysis to predict optimal timing of stem cell collections from mobilised peripheral blood.
Tanosaki R et al.
(2014) Int J Lab Hematol; 36(5): 521:
Novel and rapid enumeration method of peripheral blood stem cells using automated hematology analyzer.
Novel and rapid enumeration method of peripheral blood stem cells using automated hematology analyzer.
Summary:
This study found that CD34-positive cells fall in the area where stem cells locate in the WPC scattergram. The final yield of collected CD34-positive cells could be predicted from the HPC value in pre-apheresis blood and apheresis products.
This study found that CD34-positive cells fall in the area where stem cells locate in the WPC scattergram. The final yield of collected CD34-positive cells could be predicted from the HPC value in pre-apheresis blood and apheresis products.
Intensive Care Infection Score (ICIS RUO)
Vrbacky F et al.
(2025) Int J Lab Hematol; online ahead of print:
Intensive Care Infection Score (ICIS) is an Early Marker for Infection in Time of Admission to Intensive Care Units.
Intensive Care Infection Score (ICIS) is an Early Marker for Infection in Time of Admission to Intensive Care Units.
Summary:
In this cohort of 102 adult ICU patients (n=30 infected, n=72 non-infected), ICIS RUO demonstrated a diagnostic performance for early infection detection at admission, with an AUC of 0.958, outperforming CRP, PCT and IL6. An ICIS RUO cut-off of ≥4 provided a high sensitivity and specificity (93.3% and 84.2%, respectively). Infected patients had significantly higher levels of NEUT-SFL, NEUT#, HFLC#, and IG# (p < 0.0031).
In this cohort of 102 adult ICU patients (n=30 infected, n=72 non-infected), ICIS RUO demonstrated a diagnostic performance for early infection detection at admission, with an AUC of 0.958, outperforming CRP, PCT and IL6. An ICIS RUO cut-off of ≥4 provided a high sensitivity and specificity (93.3% and 84.2%, respectively). Infected patients had significantly higher levels of NEUT-SFL, NEUT#, HFLC#, and IG# (p < 0.0031).
van der Geest PJ et al.
(2016) Crit Care; 20(1): 180:
The intensive care infection score - a novel marker for the prediction of infection and its severity.
The intensive care infection score - a novel marker for the prediction of infection and its severity.
Summary:
ICIS RUO is potentially useful for the prediction of infections in critically ill patients and was shown to be non-inferior to CRP and PCT in this study.
ICIS RUO is potentially useful for the prediction of infections in critically ill patients and was shown to be non-inferior to CRP and PCT in this study.
Weimann K et al.
(2015) J Int Med Res; 43(3): 435:
Intensive Care Infection Score--A new approach to distinguish between infectious and noninfectious processes in intensive care and medicosurgical patients.
Intensive Care Infection Score--A new approach to distinguish between infectious and noninfectious processes in intensive care and medicosurgical patients.
Summary:
In this study, ICIS RUO showed better discriminatory power than CRP and PCT for differentiating between infected and non-infected ICU patients, especially in post-operative patients, and could therefore be useful as a decision-making aid for antibiotic treatment.
In this study, ICIS RUO showed better discriminatory power than CRP and PCT for differentiating between infected and non-infected ICU patients, especially in post-operative patients, and could therefore be useful as a decision-making aid for antibiotic treatment.
Nierhaus A et al.
(2012) Inflamm Allergy Drug Targets; 11(2): 109:
Use of a weighted, automated analysis of the differential blood count to differentiate sepsis from non-infectious systemic inflammation: the intensive care infection score (ICIS).
Use of a weighted, automated analysis of the differential blood count to differentiate sepsis from non-infectious systemic inflammation: the intensive care infection score (ICIS).
Summary:
The Intensive Care Infection Score RUO (ICIS RUO) consists of multiple differential blood count parameters and provides promising potential for reliably and swiftly discriminating sepsis from systemic inflammation (SIRS) in the first critical hours at the ICU, in this study.
The Intensive Care Infection Score RUO (ICIS RUO) consists of multiple differential blood count parameters and provides promising potential for reliably and swiftly discriminating sepsis from systemic inflammation (SIRS) in the first critical hours at the ICU, in this study.
Low WBC mode
SEO JY et al.
(2015) Int J Lab Hematol; 37(2): 155:
Performance evaluation of the new hematology analyzer Sysmex XN-series.
