Cindy UPTMORE＊１, Barbara CONNELL＊１, David HART＊２, and David S. HELMS＊２
*1 Sysmex Corporation of America
*2 Clarian Health Partners, Department of Pathology and Laboratory Medicine, Division of Hematopathology
The Sysmex XE-2100 automated hematology analyzer was evaluated at Clarian Health Partners ( CHP ), Indianapolis, IN. Results from 251 patient samples were compared to the Abbott Cell-Dyn 4000 ( CD-4000 ). The XE-2100 showed good correlation with the results to the CD-4000 for the following parameters: white blood cell ( WBC ), neutrophil ( NEUT ) %, lymphocyte ( LYMPH ) %, monocyte ( MONO ) %, eosinophil ( EO ) %, basophil ( BASO ) %, red blood cell ( RBC ), hemoglobin ( HGB ), hematocrit ( HCT ), mean corpuscular volume ( MCV ), mean corpuscular hemoglobin ( MCH ), reticulocyte ( RET )%, impedance platelet ( PLT-I ), optical platelet ( PLT-O ). Sensitivity studies performed for the overall flagging capabilities showed the XE-2100 to have significantly lower false negatives ( FN ) than the CD-4000, although CD-4000 had a lower false positive ( FP ) rate. In this study we also looked at what adjustments to the Qflags on the XE would do to the flagging. We found that lower FN and lower FP than the CD-4000 could be obtained on the XE-2100 if the Q-flags were adjusted. Q-Flags are adjustable settings that allow for the customization of the XE-2100 flagging sensitivities to meet the individual requirements of your laboratory. In reviewing the nucleated red blood cells ( NRBC ) enumeration capabilities we found the XE-2100 to have fewer FN than the CD-4000 for detection of NRBC’s. The CD-4000 correctly enumerated NRBC’s on 90% of the samples with NRBC’s present. The XE-2100 correctly enumerated NRBC’s on 97% of the samples with NRBC’s. Stability studies were performed on both analyzers. The XE-2100 proved to be stable up to 48 hours for the WBC, RBC, HGB, HCT, MCV, PLT, NEUT%, LYMPH%, MONO%, EO% and BASO%. We also found most of the XE parameters stable well beyond 48 hours with the exception of the MONO% ( 48 hours at refrigerated temps ) and MCV and MCHC, which were stable for 36 hours. The CD-4000 proved to be stable up to 36 hours for the WBC, RBC, HGB, HCT, MCV, PLT-I, PLT-O, NEUT%, LYMPH%, MONO%, EO% and BASO%. We found most of the CD-4000 parameters stable up to 48 hours with the exception of the EO%. The PLT-I and PLT-O comparisons of the XE-2100 and CD-4000 were good with r2 values >0.90.
The XE-2100 is a fully automated hematology analyzer with simultaneous analysis of 32 parameters ( 26 reportable in the USA ) including the NRBC and immature reticulocyte fraction ( IRF ) parameters. The XE-2100 uses several methodologies from previous Sysmex instrumentation along with a newly developed fluorescent optical detection unit for the following parameters: WBC, WBC differential, NRBC #, RET# and PLT-O #. The XE-2100 can process approximately 150 samples per hour, has various discrete analysis capabilities for cost-effective testing, and uses Windows NT system for easy operation.
Automated Hematology Analyzer, XE-2100, Comparison, Q-Flags