Complete Blood Counts and Research Parameters in the Detection of Myelodysplastic Syndromes.

The diagnosis of Myelodysplastic syndromes (MDS) is frequently challenging, especially in terms of the distinction from the other non-neoplastic causes of cytopenia. Currently, it is based on the presence of peripheral blood cytopenias, peripheral blood and bone marrow dysplasia/blasts, and clonal cytogenetic abnormalities, but MDS diagnostic features are polymorphic and non-specific. We investigated the utility of complete blood count (CBC) and research parameters (RUO) from the analyzer BC 6800 Plus (Mindray Diagnostics) to discriminate MDS-related cytopenia. METHODS: 100 samples from healthy individuals were used to establish the values of research parameters in normal subjects. A retrospective study was conducted including 66 patients diagnosed with MDS, 90 cytopenic patients due to other diseases (cancer patients receiving therapy, aplastic anemia, other hematological malignancies) and 50 with macrocytic anemia. The Wilcoxon test was applied to detect statistical differences among the groups of patients, considering p < 0.05 significant. The diagnostic performance of the RUO parameters for discriminating MDS among cytopenias was evaluated using receiver operating characteristic (ROC) curve analysis. Amultivariable logistic regression model was performed to identify the potential predictors for having MDS. The area under curve (AUC) and the Hosmer-Lemeshow test of the model were assessed. The performance of the model was verified in a prospective study including 224 cytopenic patients (validation group). RESULTS: In the MDS group, the mean cell volume (MCV), percentage of macrocytic red cells (MAC), red cell distribution width (RDW) and immature platelets fraction (IPF) had increased values compared to the cytopenic and normal patients, while platelets, red and white cell counts, Neu X (related to the cytoplasmic complexity of neutrophils), Neu Y (related to nucleic acid content) and Neu Z (related to cell size) were lower (p < 0.001). Neu X, Neu Y, and Neu Z showed higher AUC for detecting MDS > 0.80; MAC, RDW and IPF AUC > 0.76. The multivariable model demonstrated that Neu X and Neu Y could be used in the recognition of MDS, AUC 0.88. In the validation group, 89.0% of the MDS patients were well classified. CONCLUSION: MDS are common malignant disorders with a poor prognosis, and early diagnosis is warranted for optimal benefit from treatment. RUO gain insights to detect dysplasia of MDS and could be used in the differential diagnosis of MDS from cytopenias of other etiologies.

Pseudo-NRBC in the Mindray BC-6800Plus analyzer: A clue for diagnostic anticipation of fungemia. Experimental and preliminary clinical reports.

INTRODUCTION: Candidemia can be a significant cause of death in immunosuppressed or debilitated patients particularly. Abnormalities of the instrumental cytograms of some hematological analyzers, such as Mindray BC-6800Plus, can be related to circulating Candida. We studied the possible diagnostic usefulness of this information. METHODS: A fungal bloodstream infection has been simulated by adding aliquots of Candida albicans, Candida parapsilosis, and Candida glabrata to 75 leftovers and anonymized peripheral blood samples. Cytographic abnormalities like those of experimental samples were used to select patients with possible fungemia. The microscopic review of peripheral blood smears constituted the confirmatory method. RESULTS: In all experimental samples, the various Candida types caused pseudo-NRBC and morphological abnormalities of WNB and DIFF cytograms. Circulating blastospores, free or engulfed by neutrophils, were the microscopic findings in the peripheral blood smears. In the clinical verification, 72 patients were recruited based on the presence of an evocative cluster in the WNB and DIFF cytograms. The microscopic review of 39 out of 72 samples was positive for NRBC. According to blood cultures, light microscopy revealed fungal forms of several Candida or non-Candida types in the remaining 33 samples. Nine of these cases were not yet known to suffer from bloodstream infection. CONCLUSIONS: Although further confirmatory clinical studies are required for these diagnostic abilities, the BC 6800Plus cytographic abnormalities related to fungemia have proven helpful in rapidly monitoring persistent fungemia in already diagnosed patients. In unknown or undiagnosed cases, they could be the trigger point for the subsequent diagnostic-therapeutic pathway.

