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Performance evaluation of Sysmex XN hematology analyzer in umbilical cord blood: a comparison study with Sysmex XE-2100

  • Hanah Kim , Mina Hur EMAIL logo , Sang-Gyeu Choi , Hee-Won Moon , Yeo-Min Yun , Han Sung Hwang , Han Sung Kwon and In Sook Sohn
Published/Copyright: June 30, 2014
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 52 Issue 12

Abstract

Background: The Sysmex XN (XN) modular system (Sysmex, Kobe, Japan) is a new automated hematology analyzer equipped with different principles from its previous version, Sysmex XE-2100. We compared the performances of Sysmex XN and XE-2100 in umbilical cord blood (CB) specimens.

Methods: In 160 CB specimens, complete blood count (CBC) parameters and white blood cells (WBC) differentials were compared between the two analyzers. Their flagging performances for blasts, abnormal/atypical lymphocytes, immature granulocytes and/or left-shift (IG), and nucleated red blood cells (NRBC) counts were compared with manual counts. For the blast flagging, Q values by Sysmex XN were further compared with manual slide review.

Results: Sysmex XN and XE-2100 showed high or very high correlations for most CBC parameters but variable correlations for WBC differentials. Compared with XE-2100, XN showed significantly different flagging performances for blasts, abnormal/atypical lymphocytes, and IG. The flagging efficiency for blasts was significantly better on Sysmex XN than on XE-2100 (85.0% vs. 38.8%): Sysmex XN showed a remarkably increased specificity of blast flag, compromising its sensitivity of blast flag. Among the 24 specimens with blasts (range, 0.5%–1.5%), only one (4.2%) showed a positive Q value.

Conclusions: This study highlighted the remarkable differences of flagging performances between Sysmex XN and XE-2100 in CB specimens. The Sysmex XN modular system seems to be a suitable and practical option for the CB specimens used for hematopoietic stem cell transplantation as well as for the specimens from neonates.

Keywords: cord blood; flag; performance; Sysmex XE-2100; Sysmex XN.
Corresponding author: Mina Hur, MD, PhD, Department of Laboratory Medicine, Konkuk University School of Medicine, Konkuk University Hospital, 120-1, Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul 143-729, Korea, Phone: +82 2 20305581, Fax: +82 2 26366764, E-mail:

Acknowledgments

This work was supported by Konkuk University.

Author contributions:

All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Financial support: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

1. Kang SH, Kim HK, Ham CK, Lee DS, Cho HI. Comparison of four hematology analyzers, CELL-DYN Sapphire, ADVIA 120, Coulter LH 750, and Sysmex XE-2100, in terms of clinical usefulness. Int J Lab Hematol 2008;30:480–6.Search in Google Scholar

2. Meintker L, Ringwald J, Rauh M, Krause SW. Comparison of automated differential blood cell counts from Abbott Sapphire, Siemens Advia 120, Beckman Coulter DxH 800, and Sysmex XE-2100 in normal and pathologic samples. Am J Clin Pathol 2013;139:641–50.10.1309/AJCP7D8ECZRXGWCGSearch in Google Scholar PubMed

3. Tan BT, Nava AJ, George TI. Evaluation of the Beckman Coulter UniCel DxH 800, Beckman Coulter LH 780, and Abbott Diagnostics Cell-Dyn Sapphire hematology analyzers on adult specimens in a tertiary care hospital. Am J Clin Pathol 2011;135:939–51.10.1309/AJCP1V3UXEIQTSLESearch in Google Scholar PubMed

4. Hotton J, Broothaers J, Swaelens C, Cantinieaux B. Performance and abnormal cell flagging comparisons of three automated blood cell counters: Cell-Dyn Sapphire, DxH-800, and XN-2000. Am J Clin Pathol 2013;140:845–52.10.1309/AJCPE5R4SOQBUULZSearch in Google Scholar PubMed

5. Hur M, Cho JH, Kim H, Hong MH, Moon HW, Yun YM, et al. Optimization of laboratory workflow in clinical hematology laboratory with reduced manual slide review: comparison between Sysmex XE-2100 and ABX Pentra DX120. Int J Lab Hematol 2011;33:434–40.10.1111/j.1751-553X.2011.01306.xSearch in Google Scholar PubMed

6. Park BG, Park CJ, Kim S, Yoon CH, Kim DH, Jang S, et al. Comparison of the Cytodiff flow cytometric leucocyte differential count system with the Sysmex XE-2100 and Beckman Coulter UniCel DxH 800. Int J Lab Hematol 2012;34:584–93.10.1111/j.1751-553X.2012.01439.xSearch in Google Scholar PubMed

7. Briggs C, Longair I, Kumar P, Singh D, Machin SJ. Performance evaluation of the Sysmex haematology XN modular system. J Clin Pathol 2012;65:1024–30.10.1136/jclinpath-2012-200930Search in Google Scholar PubMed