Performance evaluation of the new hematology analyzer Sysmex XN-series.
Summary:
In this comparison study a good correlation between the XN- and XE-Series was found for all parameters. The XN-Series exhibited a dramatically reduced smear rate (by 58%). Even at counts below 500/µL the XN provided an accurate WBC count using the Low WBC mode.
In this comparison study a good correlation between the XN- and XE-Series was found for all parameters. The XN-Series exhibited a dramatically reduced smear rate (by 58%). Even at counts below 500/µL the XN provided an accurate WBC count using the Low WBC mode.
Tanaka Y et al.
(2014) Int J Hematol. 36(4): e50:
Elimination of interference by lipids in the Low WBC mode in the automated hematology analyzer XN-2000.
Elimination of interference by lipids in the Low WBC mode in the automated hematology analyzer XN-2000.
Summary:
The study shows that potential interferences by the contamination of lipids have been eliminated in the two leukocyte channels of the XN-Series, particularly compared to non-fluorescent methods. Furthermore, the new Low WBC mode showed better precision for leukocytopenic samples than the whole blood (WB) mode.
The study shows that potential interferences by the contamination of lipids have been eliminated in the two leukocyte channels of the XN-Series, particularly compared to non-fluorescent methods. Furthermore, the new Low WBC mode showed better precision for leukocytopenic samples than the whole blood (WB) mode.
Lymphocytes
Chiriac R et al.
(2024) Int J Lab Hematol; 47(2): 345:
Differential Diagnosis of Lymphocytosis in Routine Laboratory Practice: Contribution of Lymphocyte Parameters Generated by the New Sysmex XR-1000 Hematology Analyzer.
Differential Diagnosis of Lymphocytosis in Routine Laboratory Practice: Contribution of Lymphocyte Parameters Generated by the New Sysmex XR-1000 Hematology Analyzer.
Summary:
A study of lymphocyte-related parameters in 288 samples with lymphocytosis (>5 x 10^9/L) showed that LY-X, LY-Y and LY-Z were statistically different between reactive samples (n=100) and several groups of T- and B-cell malignancies (n=188).
A study of lymphocyte-related parameters in 288 samples with lymphocytosis (>5 x 10^9/L) showed that LY-X, LY-Y and LY-Z were statistically different between reactive samples (n=100) and several groups of T- and B-cell malignancies (n=188).
Kallen ME et al.
(2024) J Hematop; 17(4): 231:
Carvykti CAR T‑cell morphology in cellavision peripheral smear reviews.
Carvykti CAR T‑cell morphology in cellavision peripheral smear reviews.
Summary:
The authors report on four patients and their lymphocyte morphology of CAR T-cell expansion in the context of CAR T-cell therapy. CellaVision DM9600 confirmed the expansion of atypical lymphocytes (CAR T-cells) with kinetics very similar to those reported by Faude S et al. 2021.
The authors report on four patients and their lymphocyte morphology of CAR T-cell expansion in the context of CAR T-cell therapy. CellaVision DM9600 confirmed the expansion of atypical lymphocytes (CAR T-cells) with kinetics very similar to those reported by Faude S et al. 2021.
Lesesve JF et al.
(2022) Mediterr J Hematol Infect Dis; 14(1): e2022024:
CAR-T Cells Microscopic and Phenotypic Identification in the Peripheral Blood.
CAR-T Cells Microscopic and Phenotypic Identification in the Peripheral Blood.
Summary:
The case study of a woman with large B-cell lymphoma treated with CAR-T cells highlights the value of close monitoring of treatment progress after CAR-T cell infusion with WDF channel. WDF scattergrams and peripheral blood smear found atypical lymphocytes that could represent the proliferating CAR-T cells.
The case study of a woman with large B-cell lymphoma treated with CAR-T cells highlights the value of close monitoring of treatment progress after CAR-T cell infusion with WDF channel. WDF scattergrams and peripheral blood smear found atypical lymphocytes that could represent the proliferating CAR-T cells.
Rutkowska E et al.
(2021) Cells; 10(1): 82:
Usefulness of the New Hematological Parameter: Reactive Lymphocytes RE-LYMP with Flow Cytometry Markers of Inflammation in COVID-19.
Usefulness of the New Hematological Parameter: Reactive Lymphocytes RE-LYMP with Flow Cytometry Markers of Inflammation in COVID-19.