Diagnostic performance of machine learning models using cell population data for the detection of sepsis: a comparative study.

OBJECTIVES: To compare the artificial intelligence algorithms as powerful machine learning methods for evaluating patients with suspected sepsis using data from routinely available blood tests performed on arrival at the hospital. Results were compared with those obtained from the classical logistic regression method. METHODS: The study group consisted of consecutive patients with fever and suspected infection admitted to the Emergency Department. The complete blood counts (CBC) were acquired using the Mindray BC-6800 Plus analyser (Mindray Diagnostics, Shenzhen, China). Cell Population Data (CPD) were also recorded. The ML and artificial intelligence (AI) models were developed; their performance was evaluated using several indicators, such as the area under the receiver operating curve (AUC), calibration plots and decision curve analysis (DCA). RESULTS: Overall, all the tested approaches obtained an AUC>0.90. The logistic regression (LR) performed well compared to the ML/AI models. The naïve Bayes and the K-nearest neighbour (KNN) methods did not show good calibration properties. The multi-layer perceptron (MLP) model was the best in terms of discrimination, calibration and clinical usefulness. CONCLUSIONS: The best performance in the early detection of sepsis was achieved using the ML and AI models. However, external validation studies are needed to strengthen model derivation and procedure updating.

Serous body fluid evaluation using the new automated haematology analyser Mindray BC-6800Plus.

OBJECTIVES: Cellular analysis of body fluids (BF) has clinical relevance in several medical conditions. The objective of this study is twofold: (1) evaluate the analytical performance of the BF mode of Mindray BC-6800 Plus compared to manual counts under microscopy and (2) analyse if the high-fluorescent cell counts provided by the analyser (HF-BF) are useful to detect malignancy. METHODS: A total of 285 BF was analysed: 250 corresponding to patients without neoplasia and 35 to patients with malignant diseases. Manual differential counts were performed in BF with ≥250 cells/µL. Percentages and absolute counts were obtained on the BC-6800Plus for total nucleated cells (TC-BF), mononuclear, polymorphonuclear and HF-BF. Statistical analysis was performed using Mann-Whitney U-test, Spearman's correlation, Passing-Bablok regression, Bland-Altman graph and ROC curve. RESULTS: To compare manual and automatic total cell counts, samples were divided in three groups: <250, 250-1,000 and >1,000 cells/µL. Correlation was good in all cases (r=0.72, 0.73 and 0.92, respectively) without significant differences between both methods (p=0.65, 0.39 and 0.30, respectively). The concordance between methods showed values of 90%. Considering malignant samples, median HF-BF values showed significant higher values (102 cells/µL) with respect to non-malignant (4 cells/µL) (p<0.001). The cut-off value of 8.5 HF-BF/µL was able to discriminate samples containing malignant cells showing sensitivity and specificity values of 89 and 71%, respectively. Considering both, HF-BF and TC-BF values, sensitivity and specificity values were 100 and 53%, respectively. CONCLUSIONS: This study reveals that the Mindray BC-6800Plus offers an accurate and acceptable performance, showing results consistent with the manual method. It is recommended to consider both HF-BF and TC-BF values for the screening of the microscopic evaluation to ensure the detection of all malignant samples.

Evaluation on clinical performance of the new low-value platelet measurement mode (PLT-8X) of BC-6800Plus.

