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Updated: Apr 14, 2026

Evaluation of a Point-of-Care Testing Analyzer for Measuring Peripheral Blood Leukocytes
Published on: March 22, 2022
Fragmented red cells reference range for the Sysmex XN®-series of automated blood cell counters
J-F Lesesve1, E Speyer2, J-P Perol3
1Services d'Hématologie Biologique, University Hospital at Nancy, Vandoeuvre, France.
Introduction:
Fragmented red cells (FRCs) are a new parameter determined automatically by the latest generation of blood cell counters. FRC counts may be of interest as they may reflect schistocyte counts measured on a stained peripheral blood smear observed under the microscope. However, FRC counts depend on the technical procedure used to detect them so that reference ranges are device dependent. The XN-9000® is one of the latest models from the Sysmex series of analysers.
Material, Methods And Results:
We aimed to establish a reference range for FRCs based on 1366 normal patient samples. The mean ± SD was 0.14 ± 0.35% and the median was 0% (95% confidence interval of the mean: 0.12-0.16%). We observed that the percentage of red blood cells with <17 pg of haemoglobin content (Hypo-He) was correlated to an FRC increase and that flagged results relating to red blood cells, reticulocytes or platelets might have presented with artefactually increased FRCs.
Conclusion:
The FRCs reference range (healthy subjects) should be useful for laboratory staff for selecting which blood smears to check optically.