Summary:
A study on patients with viral infections showed that RE-LYMP% correlated with the presence of plasmablasts (activated B cells). RE-LYMP also correlated with activation markers on CD4+ and CD8+ T cells in COVID-19 (CD8+ CD45RO+) or other infections (CD38+ and HLA-DR+).
A study on patients with viral infections showed that RE-LYMP% correlated with the presence of plasmablasts (activated B cells). RE-LYMP also correlated with activation markers on CD4+ and CD8+ T cells in COVID-19 (CD8+ CD45RO+) or other infections (CD38+ and HLA-DR+).
Urrechaga E et al.
(2021) Scand J Clin Lab Invest; 81(5): 394:
Leukocyte differential and reactive lymphocyte counts from Sysmex XN analyzer in the evaluation of SARS-CoV-2 infection.
Leukocyte differential and reactive lymphocyte counts from Sysmex XN analyzer in the evaluation of SARS-CoV-2 infection.
Summary:
The prospective observational study aimed to assess the diagnostic performance in distinguishing SARS-CoV-2 infections from other viral or bacterial infections in emergency room (ER) patients presenting with fever. NLR > 3.3 and RE-LYMP >0.6% correctly distinguished 95.6% of SARS-CoV-2 infection patients in the validation group (bacterial and viral infected ER patients).
The prospective observational study aimed to assess the diagnostic performance in distinguishing SARS-CoV-2 infections from other viral or bacterial infections in emergency room (ER) patients presenting with fever. NLR > 3.3 and RE-LYMP >0.6% correctly distinguished 95.6% of SARS-CoV-2 infection patients in the validation group (bacterial and viral infected ER patients).
Tantanate C et al.
(2018) Lab Med; 49(4): 362:
Performance Evaluation of High Fluorescence Lymphocyte Count: Comparability to Atypical Lymphocyte Count and Clinical Significance.
Performance Evaluation of High Fluorescence Lymphocyte Count: Comparability to Atypical Lymphocyte Count and Clinical Significance.
Summary:
An analysis of 320 blood samples showed that the HLFC parameter from the XN-3000 was higher in samples with infection (n=229), and correlated well with the atypical lymphocytes from the microscopic examination (r=0.865 for counts, and r=0.893 for percentages). HFLC predicted the presence of atypical lymphocytes in the blood smear with an 80% sensitivity in this study.
An analysis of 320 blood samples showed that the HLFC parameter from the XN-3000 was higher in samples with infection (n=229), and correlated well with the atypical lymphocytes from the microscopic examination (r=0.865 for counts, and r=0.893 for percentages). HFLC predicted the presence of atypical lymphocytes in the blood smear with an 80% sensitivity in this study.
Henriot I et al.
(2017) Int J Lab Hematol; 39(1): 14:
New parameters on the hematology analyzer XN-10 (SysmexTM) allow to distinguish childhood bacterial and viral infections.
New parameters on the hematology analyzer XN-10 (SysmexTM) allow to distinguish childhood bacterial and viral infections.
Summary:
The study investigated new parameters from the Sysmex XN in children with fever. The authors found that the parameter AS-LYMP was significantly higher in children with viral infections. The parameter AS-LYMP (AUC=0.83) had the same discrimination power as procalcitonin (AUC=0.82) to distinguish between bacterial and viral infections in this cohort.
The study investigated new parameters from the Sysmex XN in children with fever. The authors found that the parameter AS-LYMP was significantly higher in children with viral infections. The parameter AS-LYMP (AUC=0.83) had the same discrimination power as procalcitonin (AUC=0.82) to distinguish between bacterial and viral infections in this cohort.
Sale S et al.
(2016) J Clin Lab Anal; 30(5): 779:
Detection of Apoptotic Lymphocytes Through Sysmex XN-1000 As a Diagnostic Marker for Mononucleosis Syndrome.
Detection of Apoptotic Lymphocytes Through Sysmex XN-1000 As a Diagnostic Marker for Mononucleosis Syndrome.
Summary:
The authors propose a new algorithm that integrates the 'Atypical Lympho?' flag, lymphocyte structural parameters (LY-WX, LY-WY, LY-WZ) and presence of events in area of the FCS-SSC and SFL-SSC scattergrams and could aid in the diagnosis of infectious mononucleosis.