Background: The accuracy of low-value platelet (PLT) testing is a key reference for clinical decision-making regarding PLT transfusion or surgery. This study aimed to evaluate the capability to detect low-value PLT of the 8 times optical platelet counting (PLT-8X) mode of the BC-6800Plus auto hematology analyzer. Methods: Totally 40 fresh anticoagulated venous whole blood samples with PLT ≤50×109/L were collected from the clinical laboratory at the First Affiliated Hospital of Soochow University to evaluate the precision of low-value PLT in PLT-8X mode. Moreover, 67 samples with PLT <100×109/L were collected, and a methodological comparison was conducted between the results of PLT-8X and those obtained by the reference method [red blood cell (RBC)/PLT ratio method] recommended by the International Committee for Standardization of Hematology (ICSH). In addition, fresh whole blood and PLT-free plasma were used to prepare samples at a series of concentrations within the low-value ranges to evaluate the linearity of PLT and finally investigate the limit of blank (LoB) and limit of detection (LoD) for low-value PLT in PLT-8X mode. Results: The precision low-value PLT in PLT-8X mode was significantly superior to that in PLT-I (P<0.0001); and the correlation coefficient of PLT-8X mode compared with the reference method of flow cytometer was 0.992. The expected bias at the low-value medical decision levels (5×109/L, 10×109/L and 20×109/L) of PLT fell within the range of ±1.0×109/L, and that at 50×109/L fell within the range of ±1.5×109/L. In addition, the correlation coefficient of PLT-8X in the low-value ranges (0 to 30×109/L and 0 to 100×109/L) of PLT was greater than 0.99, and its nonlinear coefficients were not significantly different from 0 (P>0.05). Finally, the LoB and LoD of PLT-8X mode were 0.33×109/L and 0.89×109/L, respectively. Conclusions: The PLT-8X mode of the BC-6800Plus auto hematology analyzer has extremely low detection sensitivity for low-value PLTs in anticoagulated venous whole blood samples. With good linearity, its precision and accuracy can sufficiently meet the needs for hematology laboratory use, and it can effectively help clinicians to accurately diagnose and treat patients with thrombopenia-related diseases.

Mindray BC-6800 haematological analyser: 3D-DIFF scattergram usefulness in infectious mononucleosis diagnosis.

INTRODUCTION: 3D-DIFF scattergram of the Mindray BC-6800 haematological analyser shows morphological abnormalities and lymphocyte cluster splitting related to the presence of reactive lymphocytes. This study aims to assess whether these cytographic changes are useful in detecting both activated and apoptotic lymphocytes, leading to an improvement in the laboratory diagnostic process of infectious mononucleosis. METHODS: Two hundred three samples with modified shape and doubled lymphocyte cluster of DIFF scattergram (study group) were divided into two different subgroups: with and, respectively, without serological evidence of ongoing IM. Activated and apoptotic cells in peripheral blood were counted by light microscopy or gating in the instrumental dot plots. Values of apoptotic cells counted by microscopy were compared with those resulting from gating. RESULTS: Samples with both shape change and doubled lymphocyte cluster had serological profiles according to the diagnosis of ongoing infectious mononucleosis. Blood smears review was positive for reactive lymphocytes in all 112 samples (100%). An underestimation of apoptotic cell count by light microscopy compared with the gating in the instrumental scatterplot was also observed (96 out of 112, 85.7%). CONCLUSION: The additional lymphocyte cluster was significantly associated with activated and apoptotic lymphocytes in samples with serology suggesting ongoing infectious mononucleosis. Considering the significance of clue for infectious mononucleosis assigned to the apoptotic lymphocytes, a specific flag such as "apoptotic cells?" could be associate with the related cluster. Such a flag could be used for dedicated rules for smears review, thus increasing infectious mononucleosis detection in laboratories that do not usually practise instrumental cytograms observation.

Performance of Platelet Counting in Thrombocytopenic Samples: Comparison between Mindray BC-6800Plus and Sysmex XN-9000.

The performance of platelet (PLT) counting in thrombocytopenic samples is crucial for transfusion decisions. We compared PLT counting and its reproducibility between Mindray BC-6800Plus (BC-6800P, Mindray, Shenzhen, China) and Sysmex XN-9000 (XN, Sysmex, Kobe, Japan), especially focused on thrombocytopenic samples. We analyzed the correlation and agreement of PLT-I channels in both analyzers and BC-6800P PLT-O mode and XN PLT-F channel in 516 samples regarding PLT counts. Ten thrombocytopenic samples (≤2.0 × 109/L by XN PLT-F) were measured 10 times to investigate the reproducibility with the desirable precision criterion, 7.6%. The correlation of BC-6800P PLT-I and XN PLT-I was arranged moderate to very high; but the correlation of BC-6800P PLT-O and XN PLT-F was arranged high to very high. Both BC-6800P PLT-I vs. XN PLT-I and BC-6800P PLT-O vs. XN PLT-F showed very good agreement (κ = 0.93 and κ = 0.94). In 41 discordant samples between BC-6800P PLT-O and XN PLT-F at transfusion thresholds, BC-6800P PLT-O showed higher PLT counts than XN-PLT-F, except the one case. BC-6800P PLT-O exceeded the precision criterion in one of 10 samples; but XN PLT-F exceeded it in six of 10 samples. BC-6800P would be a reliable option for PLT counting in thrombocytopenic samples with good reproducibility.

