[Diagnostic problems of hematological disorder using automated blood cell analyzer]

Although an automated blood cell counter provides the different test results to the clinician both precisely and rapidly, confusing data have also been reported which caused much confusion for the diagnosis of diseases. We investigated five different automated instruments using blood samples from different patients with hematological disorders to evaluate the flow of these automated counters in the interpretation of test results. Platelet aggregation, hemolysis and cryoglobulin can influence the evaluation with such automated instruments. The degree of the variance is different between false value and corrected value. Furthermore, cryoglobulin may give false data on coagulation and fibrinolysis tests. Automated white cell differentiation is based upon flow system or pattern recognition, but overlooking of the abnormal cells cannot be avoided by either method, such as a small number of blasts, atypical lymphocytes, adult T-cell leukemia cell, etc. Therefore, it is necessary of the bases is blood cell to the CD4/CD8 measurement and microscopic check along with considering biochemical parameters. We should make smears from such patients. For analysis of surface markers of hematological malignancy cell by flow cytometry proper selection of antibodies and setting of gate are required. To prevent mistakes due to morphological misinterpretation or other unsuitable conditions, we should thoroughly understand the morphologic aspects of leukemia cells.