ABSTRACT
BACKGROUND:
We evaluated the
efficacy of
white blood cell (WBC) differential counts in severely leukopenic samples by the Hematoflow
method and by automated
hematology analyzers and compared the results with manual counts.
METHODS:
EDTA-anticoagulated
blood samples (175 samples) with WBC counts of 40-990/µL were selected. Hematoflow differential counts were performed in duplicates employing
flow cytometry using the CytoDiff
reagent and
analysis software. Differential counts were also performed using the DxH 800 (Beckman Coulter) and XE-2100 (Sysmex) automated
hematology analyzers. The sum of the manual counts by a
hematology technician and a resident were used as the manual counts.
RESULTS:
The total
analysis time and
hands-on
time required by the Hematoflow
method were shorter than those required by manual counting. Hematoflow counts were reproducible, showed a good correlation with automated analyzers, and also showed strong correlation with manual counts (r > 0.8) in
neutrophils,
lymphocytes, and
monocytes. None of the cases containing less than 4% blasts as analyzed by the Hematoflow
method had blasts in the manual counts, but 8 cases of 21 cases (38.1%) with over 4% blasts by Hematoflow had blasts in manual counts.
CONCLUSION:
Hematoflow counts of severely leukopenic samples were reproducible and showed a good correlation with manual counts in terms of
neutrophil,
lymphocyte, and
monocyte counts. The Hematoflow
method also detected the presence of blasts. Manual slide
review is recommended when over 4% blasts are found by Hematoflow.