Automated Neutrophil Morphology and Its Utility in the Assessment of Neutrophil Dysplasia

Abstract

The automated hematology cell analyzer Coulter LH 750 (Beckman Coulter, Brea, CA, USA) uses a combination of 3 measurements-volume, conductivity, and scatter-to identify cells, but it could take advantage of these parameters to evaluate their morphologic changes. The neutrophil mean cell volume (MNEV), mean cell conductivity (MNEC), and mean cell scatter (MNES) were evaluated in 54 patients with myelodysplastic syndrome (MDS), 18 with chronic myelomonocytic leukemia (CMML), and 59 healthy controls. MNES and MNEC in the MDS group including all subtypes (World Health Organization classification) and in the CMML patients were significantly lower than the control group. MNES in MDS and CMML correlated well with the cytoplasmic hypogranularity evaluated by microscopic observation (P = .01). The value of MNES and MNEC as screening parameters in the neutrophil dysplasia evaluation showed, for this study, a sensitivity of 71.8% with a specificity of 86.4% (area under the curve [AUC], 0.817) and a cutoff of <139.3 for MNES and a sensitivity of 70.4% with a specificity of 76.3% (AUC, 0.752) and a cutoff of <150.9 for MNEC.

Clinical utility of the neutrophil distribution pattern obtained using the CELL-DYN SAPPHIRE hematology analyzer for the diagnosis of myelodysplastic syndrome

“…On the other hand, it might be that neutrophil distribution analysis using CELL-DYN SAPPHIRE was more sensitive than microscopic observation and could detect minimal PBDG that were not yet microscopically definitive. Such a discrepancy between the results obtained using a hematology analyzer and those of microscopic observation was also reported by Miguel et al [22]. They also suggested the higher sensitivity of the hematology analyzer, although the utilized parameters were different between their study and ours.…”

“…Therefore, it seemed convenient if we could utilize such a hematology analyzer as a surrogate flow cytometer for the screening of patients with MDS. Concerning this, Miguel et al [22] examined patients with MDS using a Coulter LH 750 hematology analyzer (Beckman Coulter, Brea, CA, USA) equipped with VCS (volume, conductivity, scatter) technology. They reported that patients with MDS showed significantly lower levels of both neutrophil mean cell scatter and mean cell conductivity than healthy controls in research population data, and concluded that these parameters were especially useful for the screening of neutrophil dysplasia, such as hypogranularity.…”

A novel complete blood count‐based score to screen for myelodysplastic syndrome in cytopenic patients

“…Structural parameters of neutrophils have already been studied and are used routinely to detect granular dysplasia (Miguel et al , ; Furundarena et al , ; Inaba et al , ). However, the Ne‐SSC parameter commonly used to evaluate hypo‐granulated neutrophils on Sysmex ® X‐class analysers (Le Roux et al , ) did not discriminate MDS from cytopenic controls in multivariate analysis (data not shown).…”

Haematology- From CBC to CPD

“…CPD has been used to diagnose a variety of other haematologic conditions, both malignant & non malignant, including megaloblastic anaemia, myelodysplastic syndrome lymph proliferative disease and in various platelet associated disorders [17][18][19][20][21].…”