Evaluation of the immature myeloid information (IMI) by Sysmex XE 2100® hematology analyzer in the identification of blasts of myeloid lineage.

The immature myeloid information (IMI) provided by the Sysmex XE 2100 hematology analyzer has demonstrated that it is possible to differentiate granulocytes of immature cells in daily practice. A specific reagent lyses mature white blood cells, allowing that immature myeloid cells remain intact and consequently detectable. It is known that lymphoblasts cannot be detected in this channel. This channel does not entail additional costs, since it is provided by the traditional hematology analyzers used in blood tests and is widely useful in differentiating cell lines. This study has aimed to assess the consonance between IMI results and subtypes of acute leukemias and other hematologic malignancies in order to use it as screening test in the definition of cell lineage. A total of 141 cases of hematologic malignancies have been evaluated. Results of the IMI channel were compared using the Sudan Black cytochemical and flow cytometry. The Cohen's Kappa coefficient of agreement between IMI and flow cytometry results was 0.8%. IMI had sensibility and specificity levels of 90.7% and 90.8%, respectively; VP: 68 (91.9%); FP: 6 (8.1%); VN: 59 (89.4%) and FN: 7 (10.6%); PPV 91.9% and NPV 89.4%. The Sysmex XE 2100 analyzer showed a good analytical performance for the detection of immature myeloid cells. These results indicate that the IMI channel has sensitivity and specificity levels, consistent with previous studies. Given this situation, one may conclude that IMI was able to be used as a screening test to complement cytochemistry for identify blasts of myeloid lineage.

Reference interval determination of hemoglobin fractions in umbilical cord and placental blood by capillary electrophoresis.

INTRODUCTION: Umbilical cord and placental blood (UCPB) is a rich source of hematopoietic stem cells widely used to treat diseases that did not have effective treatments until recently. Umbilical cord and placental blood banks (UCPBBs) are needed to be created to store UCPB. UCPB is collected immediately after birth, processed, and frozen until infusion. Detection of abnormal hemoglobins is one of UCPB screening tests available. The objective of the present study was to determine the reference interval for HbA, HbF, and HbA2 in UCPB using capillary electrophoresis. Methods: Observational retrospective study of UCPB samples undergoing hemoglobin electrophoresis was performed between April 2012 and May 2013. We analyzed 273 UCPB samples. All cords met the criteria of BrasilCORD. RESULTS: We found 19.9% (10.5­36.7%) for HbA, 80.1% (62.7­89.4%) for HbF, and 0.1% (0.0­0.6%) for HbA2. Data were expressed as median (P2.5­P97.5). CONCLUSION: Establishing specific reference intervals is the best option for most tests because such ranges reflect the status of the population in which the tests will be applied. The use of appropriate reference intervals ensures that clinical labs provide reliable information, thus enabling clinicians to correctly interpret results and choose the best approach for the target population.