The authors propose a new algorithm that integrates the 'Atypical Lympho?' flag, lymphocyte structural parameters (LY-WX, LY-WY, LY-WZ) and presence of events in area of the FCS-SSC and SFL-SSC scattergrams and could aid in the diagnosis of infectious mononucleosis.
Brisou G et al.
(2015) J ClinLab Anal: 29(2): 153:
Alarms and Parameters Generated by Hematology Analyzer: New Tools to Predict and Quantify Circulating Sezary Cells.
Alarms and Parameters Generated by Hematology Analyzer: New Tools to Predict and Quantify Circulating Sezary Cells.
Summary:
The authors combined the 'Blasts/Abn Lympho?' flag with the LY-X and LY-Y parameters to differentiate Sezary patients from control patients (sensitivity 89%; specificity 98%) or from patients with chronic lymphoproliferative diseases (sensitivity 89%; specificity 94%). The proposed algorithm could alert the microscopist that a sample likely contains Sezary cells.
The authors combined the 'Blasts/Abn Lympho?' flag with the LY-X and LY-Y parameters to differentiate Sezary patients from control patients (sensitivity 89%; specificity 98%) or from patients with chronic lymphoproliferative diseases (sensitivity 89%; specificity 94%). The proposed algorithm could alert the microscopist that a sample likely contains Sezary cells.
Oehadian A et al.
(2015) Int J Lab Hematol; 37(6): 861:
New parameters available on Sysmex XE-5000 hematology analyzers contribute to differentiating dengue from leptospirosis and enteric fever.
New parameters available on Sysmex XE-5000 hematology analyzers contribute to differentiating dengue from leptospirosis and enteric fever.
Summary:
This study investigated how detection of atypical lymphocytes, high-fluorescent lymphocytes and immature granulocytes on the XE-5000 supports the differentiation between common causes of febrile illnesses with thrombocytopenia in dengue areas.
This study investigated how detection of atypical lymphocytes, high-fluorescent lymphocytes and immature granulocytes on the XE-5000 supports the differentiation between common causes of febrile illnesses with thrombocytopenia in dengue areas.
Van Mirre E et al.
(2011) Clin Chem Lab Med; 49: 685:
Sensitivity and specificity of the high fluorescent lymphocyte count-gate on the Sysmex XE-5000 hematology analyzer for detection of peripheral plasma cells.
Sensitivity and specificity of the high fluorescent lymphocyte count-gate on the Sysmex XE-5000 hematology analyzer for detection of peripheral plasma cells.
Summary:
The authors showed that Sysmex XE-5000 was suitable for screening blood samples for the presence of elevated numbers of plasma cells in peripheral blood.
The authors showed that Sysmex XE-5000 was suitable for screening blood samples for the presence of elevated numbers of plasma cells in peripheral blood.
Linssen J et al.
(2007) Cytometry B (Clin Cytometry) 72: 157–166. Reprinted in: Sysmex J Int 19(1): 19–25.:
Identification and quantification of high fluorescence-stained lymphocytes as antibody synthesizing/secreting cells using the automated routine hematology analyzer XE-2100.
Identification and quantification of high fluorescence-stained lymphocytes as antibody synthesizing/secreting cells using the automated routine hematology analyzer XE-2100.
Summary:
This study demonstrates that the Sysmex high-fluorescence lymphocyte count quantifies activated B-lymphocytes with high precision and reliability in patients without haematological systemic diseases, thus providing a potential screening and monitoring tool for a suspected infection.
This study demonstrates that the Sysmex high-fluorescence lymphocyte count quantifies activated B-lymphocytes with high precision and reliability in patients without haematological systemic diseases, thus providing a potential screening and monitoring tool for a suspected infection.
Monocytes
Cornet E et al.
(2024) Int J Lab Hematol; 46(5): 971:
Applicability of mono dysplasia score on the new Sysmex XR analyzer range to predict diagnosis of chronic myelomonocytic leukaemia.
Applicability of mono dysplasia score on the new Sysmex XR analyzer range to predict diagnosis of chronic myelomonocytic leukaemia.
Summary:
A study of 316 patients with monocytosis showed that a mono-dysplasia score > 0.16 calculated on XR-Series could differentiate CMML samples (n=22) from reactive monocytosis cases (n=294) with an AUC of 0.994, sensitivity 100% and specificity of 95.2%.
