[Impact of hyperleucocytosis on erythrocytic parameters of cell blood count: management by Sysmex XN-10 RET analyzer]. / Impact des hyperleucocytoses sur les paramètres érythrocytaires de la numération : prise en charge par l'analyseur XN-10 RET.

ABSTRACT

INTRODUCTION: Extreme hyperleukocytosis can interfere with the haemoglobin measurement, red blood cell counts and the calculation of the erythrocyte indices. Current recommendations require various sample manipulations, resulting in high inter-operator variability. The aim of our study was to define an automated method on the XN-10 RET analyser to ensure the speed and accuracy of the haemogram results reported in cases of extreme hyperleukocytosis. METHOD: Samples from 228 control patients without hyperleukocytosis and 81 patients with haematological malignancies with extreme hyperleukocytosis were analysed on the XN-10 RET analyser. The results of photometry haemoglobin (Hb), impedance red blood cells (RBC-I) and MCV were compared to the optical methods (Hb-O and RBC-O), as well as R-MFV. RESULTS: The control group allowed us to confirm that the usual methods (photometry and impedance) were correlated with the optical methods and R-MFV. Among patients with extreme hyperleukocytosis, the white blood cells (WBC) in chronic lymphocytic leukaemia (CLL) and acute lymphoblastic leukemia (ALL) groups interfered with RBC-I and MCV but not with Hb. In chronic myeloid leukaemia (CML) and acute myeloid leukemia (AML) groups, WBC interfered with Hb and not with RBC-I nor MCV. The optical methods and R-MFV have corrected the various parameters affected by interference from hyperleukocytosis. CONCLUSION: We propose a decision tree based on simple criteria for triggering optical measurements and R-MFV to quickly correct the results of parameters impacted by hyperleukocytosis.