A Picture is Worth a Thousand Words

• A Picture is Worth a Thousand Words

AUTHOR(S)

R. M. ROWAN and J. LINSSEN

Sysmex Europe GmbH

SUMMARY

During the past forty years blood cell analysers have developed from comparatively simple semi-automated single parameter devices producing only numerical data to fully automated complex multiparameter devices frequently employing multiple technologies and producing a bewildering array of numerical and graphical parameters. The history of these developments is well described in a text by Groner and Simson in 1995. In spite of these developments, however, many laboratories continue to ignore all but the numerical output of analyzers, which they report to the clinician frequently as uninterpreted data. Raw data often has minimal or no information content. For many, routine analytical haematology remains locked into a time frame defined by Wintrobe in the 1930s. Modern cell counters, however, provide significant additional information, some of which overlaps that obtained at the microscope and some that is undoubtedly new. The latter possesses the capability to improve patient care both in a diagnostic and in a therapy monitoring sense. Ignoring these new parameters including the graphics is tantamount to ‘throwing the baby out with the bath water’, which seems to be a bad practice. At least six companies now produce multiparameter haematology analysers but employ various often subtly different methods and reagents for identifying and classifying cells. As a result a series of instrument specific parameters is produced and for correct clinical interpretation the particular method used must be known. The principles of measurement employed in haematology analysers manufactured by the Sysmex Corporation have recently been reviewed by Fujimoto.

This is the first of a series of articles describing the graphical output of the Sysmex XE-2100 and illustrating examples of clinical benefit following the scrutiny and analysis of scattergrams. The clinical cases illustrated come from a variety of sources within Europe and Sysmex is very grateful to the many clinicians who have given permission for their publication. A detailed description of these cases together with others is available and can be found on the Sysmex Europe homepage. A new case contribution is submitted every month.