A study of 316 patients with monocytosis showed that a mono-dysplasia score > 0.16 calculated on XR-Series could differentiate CMML samples (n=22) from reactive monocytosis cases (n=294) with an AUC of 0.994, sensitivity 100% and specificity of 95.2%.
Kouame H et al.
(2023) AHRJ; 6(3): 104:
Monocytosis / Monocytic Dysplasia: Testing a New Diagnostic Tool Using Sysmex XN Analyzer Parameters.
Monocytosis / Monocytic Dysplasia: Testing a New Diagnostic Tool Using Sysmex XN Analyzer Parameters.
Summary:
A study in 263 patients with monocytosis (≥1x10^9/L and >10%) showed that the mono-dysplasia score (described in Schillinger F et al. 2018) had a sensitivity of 100% and a specificity of 96.4% in identifying samples with monocytic dysplasia.
A study in 263 patients with monocytosis (≥1x10^9/L and >10%) showed that the mono-dysplasia score (described in Schillinger F et al. 2018) had a sensitivity of 100% and a specificity of 96.4% in identifying samples with monocytic dysplasia.
Zhu J et al.
(2019) Int J Lab Hematol; 41(6): 782:
A hierarchical approach in the diagnostic workflow of chronic myelomonocytic leukemia: Pivotal role of the "Mono-dysplasia-score" combined with flow cytometric quantification of monocyte subsets.
A hierarchical approach in the diagnostic workflow of chronic myelomonocytic leukemia: Pivotal role of the "Mono-dysplasia-score" combined with flow cytometric quantification of monocyte subsets.
Summary:
The authors set up a workflow for monocytosis samples including Mono-dysplasia score, smear review and flow cytometry. The proposed mono-dysplasia score was shown to be a valuable filter for reducing the number of smears without losing sensitivity for CMML suspicious samples.
The authors set up a workflow for monocytosis samples including Mono-dysplasia score, smear review and flow cytometry. The proposed mono-dysplasia score was shown to be a valuable filter for reducing the number of smears without losing sensitivity for CMML suspicious samples.
Buoro S et al.
(2018) Int J Lab Hematol; 40(5): 577:
Evaluation and comparison of automated hematology analyzer, flow cytometry, and digital morphology analyzer for monocyte counting.
Evaluation and comparison of automated hematology analyzer, flow cytometry, and digital morphology analyzer for monocyte counting.
Summary:
Comparison of the XN-9000, CyFlow Space System and DI-60 compared with OM (optical microscopy) for the monocyte count revealed a better performance and higher values for flow cytometry than OM and DI-60 which have also a higher imprecision. The authors conclude also that the absolute monocyte count may be more reliable.
Comparison of the XN-9000, CyFlow Space System and DI-60 compared with OM (optical microscopy) for the monocyte count revealed a better performance and higher values for flow cytometry than OM and DI-60 which have also a higher imprecision. The authors conclude also that the absolute monocyte count may be more reliable.
Schillinger F et al.
(2017) Scand J Clin Lab Invest; 78(3):159:
A new approach for diagnosing chronic myelomonocytic leukemia using structural parameters of Sysmex XN analyzers in routine laboratory practice.
A new approach for diagnosing chronic myelomonocytic leukemia using structural parameters of Sysmex XN analyzers in routine laboratory practice.
Summary:
The study presents a score derived from Sysmex XN parameters that identifies possible CMML samples by excluding reactive monocytes. This reduces the smear review workload.
The study presents a score derived from Sysmex XN parameters that identifies possible CMML samples by excluding reactive monocytes. This reduces the smear review workload.
Mazumdar R et al.
(2013) Leukemia Research; 37(6): 614:
The automated monocyte count is independently predictive of overall survival from diagnosis in chronic lymphocytic leukaemia and of survival following first-line chemotherapy.
The automated monocyte count is independently predictive of overall survival from diagnosis in chronic lymphocytic leukaemia and of survival following first-line chemotherapy.
Summary:
The authors found that a monocyte count >0.91 ×109/L at the time of diagnosis was associated with a shortened overall and treatment-free survival in CLL patients in this cohort.
The authors found that a monocyte count >0.91 ×109/L at the time of diagnosis was associated with a shortened overall and treatment-free survival in CLL patients in this cohort.
Reference intervals
Laugesen K et al.