Clinical and hematological characteristics of 88 patients with COVID-19.

INTRODUCTION: To retrospectively analyze epidemiological, clinical and hematological characteristics of COVID-19 patients. METHODS: The demographic, symptoms, and physiological parameters of 88 patients were collected and analyzed. The performance of complete blood count (CBC) indexes for monitoring and predicting the severity of COVID-19 in patients was evaluated by analyzing and comparing CBC results among different COVID-19 patient groups. RESULTS: White blood cells (WBCs), the neutrophil percentage (Neu%), absolute neutrophil count (Neu#), and neutrophil-to-lymphocyte ratio (NLR) were significantly higher in the critical group than in the other three groups (P < .05), while the lymphocyte percentage (Lym%), monocyte percentage (Mon%), lymphocyte count (Lym#), and lymphocyte-to-monocyte ratio (LMR) were significantly lower in the critical group than in the other three groups (P < .05). WBCs, the Neu%, Neu#, NLR, and neutrophil-to-monocyte ratio (NMR) were significantly higher in the severe group than in the mild and moderate groups (P < .05), while the Lym% was significantly lower in the severe group than in the mild and moderate groups (P < .05). The Mon%, Lym#, and LMR were significantly lower in the severe group than in the moderate group (P < .05). Using receiver operating characteristic (ROC) curve analysis to differentiate severe and nonsevere patients, the areas under the curve (AUCs) for the NLR, Neu%, and Lym% were 0.733, 0.732, and 0.730, respectively. When differentiating critical patients from noncritical patients, the AUCs for the NLR, Neu%, and Lym% were 0.832, 0.831, and 0.831. CONCLUSIONS: The NLR is valuable for differentiating and predicting patients who will become critical within 4 weeks after the onset of COVID-19.

Hematological performance of a last generation automated blood cell counter: The Mindray BC-6800 Plus.

INTRODUCTION: Hematology analyzers produce reliable, reproducible, precise, accurate results, as well as a premicroscopic characterization of abnormal samples. We have evaluated the clinical performance of a new blood cell counter, which has been temporarily made available to our hematology laboratory. METHODS: Over four months, we analyzed with the Mindray BC-6800 Plus more than 1000 samples with a high incidence of hematological abnormalities, using recommended ICSH and CLSI protocols. We have also assessed flagging efficiency for abnormal cells and scattergram cell distribution. RESULTS: From a quantitative point of view, our assessment has identified state-of-the-art level reproducibility, excellent linearity, stability over 48°C at 4°C for the conventional parameters, lack of carry-over (<0.2%), and comparability with the routine instruments. These features would make the instrument suitable for immediate and smooth introduction in the hematology laboratory. Flags for abnormal cells are efficient; flag for blast cells has high sensitivity and predictive value of negative results. Additional benefits are provided by a competent interpretation of cell distribution scattergrams in samples from patients with specific hematological disorders. CONCLUSION: We have demonstrated good analytical and useful diagnostic performance of this new instrument, including effective selection of abnormal samples for informed microscope morphological analysis.

Infected RBC flag/parameter provided by Mindray BC-6800 haematology analyzer aid the diagnosis of malaria.

