Differences in detecting blasts between ADVIA 2120 and Beckman-Coulter LH750 hematology analyzers

The complete blood count is often used as a screening tool to detect hematologic abnormalities in the peripheral blood. In patients with suspected or known leukemia, blast cells serve as an indicator of disease pathology. We compared the analytical performance of the Siemens ADVIA 2120 to the Beckman-Coulter LH750 in the detection of blasts. In the study, 390 blood samples were analyzed from a general hospital population, which included oncology patients. The presence of blasts, as indicated by the analyzers' flags, was compared with the results of a manual differential (regarded as the reference method). The ADVIA 2120 demonstrated 100% sensitivity at detecting blasts compared with 62% using the LH750. This improved sensitivity came at the expense of a lower specificity (49% vs. 86%). The effect of the false-positive and false-negative samples on the laboratory's manual review was partially (false-positive) or completely (false-negative) mitigated by triggering of other criteria. Detecting blasts in the peripheral blood depends on the performance characteristics of the hematology analyzer, in conjunction with the stringency of the laboratory's manual review criteria.