(2024) Clin Chem Lab Med; 63(4): 812:
Paediatric reference intervals for haematology parameters analysed on Sysmex XN-9000: a comparison of methods in the framework of indirect sampling.
Paediatric reference intervals for haematology parameters analysed on Sysmex XN-9000: a comparison of methods in the framework of indirect sampling.
Summary:
The study presents indirectly determined reference intervals (RI) of 13 CBC parameters for paediatric patients (0-18 years) in a Caucasian population (n= 10,199) on XN-9000. Data were stratified by age and sex where statistically necessary (except for < 1 year). Comparing to a direct method (Bohn et al.) as a verification the authors found only minor differences.
The study presents indirectly determined reference intervals (RI) of 13 CBC parameters for paediatric patients (0-18 years) in a Caucasian population (n= 10,199) on XN-9000. Data were stratified by age and sex where statistically necessary (except for < 1 year). Comparing to a direct method (Bohn et al.) as a verification the authors found only minor differences.
Bildirici A et al.
(2023) Turk J Biochem; 48(4): 388:
Determination of reference intervals of hemogram with advanced clinical parameters by indirect method on Sysmex XN-1000.
Determination of reference intervals of hemogram with advanced clinical parameters by indirect method on Sysmex XN-1000.
Summary:
This publication presents CBC+DIFF reference intervals of 68 316 patients aged 18–65 years as determined by the indirect method using the non-parametric percentage estimation in the Turkish Kastamonu Training and Research Hospital.
This publication presents CBC+DIFF reference intervals of 68 316 patients aged 18–65 years as determined by the indirect method using the non-parametric percentage estimation in the Turkish Kastamonu Training and Research Hospital.
Mrosewski I et al.
(2023) Clin Chem Lab Med; 61(6): 1116:
Indirectly determined reference intervals for automated white blood cell differentials of pediatric patients in Berlin and Brandenburg.
Indirectly determined reference intervals for automated white blood cell differentials of pediatric patients in Berlin and Brandenburg.
Summary:
The study presents indirectly determined WBC differential reference intervals (RI) for paediatric patients (0-18 years) in Berlin and Brandenburg area in Germany. No RI for DIFF parameters are available for children < 7 months.
The study presents indirectly determined WBC differential reference intervals (RI) for paediatric patients (0-18 years) in Berlin and Brandenburg area in Germany. No RI for DIFF parameters are available for children < 7 months.
Becker M et al.
(2022) Int J Lab Hematol; 44(4): 729:
Differences between capillary and venous blood counts in children—A data mining approach.
Differences between capillary and venous blood counts in children—A data mining approach.
Summary:
In this multicentric study the differences between capillary and venous bloods were investigated in paediatric samples specifying a delta for the CBC parameters dependant on measurement range of the parameter value, time difference in sampling and age of the patient.
In this multicentric study the differences between capillary and venous bloods were investigated in paediatric samples specifying a delta for the CBC parameters dependant on measurement range of the parameter value, time difference in sampling and age of the patient.
L van Pelt J et al.
(2022) Clin Chem Lab Med; 60(6): 907:
Reference intervals for Sysmex XN hematological parameters as assessed in the Dutch Lifelines cohort.
Reference intervals for Sysmex XN hematological parameters as assessed in the Dutch Lifelines cohort.
Summary:
The publication provides reference intervals for 105 XN parameters (incl. functional and cell activation parameters) based on data of 15,803 healthy individuals from the Lifelines cohort in the Netherlands. The reference intervals were calculated in accordance to the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) recommended statistical methods.
The publication provides reference intervals for 105 XN parameters (incl. functional and cell activation parameters) based on data of 15,803 healthy individuals from the Lifelines cohort in the Netherlands. The reference intervals were calculated in accordance to the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) recommended statistical methods.
Angelo A et al.
(2021) BMC Pediatrics; 21: 275:
Umbilical cord blood hematological parameters reference interval for newborns from Addis Ababa, Ethiopia.
Umbilical cord blood hematological parameters reference interval for newborns from Addis Ababa, Ethiopia.
Summary:
This pilot study enrolled 139 umbilical cord blood samples from healthy newborns to establish reference values for the KX-21N. For WBC, RBC, and NEUT significant differences were found between caesarean and natural birth.
This pilot study enrolled 139 umbilical cord blood samples from healthy newborns to establish reference values for the KX-21N. For WBC, RBC, and NEUT significant differences were found between caesarean and natural birth.