BACKGROUND: The Mindray BC-6800 haematology analyzer (BC-6800) provides a dedicated flag 'Infected RBC' (InR) and the number of InR (InR#)/the permillage of InR (InR‰) in routine blood testing as a screening tool for malaria in endemic areas. This study sought to evaluate the effectiveness of the BC-6800 flag parameter for aiding the diagnosis of malaria. METHODS: A total of 181 samples were tested using the Mindray BC-6800 haematology analyzer, including 117 malaria-infected samples collected from Yunnan, China, and 64 samples from healthy controls. Microscopy examination was conducted as reference when stained thick blood film revealed the presence of malaria parasites identified as Plasmodium vivax and Plasmodium falciparum. The receiver operating characteristic (ROC) curve analysis was developed using Analyse-it v4.92.3. The Kappa value was determined to evaluate the agreement between BC-6800 and light microscopy. RESULTS: The sensitivity of InR‰ generated by BC-6800 for P. vivax and P. falciparum was 88.3 and 24.1%, respectively; specificity of InR‰ for malaria parasites was 84.3 and 84.3%, respectively; positive predictive value and negative predictive value was 89.4 and 82.7% for P. vivax, and 52.8 and 60.3% for P. falciparum. There was a strong correlation between ΔWBC and InR‰ (R2 = 0.9731 for P. vivax and R2 = 0.9757 for P. falciparum). There was also a significant correlation between parasitaemia and InR# in P. vivax-infected samples (R2 = 0.734). InR# was evaluated using ROC curve analysis, the area under the ROC curve is 0.95 with a 95% confidence interval of 0.926 to 0.974, and the cut-off value is 0.01 × 109/L for P. vivax. However, the ring stage and the early trophozoite stage of Plasmodium cannot be detected easily on BC-6800, possibly because of the small size and low nucleic acid content of these stages. CONCLUSIONS: The findings suggest that the flag 'InR' and the parameters 'InR#/InR‰' provided by the BC-6800 haematology analyzer could be used to screen for malaria in a clinical setting.

Lack of harmonization in high fluorescent cell automated counts with body fluids mode in ascitic, pleural, synovial, and cerebrospinal fluids.

INTRODUCTION: Cellular analysis in body fluids (BFs) provides important diagnostic information in various pathological settings. This study was hence aimed at comparing automated cell count obtained with Mindray BC-6800 (BC-BF) vs Sysmex XN-series (XN-BF) and evaluating other quantitative and qualitative information provided by these analyzers in ascitic (AF), pleural (PF), synovial (SF), and cerebrospinal (CSF) fluids. METHODS: Three hundred and fifty-one samples (99 AFs, 45 PFs, 75 SFs, and 132 CSFs) were analyzed in parallel with BC-BF, XN-BF, and optical microscopy (OM). The study also included the assessment of diagnostic agreement among BC-BF, XN-BF, and OM. RESULTS: The comparison of BC-BF vs XN-BF yielded slopes of Passing and Bablok regression always comprised between 0.9 and 1.0 except for EO-BF and HF-BF, whilst the intercepts ranged from -0.4 for MN-BF and 12.0 for PMN-BF. The bias was comprised between -103.3% and 67.1% for HF-BF and EO-BF, respectively. A significant bias was found for TC-BF, WBC-BF, HF-BF (negative bias) and for PMN-BF and EO-BF (positive bias). The agreement (Cohen's kappa) between XN-BF and BC-BF was always ≥0.7, ranging between 0.87 in CSFs and 0.94 in AFs, and that with OM was similar (ie, 0.85 and 0.96). CONCLUSION: The cytometric analysis of BF samples using BC-BF and XN-BF is clinically favorable when appropriately combined with OM. Quantitative and qualitative parameters displayed optimal agreement, whilst instrument-specific cut-offs should be defined and implemented for HF-BF and EO-BF. Further efforts should be made for achieving better harmonization in cytometric analysis of BF samples.

Automated nucleated red blood cell count using the Mindray BC-6800 hematology analyzer.

