Comparison of white blood cell counts by <scp>WNR</scp>,<scp> WDF</scp>, and <scp>WPC</scp> channels in Sysmex <scp>XN</scp> hematology analyzer

Kim, Hyeong-Su; Hur, Mina; Choi, S.-G.; Oh, Kwang-Jun; Moon, Hee‐Won; Yun, Yeo‐Min

doi:10.1111/ijlh.12421

Cited by 19 publications

(23 citation statements)

References 15 publications

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“…Moreover, WBC count is a cheap laboratory test which is feasible to be performed as point-ofcare testing. Besides that, with appropriate training, even nonmedical, non-healthcare lay users were able to perform WBC count (total and differential) with similar accuracy as trained laboratory professionals when automatic techniques were used, what means that WBC count is an easily reproducible laboratory test (22,23).…”

Section: Discussionmentioning

confidence: 99%

The Negative Predictive Ability of Immature Neutrophils for Bacteremia in Children With Community-Acquired Infections

et al. 2020

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Background: Bacteremia is a serious condition. We aimed to assess the role of immature neutrophils in peripheral blood smears for prediction of bacteremia in children. Methods: In this cross-sectional study conducted in Salvador, Brazil, blood cultures collected from patients aged ≤18 years were identified. White Blood Cell count (WBC) was performed upon admission. Medical charts were reviewed and cases from the community were included. Results: Out of 833 potentially eligible patients, 263 (31.6%) were excluded. Therefore, the study group comprised 570 patients being blood collected for culture upon admission from all of them and WBC performed upon admission from 566. The median age was 2 years (IQR: 9.4 mo−5 y) and 300 (52.6%) were male. Acute respiratory infection was the most frequent diagnosis (n = 388; 68.1%), being 250 (43.9%) lower (LRTI) and 138 (24.2%) upper respiratory tract infections. Blood culture was positive in 9 (1.6%; 95% CI: 0.8-2.9%) cases, out of which 7 (2.8%) had LRTI. Streptococcus pneumoniae (n = 3), Haemophilus (n = 2), Neisseria meningitidis, viridans streptococci, Streptococcus agalactiae, and Acinetobacter baumanii (n = 1 each) were isolated. The total WBC/mm 3 did not differ when children with positive or negative blood culture were compared (12,100 [IQR: 6,950-15,250] vs. 11,000 [IQR: 7,900-14,900]; P = 0.9). However, presence of any immature neutrophil was significantly more frequent among patients with bacteremia in comparison with patients without bacteremia (100% [9/9] vs. 40% [223/557]; P < 0.001). The absolute number of immature neutrophils was significantly lower among children without bacteremia (0 [IQR: 0-259] vs. 325 [IQR: 275-1,106]; P < 0.001). Overall, the area under the ROC curve of the number of immature neutrophils in regard to bacteremia was 0.82 (95% CI: 0.76-0.88; P = 0.001). Among 413 patients with absolute number of immature neutrophils <242/mm 3 , none had bacteremia; among 153 patients with absolute number of immature neutrophils ≥242/mm 3 , 9 (5.9%) had bacteremia. Absolute number of immature neutrophils ≥242/mm 3 showed: sensitivity 100% (95% CI: 71.7-100%), specificity 74.1% (95% CI: 70.4-77.7%), negative predictive value 100% (95% CI: 99.3-100.0%), and positive Pimentel et al. Immature Neutrophils and Childhood Bacteremia predictive value 5.9% (95% CI: 2.9-10.5%). When only children with LRTI were analyzed, the results were similar. Conclusion: The absolute number of immature neutrophils in peripheral blood smear is a potential tool to rule out bacteremia among children with community-acquired infections.

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Section: Discussionmentioning

confidence: 99%

The Negative Predictive Ability of Immature Neutrophils for Bacteremia in Children With Community-Acquired Infections

et al. 2020

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“…In our laboratory, this XN series is composed of two XN‐10 and one XN‐20 modules, directly connected to a SP‐50–automated slidemaker‐stainer module and a DI‐60 digital cell imaging analyzer. Each XN module is equipped with a White Differentiation (WDF) channel, used for leukocyte differentiation and flagging for among which blast/abnormal lymphocytes, and the XN‐20 offers an additional White Progenitor Cell (WPC) channel that can differentiate between blasts and abnormal lymphocytes or can remove a false‐positive WDF flag in order to decrease manual microscopic review rate 1‐3 …”