Dockree S et al.
(2021) EBioMedicine; 74: 102715:
White blood cells in pregnancy: reference intervals for before and after delivery
White blood cells in pregnancy: reference intervals for before and after delivery
Summary:
The study established pregnancy-specific reference intervals for WBC subtypes for use between 8-40 weeks of gestational age and 7-21 days postnatally based on 80,637 blood measurements from 24,318 women from the UK.
The study established pregnancy-specific reference intervals for WBC subtypes for use between 8-40 weeks of gestational age and 7-21 days postnatally based on 80,637 blood measurements from 24,318 women from the UK.
Mrosewski I et al.
(2021) Clin Chem Lab Med; 60(3): 408:
Indirectly determined hematology reference intervals for pediatric patients in Berlin and Brandenburg.
Indirectly determined hematology reference intervals for pediatric patients in Berlin and Brandenburg.
Summary:
The study presents indirectly determined CBC reference intervals (RI) for paediatric patients (0-18 years) in Berlin and Brandenburg area in Germany.
The study presents indirectly determined CBC reference intervals (RI) for paediatric patients (0-18 years) in Berlin and Brandenburg area in Germany.
Song MY et al.
(2021) Int J Lab Hematol; 43(6): 1363:
Establishment of pediatric reference intervals for complete blood count parameters in capillary blood in Beijing.
Establishment of pediatric reference intervals for complete blood count parameters in capillary blood in Beijing.
Summary:
The authors established reference intervals for 22 CBC+DIFF parameters from capillary blood in 6,799 children aged 3 months to 18 years from Beijing area in China.
The authors established reference intervals for 22 CBC+DIFF parameters from capillary blood in 6,799 children aged 3 months to 18 years from Beijing area in China.
Wilson S et al.
(2021) Int J Lab Hematol; 43(6): 1394:
Continuous reference curves for common hematology markers in the CALIPER cohort of healthy children and adolescents on the Sysmex XN-3000 system.
Continuous reference curves for common hematology markers in the CALIPER cohort of healthy children and adolescents on the Sysmex XN-3000 system.
Summary:
This is the first study published on continuous reference intervals (curves) of healthy children and adolescents for 19 haematological XN parameters. Seven parameters required sex-specific reference curves. Continuous reference intervals were found to be accurate estimate of haematological reference ranges over the paediatric age range.
This is the first study published on continuous reference intervals (curves) of healthy children and adolescents for 19 haematological XN parameters. Seven parameters required sex-specific reference curves. Continuous reference intervals were found to be accurate estimate of haematological reference ranges over the paediatric age range.
Bohn MK et al.
(2020) Int J Lab Hematol; 42(6): 759:
Complex biological patterns of hematology parameters in childhood necessitating age- and sex-specific reference intervals for evidence-based clinical interpretation.
Complex biological patterns of hematology parameters in childhood necessitating age- and sex-specific reference intervals for evidence-based clinical interpretation.
Summary:
The study establishes a comprehensive paediatric (birth to 21 years) reference intervals for haematology parameters using the XN analyser. The data highlight the dynamic haematological profiles observed in healthy children and adolescents and the need for reference interval stratification by age and sex.
The study establishes a comprehensive paediatric (birth to 21 years) reference intervals for haematology parameters using the XN analyser. The data highlight the dynamic haematological profiles observed in healthy children and adolescents and the need for reference interval stratification by age and sex.
Florin L et al.
(2020) Int J Lab Hematol; 42(3): e110:
Establishment of common reference intervals for hematology parameters in adults, measured in a multicenter study on the Sysmex XN-series analyzer.
Establishment of common reference intervals for hematology parameters in adults, measured in a multicenter study on the Sysmex XN-series analyzer.
Summary:
The study provides reference intervals (CBC+DIFF+RET) that could serve as reference values for haematology parameters in adults for laboratories that use the XN-Series analysers.
The study provides reference intervals (CBC+DIFF+RET) that could serve as reference values for haematology parameters in adults for laboratories that use the XN-Series analysers.
Zierk J et al.
(2019) Clin Chem Lab Med; 57(10): 1595:
Next-generation reference intervals for pediatric hematology.
Next-generation reference intervals for pediatric hematology.