INTRODUCTION: In current laboratory practice, obtaining a nucleated red blood cell (NRBC) count by manual microscopy (MM) is a laborious and time-consuming process. Modern hematology analyzers based on different technologies and methods have variable accuracies when determining NRBC counts. The aim of this study was to compare NRBC counts acquired by an automated Mindray BC-6800 analyzer (BC-6800), a flow cytometry (FC) reference method, and traditional MM. METHODS: A hundred EDTA samples with initial NRBC flags from the BC-6800 were included. FC was used as a reference method to correlate the NRBC count with BC-6800 and MM counts. In addition, the performance of the Mindray SC-120 analyzer for preparing automated blood films for manual NRBC counting was compared to that of manually prepared blood films. RESULTS: The NRBC counts obtained with the BC-6800 and MM vs the reference method were highly correlated (r = .994 and .989, respectively). However, the BC-6800 showed a lower bias than MM when compared with FC (0.3 × 109 /L and -6.0 × 109 /L, respectively). NRBC counts obtained using the automated Mindray SC-120 films were comparable to manually prepared films. CONCLUSION: The Mindray CAL8000 automated hematology system, which is composed of the BC-6800 and the SC-120, yields a precise NRBC count and can replace the traditional MM method for obtaining accurate and reproducible NRBC counts in high-value samples, such as patient monitoring samples used to determine the necessity of transfusion therapy in thalassemia patients. Moreover, this method offers several advantages, including a faster turnaround time, labor savings, and cost effectiveness.

Reticulocyte count and extended reticulocyte parameters by Mindray BC-6800: Reference intervals and comparison with Sysmex XE-5000.

INTRODUCTION: In this study, analytic performance (imprecision, carryover, time stability) and diagnostic efficiency of Mindray BC-6800 analyzer to quantify reticulocytes and extended reticulocyte parameters was evaluated. Moreover, reference intervals on adult population were determined. Results were compared with those obtained by Sysmex XE-5000 analyzer. METHODS: One hundred and eighty-four healthy adults of both sexes, and 368 subjects affected by various pathologic conditions (nutritional anemias before and after treatment, hemolytic and posthemorragic anemias, acute and chronic inflammations, malignancy under therapy, and beta thalassemia trait) were selected. RESULTS: Reference intervals were as follows: reticulocytes (×109 /L): 23.2-93.2; immature reticulocyte fraction: 0.015-0.14; mean reticulocyte hemoglobin equivalent (RHE) (pg): 30.9-35.7; mean reticulocyte volume (fL): 97.8-118. Imprecision on reticulocyte count at all concentrations was close to analytic goal based on within-subject biological variation. Carryover (2.3%) was negligible, and time-stability was excellent up to 8 hours. CONCLUSION: When compared with XE-5000, BC-6800 shows a good overall correlation on counting despite evidence of difference in the upper limit of reference intervals (93.2 vs 101.3). Comparison of diagnostic efficiency of extended parameters shows a good total agreement of RHE (91.6%).

Reliability of automated synovial fluid cell counting with Mindray BC-6800 body fluid mode.

INTRODUCTION: The enumeration and differentiation of nuclear elements in synovial fluid is a cornerstone for diagnosis and follow-up of many orthopedic and rheumatologic diseases. In this study, we evaluated the analytical performance of Mindray BC-6800 BF mode (BC-6800-BF) for synovial fluid analysis. METHODS: Overall, 78 synovial fluids were collected and analyzed with both BC-6800-BF and light microscopy. The study also entailed the assessment of limit of blank (LoB), limit of detection (LoD), limit of quantification (LoQ), carryover and linearity. RESULTS: The LoB for the parameters total cells and white blood cells was 6 × 106 cells/L, and the LoD and LoQ were instead 15 and 16 × 106 cells/L, respectively. Linearity was excellent and carryover was negligible. The agreement between BC-6800-BF and light microscopy was satisfactory for all samples pretreated with hyaluronidase, displaying a bias between -5.9% and 8.2%. CONCLUSIONS: The use of BC-6800-BF for synovial fluid analysis enables rapid and accurate assessment, especially for total cell and polymorphonuclear counts. The use of BC-6800-BF may therefore allow the replacement of optical analysis, especially in samples pretreated with hyaluronidase, thus allowing its routine use for the screening of synovial specimens.

Assessment of blood sample stability for complete blood count using the Sysmex XN-9000 and Mindray BC-6800 analyzers.

