Use of the Cell-Dyn Sapphire Hematology Analyzer for Automated Counting of Blood Cells in Body Fluids

Abstract

The enumeration and identification of blood cells in body fluids offers important information for the diagnosis and treatment of various medical conditions. Manual microscopic methods (hemacytometer total cell count and cytocentrifuged differential count) have inherent analytic and economic disadvantages but are still considered the "gold standard" methods. We evaluated the analytic and clinical performance of the Cell-Dyn Sapphire hematology analyzer (Abbott Diagnostics Division, Santa Clara, CA) for automated blood cell counting and leukocyte differential counting in cerebrospinal fluid, serous fluid (peritoneal and pleural fluid), and continuous ambulatory peritoneal dialysis fluid, and we compared the performance with the respective manual methods. In the present article, we describe its applicability for the distinct body fluids, and we highlight limitations and caveats.

Clinical relevance and contemporary methods for counting blood cells in body fluids suspected of inflammatory disease

“…Abbott's newer generation, the CELL-DYN Sapphire, was evaluated for counting cells in CSF and serous fluids [128]. No significant differences were found when concentrations exceeded the detection limits ( > 50 × 10 6 WBC/L and > 3000 × 10 6 RBC/L); however, samples below these values differed significantly.…”

“…The Sapphire has a high diagnostic ability (sensitivity and specificity > 90%) to distinguish normal from abnormal samples in serous and CAPD samples; whereas, for CSF samples (cut-off limit WBC > 5 × 10 6 /L), sensitivity was poor (45%) [128]. This could be expected because of analyzers high detection limits.…”

Reflex Testing Rules for Cell Count and Differentiation of Nucleated Elements in Pleural and Ascitic Fluids on Sysmex XE-5000

“…[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] It is noteworthy that the automated analysis of body fluid cellularity is mostly challenged by the presence of macrophages (MACROs), mesothelial cells (MESOs), and other abnormal or pathological cells (especially solid cancer cells) that are typically absent in blood or urine, so that the accuracy and differentiation of cellular elements may be impaired. 6,7,15,22,24 More specifically, some automated cell count analyzers provide a TNC count but not morphological differentiation, [16][17][18][19][20] whereas specific information about the accuracy of cell recognition is unavailable for others. 8,23,24 Even more importantly, validation rules for automated cell counting and a definition of the reflex testing required for accurate result reporting are unavailable in the current scientific literature to the best of our knowledge.…”

“…6,7,15,22,24 More specifically, some automated cell count analyzers provide a TNC count but not morphological differentiation, [16][17][18][19][20] whereas specific information about the accuracy of cell recognition is unavailable for others. 8,23,24 Even more importantly, validation rules for automated cell counting and a definition of the reflex testing required for accurate result reporting are unavailable in the current scientific literature to the best of our knowledge.…”

Effects of Electromagnetic Fields on Automated Blood Cell Measurements

“…[9][10][11][12][13] Electronic noise is considered the electric interference or voltage fluctuation or external noise contamination (e.g., from other electrical equipment).…”