Summary:
The authors determined percentile charts and z-scores for CBC reference intervals from birth to adulthood. A total of 9,576,910 specimens were gathered from ten German facilities and analysed using predominantly Sysmex X-Class and XN-Class analysers and one Beckman Coulter DxH800 analyser.
The authors determined percentile charts and z-scores for CBC reference intervals from birth to adulthood. A total of 9,576,910 specimens were gathered from ten German facilities and analysed using predominantly Sysmex X-Class and XN-Class analysers and one Beckman Coulter DxH800 analyser.
Arbiol-Roca A et al.
(2018) EJIFCC; 29(1): 48:
Reference intervals for a complete blood count on an automated haematology analyser Sysmex XN in healthy adults from the southern metropolitan area of Barcelona.
Reference intervals for a complete blood count on an automated haematology analyser Sysmex XN in healthy adults from the southern metropolitan area of Barcelona.
Summary:
The aim of the study was to establish reference intervals for CBC, DIFF and reticulocytes for a Spanish population. Significant gender differences were found for RBC, PLT, HCT and HGB.
The aim of the study was to establish reference intervals for CBC, DIFF and reticulocytes for a Spanish population. Significant gender differences were found for RBC, PLT, HCT and HGB.
Ozarda Y et al.
(2017) Clin Chem Lab Med; 57(1): 30:
Verification of reference intervals in routine clinical laboratories - practical challenges and recommendations.
Verification of reference intervals in routine clinical laboratories - practical challenges and recommendations.
Summary:
The opinion paper summarises guidelines and approaches for the verification of reference intervals (RI) in routine clinical laboratories. It gives definitions for common terms, refers to examples and covers challenges such as RI for geriatric and paediatric populations.
The opinion paper summarises guidelines and approaches for the verification of reference intervals (RI) in routine clinical laboratories. It gives definitions for common terms, refers to examples and covers challenges such as RI for geriatric and paediatric populations.
Cornet E et al.
(2015) Int J of Lab Hematol.: 37(5): e123:
Contribution of the new XN-1000 parameters NEUT-RI and NEUT-WY for managing patients with immature granulocytes.
Contribution of the new XN-1000 parameters NEUT-RI and NEUT-WY for managing patients with immature granulocytes.
Summary:
In this study, reference values were determined on the XN-Series for the structural neutrophil parameters NEUT-GI, NEUT-RI, and NEUT-WY. In addition, the authors demonstrated a value for NEUT-RI and NEUT-WY to predict IG% values within a 72 hour-time frame.
In this study, reference values were determined on the XN-Series for the structural neutrophil parameters NEUT-GI, NEUT-RI, and NEUT-WY. In addition, the authors demonstrated a value for NEUT-RI and NEUT-WY to predict IG% values within a 72 hour-time frame.
Zimmermann M et al.
(2015) Clin Lab; 61: 235:
Detection and quantification of hypo- and hypergranulated neutrophils on the new Sysmex XN hematology analyzer: establishment of an adapted reference interval for the neutrophil-granularity-intensity compared to XE-technology in adult patients.
Detection and quantification of hypo- and hypergranulated neutrophils on the new Sysmex XN hematology analyzer: establishment of an adapted reference interval for the neutrophil-granularity-intensity compared to XE-technology in adult patients.
Summary:
In this study, the reference intervals for NEUT-GI (XN-Series) and NEUT-X (XE-series) were determined using 246 blood-healthy control patients: 140.91 - 160.46 channels and 129.20 - 142.33 channels, respectively. Neutrophil granularity was higher in ICU patients.
In this study, the reference intervals for NEUT-GI (XN-Series) and NEUT-X (XE-series) were determined using 246 blood-healthy control patients: 140.91 - 160.46 channels and 129.20 - 142.33 channels, respectively. Neutrophil granularity was higher in ICU patients.
Roehrl MHA et al.
(2011) Arch Pathol Lab Med; 135: 471:
Age-dependent reference ranges for automated assessment of immature granulocytes and clinical significance in an outpatient setting.
Age-dependent reference ranges for automated assessment of immature granulocytes and clinical significance in an outpatient setting.
Summary:
In this study, the use of appropriate reference ranges made the IG count a powerful haematologic parameter for outpatient care that was associated with differential diagnoses that were distinctly characteristic of that setting.
In this study, the use of appropriate reference ranges made the IG count a powerful haematologic parameter for outpatient care that was associated with differential diagnoses that were distinctly characteristic of that setting.