8. Seo JY, Lee ST, Kim SH. Performance evaluation of the new hematology analyzer Sysmex XN-series. Int J Lab Hematol 2014. doi: 10.1111/ijlh.12254. [Epub ahead of print 12 May 2014].10.1111/ijlh.12254Search in Google Scholar PubMed

9. Kim JE, Kim BR, Woo KS, Han JY. Evaluation of the leukocyte differential on a new automated flow cytometry hematology analyzer. Int J Lab Hematol 2012;34:547–50.10.1111/j.1751-553X.2012.01432.xSearch in Google Scholar PubMed

10. Kim MJ, Park Q, Kim MH, Shin JW, Kim HO. Comparison of the accuracy of noninvasive hemoglobin sensor (NBM-200) and portable hemoglobinometer (HemoCue) with an automated hematology analyzer (LH500) in blood donor screening. Ann Lab Med 2013;33:261–7.10.3343/alm.2013.33.4.261Search in Google Scholar PubMed PubMed Central

11. Gac F, Thibert JB, Le Berre C, Le Priol J, Semana G, Fest T, et al. Evaluation of CytoDiff™ on cord blood WBC differential. Int J Lab Hematol 2013;35:46–54.10.1111/j.1751-553X.2012.01460.xSearch in Google Scholar PubMed

12. Walka MM, Sonntag J, Kage A, Dudenhausen JW, Obladen M. Complete blood counts from umbilical cords of healthy term newborns by two automated cytometers. Acta Haematol 1998; 100:167–73.10.1159/000040898Search in Google Scholar PubMed

13. Kwon MJ, Nam MH, Kim SH, Lim CS, Lee CK, Cho Y, et al. Evaluation of the nucleated red blood cell count in neonates using the Beckman Coulter UniCel DxH 800 analyzer. Int J Lab Hematol 2011;33:620–8.10.1111/j.1751-553X.2011.01335.xSearch in Google Scholar PubMed

14. Carroll PD, Nankervis CA, Iams J, Kelleher K. Umbilical cord blood as a replacement source for admission complete blood count in premature infants. J Perinatol 2012;32:97–102.10.1038/jp.2011.60Search in Google Scholar PubMed PubMed Central

15. Kim H, Hur M, Choi SG, Kim BH, Moon HW, Yun YM, et al. Evaluation of ABX Pentra DX 120 and Sysmex XE-2100 in umbilical cord blood. Int J Lab Hematol 2013;35:658–65.10.1111/ijlh.12110Search in Google Scholar PubMed

16. Fujimoto K. Principles of measurement in hematology analyzers manufactured by Sysmex Corporation. Sysmex J Int 1999;9:31–40.Search in Google Scholar

17. Tantanate C. Spurious white blood cell count from a new automated Sysmex XN hematology analyzer. Int J Lab Hematol 2014. doi: 10.1111/ijlh.12200. [Epub ahead of print 14 Mar 2014].10.1111/ijlh.12200Search in Google Scholar PubMed

18. Clinical and Laboratory Standards Institute. Reference leukocyte (WBC) differential count (proportional) and evaluation of instrumental methods; approved standard, 2nd ed. Wayne, PA: CLSI, 2007.Search in Google Scholar

19. McArthur JR, editor. ASH education book. Philadelphia: Hematology Am Soc Hematol Educ Program, 2000:457–74.Search in Google Scholar

20. Simson E, McFadden S, Barnes P, Machin S, editors. International Society for Laboratory Hematology Consensus Guidelines. Available from: http://www.islh.org/web/consensus_rules.php. Accessed on 20 May 2014.Search in Google Scholar

21. Eilertsen H, Vøllestad NK, Hagve TA. The usefulness of blast flags on the Sysmex XE-5000 is questionable. Am J Clin Pathol 2013;139:633–40.10.1309/AJCPDUZVRN5VY9WZSearch in Google Scholar PubMed

22. Taylor R. Interpretation of the correlation coefficient: a basic review. J Diagn Med Sonogr 1990;1:35–9.10.1177/875647939000600106Search in Google Scholar

23. Tanaka Y, Tanaka Y, Gondo K, Maruki Y, Kondo T, Asai S, et al. Performance evaluation of platelet counting by novel fluorescent dye staining in the XN-Series automated hematology analyzers. J Clin Lab Anal 2014. doi: 10.1002/jcla.21691. [Epub ahead of print 19 Mar 2014].10.1002/jcla.21691Search in Google Scholar PubMed PubMed Central

24. Lesesve JF, Benbih M, Lecompte T. Accurate basophils counting: not an easy goal! Clin Lab Haematol 2005;27:143–4.10.1111/j.1365-2257.2005.00667.xSearch in Google Scholar PubMed

