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Automated Red and White Blood Cell Counting in Capillary Microsamples by Sysmex-XN Predilution Mode.

Claus Vinter Bødker Hviid1,2, Vibeke Staun Christensen1, Klaus Rosenkilde Jensen1

  • 1Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark.

International Journal of Laboratory Hematology
|April 7, 2025
PubMed
Summary

The Sysmex XN-series predilution (PD) mode offers reliable white blood cell analysis from small blood samples. However, red blood cell parameter accuracy was insufficient for clinical use.

Keywords:
biochemistrymethod comparisonneonatal hematologyprecisionred blood cellswhite blood cells

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Area of Science:

  • Clinical Laboratory Science
  • Hematology
  • Pediatric Medicine

Background:

  • Neonatal patients require minimal blood volume for hematologic analysis, posing a challenge for standard laboratory methods.
  • The Sysmex XN-series predilution (PD) mode allows for hematologic measurements using small blood volumes (20-50 μL).

Purpose of the Study:

  • To verify the analytical performance and preanalytical stability of the Sysmex XN-series PD mode using 50 μL microsamples.
  • To evaluate the suitability of the PD mode for analyzing key hematologic parameters in low-volume samples.

Main Methods:

  • Microsamples (50 μL) were prepared from adult EDTA blood for analysis.
  • Evaluated white blood cell counts and red blood cell parameters for imprecision and accuracy.
  • Assessed the impact of capillary sampling, storage stability, and pneumatic tube transport.
  • Validated findings in a small cohort of pediatric patients.

Main Results:

  • White blood cell counts demonstrated acceptable bias (≤5.4%) and imprecision (<3.5%).
  • PD mode showed good analytical performance with capillary sampling and stability for 7 hours.
  • Red blood cell parameters generally exceeded acceptable bias and imprecision limits.
  • Pediatric sample bias was within predicted intervals.

Conclusions:

  • The PD mode is analytically suitable for white blood cell counts, offering good preanalytical stability.
  • The PD mode is not recommended for red blood cell parameter analysis due to performance limitations.
  • The PD mode presents a potential low-volume alternative for specific hematologic monitoring needs.