BACKGROUND: Different hematological analyzers have different analytical performances that are often reflected in the criteria for sample stability of the complete blood count. This study aimed to assess the stability of several hematological parameters using the XN-9000 Sysmex and BC-6800 Mindray analyzers. METHODS: The impact of storage at room temperature and 4°C was evaluated after 2, 4, 6, 8, 24, 36 and 48h using ten normal and 40 abnormal blood samples. The variation from the baseline measurement was evaluated by the Steel-Dwass-Critchlow-Fligner test and by Bland-Altman plots, using quality specifications and critical difference as the total allowable variation. RESULTS: Red blood cells and reticulocyte parameters (i.e. hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, red blood cell distribution width, immature reticulocyte fractions, low-fluorescence reticulocytes, middle-fluorescence reticulocytes, high fluorescence mononuclear cells) showed less stability compared to leukocyte and platelet parameters (except for monocyte count and mean platelet volume). The bias for hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration and red blood cell distribution width coefficient of variation was higher than the critical difference after 8h using both analyzers. CONCLUSION: Blood samples measured with both analyzers do not show analytically significant changes in up to 2h of storage at room temperature and 4°C. However, the maximum time for analysis can be extended for up to 8h when the bias is compared to the critical difference.

Mindray BC-6800 body fluid mode, performance of nucleated cells, and differential count in ascitic and pleural fluids.

INTRODUCTION: An accurate and rapid analysis of cells in body fluids (BFs) is important for diagnosis and follow-up in many pathological conditions. We evaluated the analytical performance of the module BF Mindray BC-6800 (BC-6800-BF) for cytometric analysis of ascitic and pleural fluids. METHODS: A total of 99 ascitic and 45 pleural samples were collected and assessed with BC-6800-BF and optical microscopy. This study also includes the evaluation of limit blank (LoB), limit detection (LoD), limit quantitation, (LoQ), carryover, linearity, and diagnostic concordance between the two methods. RESULTS: For TC-BF, LoB was 1 × 10(6) cells/L, LoD was 3 × 10(6) cells/L, and LoQ was 4 × 10(6) cells/L. Linearity was excellent (r(2) = 0.99) and carryover was negligible. TC-BF performed with the two methods showed Pearson's correlation of 0.99 (P < 0.0001), Passing-Bablok regression y = 1.04x - 1.17, and bias 33.7 cells. In ascitic fluids, polymorphonuclear cells (PMN) showed an area under curve (AUC) of 0.98 (P < 0.0001). In pleural fluids, mononuclear cells (MN) and PMN % displayed an AUC of 0.79 (P < 0.0001) and 0.93 (P < 0.0001), respectively. CONCLUSIONS: BC-6800-BF in ascitic and pleural fluids offers rapid and accurate cell and differential counts in clinically relevant concentration ranges. The use of BC-6800-BF may allow to replace routine optical counting, except for samples displaying abnormal cell counts or abnormal DIFF scattergram.

Assessment of blood sample stability for complete blood count using the Sysmex XN-9000 and Mindray BC-6800 analyzers

Background: Different hematological analyzers have different analytical performances that are often reflected in the criteria for sample stability of the complete blood count. This study aimed to assess the stability of several hematological parameters using the XN-9000 Sysmex and BC-6800 Mindray analyzers. Methods: The impact of storage at room temperature and 4 ◦C was evaluated after 2, 4, 6, 8, 24, 36 and 48h using ten normal and 40 abnormal blood samples. The variation from the baseline measurement was evaluated by the Steel­Dwass­Critchlow­Fligner test and by Bland­Altman plots, using quality specifications and critical difference as the total allowable variation. Results: Red blood cells and reticulocyte parameters (i.e. hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, red blood cell distribution width, immature reticulocyte fractions, low-fluorescence reticulocytes, middle-fluorescence reticulocytes, high fluorescence mononuclear cells) showed less stability compared to leukocyte and platelet parameters (except for monocyte count and mean platelet volume). The bias for hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration and red blood cell distribution width coefficient of variation was higher than the critical difference after 8h using both analyzers. Conclusion: Blood samples measured with both analyzers do not show analytically signifi- cant changes in up to 2h of storage at room temperature and 4 ◦C. However, the maximum time for analysis can be extended for up to 8h when the bias is compared to the critical difference