Differential blast counts obtained by automated blood cell analyzers

Area of Science:

• Hematology
• Clinical Pathology
• Medical Technology

Background:

• Automated blood cell analyzers frequently misidentify leukemic blasts as normal cells.
• Accurate blast identification is crucial for diagnosing and classifying acute leukemia.

Purpose of the Study:

• To evaluate the capability of automated analyzers in differentiating blast types based on their 5-part differential patterns.
• To assess the utility of automated complete blood counts in guiding initial decisions on leukemia cell lineage.

Main Methods:

• Blood samples from 175 acute leukemia patients (≥10% blasts) were analyzed.
• The DxH 800 and XE-2100 automated analyzers performed 5-part differential counts.
• Results were compared against manual differential counts as the reference standard.

Main Results:

• The DxH 800 successfully provided a 5-part differential count in 98.9% of cases.
• The XE-2100 yielded invalid automated differentials in 72% of cases.
• Both analyzers often misclassified lymphoblasts as lymphocytes and myeloblasts as monocytes; DxH 800 reported counts without blast flags in 11 instances.

Conclusions:

• Certain automated analyzers can recognize and categorize blasts by cell type.
• Automated complete blood counts offer valuable preliminary data for determining leukemia cell lineage.
• These findings support the use of automated analyzers in initial leukemia diagnostics.