Section: Introductionmentioning

confidence: 99%

“…Thereafter, "Fluorocell WDF" stains intracellular nucleic acids, mainly RNA, representing cytoplasmic activity. These reagents makes it possible to differentiate white blood cells (WBC) based on their intensity of side‐fluorescent light (SFL) and side‐scattered light (SSC) 2,4‐7 . Malignant lymphocytes and blasts both exhibit increased fluorescence compared with normal lymphocytes and can therefore hardly be distinguished by the WDF channel, resulting in the WBC "Suspect" flag "Blasts/Abnormal lymphocytes?"…”

Section: Introductionmentioning

confidence: 99%

“…This causes intracellular structures leaking through the pores with more fluorescence marker entering the cell and binding to DNA, causing higher fluorescence intensity representing DNA activity. The obtained information is expressed in a WPC (SSC‐SFL) scattergram and WPC SSC‐FSC (forward scatter)) scattergram 2,6‐8 . The importance of the WPC channel lies in the ability to separate malignant from "healthy" cells and immature from mature cells due to differences in membrane lipid composition.…”

Section: Introductionmentioning

confidence: 99%

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The integration of Sysmex XN‐9100’ WPC channel reflex testing in the detection of reactive versus malignant blood samples

Blomme

Boeckx

Brusselmans

et al. 2020

Int J Lab Hematology

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Introduction Sysmex XN‐9100™ (Sysmex, Kobe, Japan) system has an optional White Progenitor Cell (WPC) channel. While the White Differentiation (WDF) channel reports a combined flag for blasts/abnormal lymphocytes, WPC channel specifies flagging into a separate flag for each cell type or removes the flag entirely. Aim of this study was to evaluate the added value of this WPC channel in the detection of malignant samples. Methods Routine blood samples analyzed on Sysmex XE‐5000 with flagging for either blasts, abnormal lymphocytes, or atypical lymphocytes (n = 630) were selected for testing on Sysmex XN‐9100, resulting in a reflex WPC analysis in 420 samples. All samples were microscopically evaluated with DI‐60 digital cell imaging analyzer. Results WPC reflex testing resulted in a suspect flag ("blasts" and/or "abnormal lymphocytes") in 334 samples, which was confirmed microscopically in 38% (128/334). In all true positive samples, WPC correctly classified the initial WDF flag in either "blasts" flag or "abnormal lymphocytes?" flag in 75%. Only 12% (50/420) of WDF "blasts/abnormal lymphocytes" positive samples became negative after WPC reflex testing. Subgroup analysis showed differences between the "pediatric" versus "adult" groups and the "hematological/chemotherapy" versus "nonhematological/nonchemotherapy" groups in specificity and smear reduction. Conclusion Overall, WPC reflex testing showed good sensitivity (99%); however, the specificity remains poor (29%). Using reflex WPC to the WDF channel resulted in a 12% reduction of the smear review rate. Although the WPC channel offers different interesting advantages, additional topics and a specific workflow should be applied to optimize the use of this channel.

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“…Sir, Complete blood cell count (CBC) is the most frequent test ordered in hematology laboratory, and developed technology has allowed automatic hematology analyzers to provide more accurate CBC results [1,2]. In small laboratories, large purchase costs can act as a barrier to introducing routine hematology analyzer.…”

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confidence: 99%

Performance evaluation of recently launched Sysmex XN‐550 Automatic Hematology Analyzer

Park

Kim

et al. 2016

Int J Lab Hematology

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Comparison of white blood cell counts by WNR, WDF, and WPC channels in Sysmex XN hematology analyzer

Abstract: This is the first large-scale study on novel channel technology for WBC counts in the Sysmex XN. WBC counts by WNR, WDF, and WPC channels are highly correlated, and they are overall interchangeable and reliable.

Cited by 19 publications

References 15 publications

The Negative Predictive Ability of Immature Neutrophils for Bacteremia in Children With Community-Acquired Infections

The Negative Predictive Ability of Immature Neutrophils for Bacteremia in Children With Community-Acquired Infections

The integration of Sysmex XN‐9100’ WPC channel reflex testing in the detection of reactive versus malignant blood samples

Performance evaluation of recently launched Sysmex XN‐550 Automatic Hematology Analyzer

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