Advanced algorithm for correcting cold agglutination interference in red blood cell parameters with the Mindray...

To develop an advanced algorithm for correcting spurious RBC parameters in cold agglutination (CA) samples, and evaluate the performance of the algorithm and explore its clinical applications.

RBC-specific antibodies were added to blood samples at different dilution ratios to simulate CA samples. On the difference of the RBC aggregates histogram between CA and normal, degree of aggregation and the corresponding RBC particle compensations were determined to calculate corrected values. Twenty clinical samples with microscopy-confirmed CA were analyzed and prewarmed at 37 °C for 2 h to eliminate RBC agglutination to obtain the reference values. The corrected values (Corr-RBC, Corr-MCV, and Corr-MCHC) from the BC-7600 were compared with prewarmed reference values with linear regression and Bland-Altman analyses. Relative deviations were assessed to determine the clinical acceptability of the corrected values.

The uncorrected values were significantly different from the reference values; In contrast, the corrected values demonstrated strong agreement with the reference values. Corr-RBC (r = 0.997) and Corr-MCV (r = 0.986) were strongly correlated with RBC-37 °C and MCV-37 °C, respectively, while Corr-MCHC demonstrated a good correlation with MCHC-37 °C (r = 0.905). Bland-Altman analysis indicated agreement between the algorithm-corrected values and the prewarmed reference values, with mean biases of 2.43% (95% CI, 1.26% ∼ 3.59%) for RBC count, -0.97% (95% CI, -1.77% ∼ -0.18%) for MCV, and - 1.35% (95% CI, -2.35% ∼ -0.34%) for MCHC.

The advanced algorithm effectively corrects spurious CA-interfered hematology parameters, highlighting the potential of the algorithm as a valuable tool for addressing cold agglutination interference.