25. Amundsen EK, Henriksson CE, Holthe MR, Urdal P. Is the blood basophil count sufficiently precise, accurate, and specific?: three automated hematology instruments and flow cytometry compared. Am J Clin Pathol 2012;137:86–92.10.1309/AJCP19BFTHYTMOROSearch in Google Scholar PubMed

26. Briggs CJ, Linssen J, Longair I, Machin SJ. Improved flagging rates on the Sysmex XE-5000 compared with the XE-2100 reduce the number of manual film reviews and increase laboratory productivity. Am J Clin Pathol 2011;136:309–16.10.1309/AJCPDLR4KGKAFW4WSearch in Google Scholar PubMed

27. Pranke P, Failace RR, Allebrandt WF, Steibel G, Schmidt F, Nardi NB. Hematologic and immunophenotypic characterization of human umbilical cord blood. Acta Haematol 2001;105:71–6.10.1159/000046537Search in Google Scholar PubMed

28. Newcomb JD, Sanberg PR, Klasko SK, Willing AE. Umbilical cord blood research: current and future perspectives. Cell Transplant 2007;16:151–8.10.3727/000000007783464623Search in Google Scholar

Received: 2014-4-9
Accepted: 2014-6-2
Published Online: 2014-6-30
Published in Print: 2014-12-1

©2014 by De Gruyter

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https://doi.org/10.1515/cclm-2014-0392
Keywords for this article
cord blood; flag; performance; Sysmex XE-2100; Sysmex XN.

Articles in the same Issue

  1. Frontmatter
  2. Editorials
  3. CCLM Award for The Most Cited Paper Recently Published
  4. Laboratory preparedness to face infectious outbreaks. Ebola and beyond
  5. Reviews
  6. Determination of reference limits: statistical concepts and tools for sample size calculation
  7. Recent advances in physiological lipoprotein metabolism
  8. New laboratory markers for the management of rheumatoid arthritis patients
  9. General Clinical Chemistry and Laboratory Medicine
  10. The impact of repeat-testing of common chemistry analytes at critical concentrations
  11. Performance of CKD-EPI equation to estimate glomerular filtration rate as compared to MDRD equation in South Brazilian individuals in each stage of renal function
  12. The serum uromodulin level is associated with kidney function
  13. Efficient assessment of peripheral blood lymphocytosis in adults: developing new thresholds for blood smear review by pathologists
  14. Performance evaluation of Sysmex XN hematology analyzer in umbilical cord blood: a comparison study with Sysmex XE-2100
  15. UF-1000i: validation of the body fluid mode for counting cells in body fluids
  16. Newborn screening for haemoglobinopathies by high performance liquid chromatography (HPLC): diagnostic utility of different approaches in resource-poor settings
  17. Progressive chromogenic anti-factor Xa assay and its use in the classification of antithrombin deficiencies
  18. Reference Values and Biological Variations
  19. Thyroid-stimulating hormone reference range and factors affecting it in a nationwide random sample
  20. Reference ranges for serum β-trace protein in neonates and children younger than 1 year of age
  21. A multicenter nationwide reference intervals study for common biochemical analytes in Turkey using Abbott analyzers
  22. Serum reference intervals of homoarginine, ADMA, and SDMA in the Study of Health in Pomerania
  23. Cancer Diagnostics
  24. Low SOX17 expression: prognostic significance in de novo acute myeloid leukemia with normal cytogenetics
  25. Results of first proficiency test for KRAS testing with formalin-fixed, paraffin-embedded cell lines in China
  26. Aberrant hypermethylation of CTNNA1 gene is associated with higher IPSS risk in patients with myelodysplastic syndrome
  27. Cardiovascular Diseases
  28. Association between SNP rs13376333 and rs1131820 in the KCNN3 gene and atrial fibrillation in the Chinese Han population
  29. Acknowledgment
  30. Acknowledgment
  31. Letters to the Editor
  32. Interference in thyroid hormones with Roche immunoassays: an unfinished story
  33. Discrepant results in plasma, but not serum in the Beckman Coulter DxI Access HYPERsensitive hTSH 3rd generation assay affect the management of differentiated thyroid cancer and hyperthyroid patients
  34. Improper serum separation on gel tubes: a trivial laboratory problem or an indicator of monoclonal gammopathy?
  35. Analytical comparison of the new point-of-care troponin T immunoassay on AQT90Flex® analyzer (Radiometer) and the high-sensitivity troponin T immunoassay on ModularE170® (Roche Diagnostics)
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  37. Multi-center proficiency tests for Lab-MELD score diagnostics to improve the quality and safety for patients awaiting liver transplantation
  38. The apolipoprotein B/apolipoprotein A-I ratio in healthy men with normolipidemia: limits of variation and relationship with other lipid parameters
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  40. Enzymatic and endpoint methods yield comparable adenosine deaminase activity in pleural fluid samples
  41. Congress Abstract
  42. 5th Italian GREAT Network Congress
  43. Congress of Laboratory Medicine and Clinical Chemistry
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