Sysmex Journal International

2020Vol.30 No.1


Evaluation of the Automated Nucleated Red Blood Cell (NRBC) Enumeration on Sysmex XN Analyser in Preterm and Term Neonates


Ondrej VALINA*1, Jo LINSSEN*1, Jacqueline RUTSCHE*2 and Kurt LEIBUNDGUT*2

*1 Sysmex Europe GmbH
*2 Department of Paediatrics, Bern University Hospital


Introduction: Increased NRBC values are associated with poor postnatal prognosis of neonates. The described study compares preterm and term neonatal NRBC counts at various levels by traditional microscopic manual counts and automated NRBC counts using the Sysmex XN-Series analyser. Furthermore, mean NRBC counts (%) at various postnatal days were determined.

Methods: One hundred and twenty-one samples from preterm and term neonates were included in the study and evaluated microscopically and on a Sysmex XN-Series analyser. The NRBC values from the analyser were used to determine mean NRBC counts (%) at various postnatal days for term as well as preterm neonates.

Results: A comparison between the manual and Sysmex XN counts for all 121 samples, assessed by Passing-Bablok regression, revealed a good correlation with regression equation y = 0.998x + 0.201. For samples with both manual and Sysmex Automated Hematology Analyzer XN-Series counts in the range of 0–10% (99 samples) Bland-Altman analysis showed a mean bias of -0.5% with 95% limits of agreement between -3.4% and 2.5%. The mean NRBC counts (%) at different postnatal days for term and preterm neonates showed a significant difference between these groups. A significant drop in the percentage NRBC was seen for all groups from the day of birth to 2–4 days after birth.

Conclusion: The results indicate that the automated NRBC counts in neonatal samples correlate well with the manual counts. The Sysmex Automated Hematology Analyzer XN-Series count is accurate and effective for the analysis of neonates’ NRBC.


NRBC, Sysmex XN, Neonates, Enumeration, Evaluation


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