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Mansyur Arif1, Asvin Nurulita1, Agus Alim Abdullah1, Fili Oei1, Arifin Seweng2
1 Department of Clinical Pathology and Laboratory Medicine, Medical University of Hasanuddin, Makassar, 2Medical University of Hasanuddin
The hematology analyzer allows the measurement of several hematological parameters useful in diagnostic and clinical patients. In leukemia, hematological parameters especially in the case of leukocyte differential count helps early diagnosis of leukemia.
A cross sectional study in 57 subjects. Measurement of differential count using two hematology analyzers Yumizen H1500/2500 and Sysmex XN-1000. The statistical tests were Mann-Whitney and Spearman’s test. The test results are significant if the p-value < 0.001.
57 patients consisted of 15 AML, 12 ALL, 14 CML, 9 MDS, and 7 other diagnosis. There was significant relationship between the leukocyte differential count parameter with the morphology of peripheral blood smear and bone marrow aspiration (p<0,001). The correlation between leukocyte differential counts parameters of two hematology analyzers using Spearman’s correlation has a significant positive correlation with moderate to very strong (p<0,001). The parameters of leukocytes, lymphocytes, and eosinophils were very strong correlation (r = 0,990, 0,892 and 0,717), monocytes and neutrophils were a strong correlation (r = 0,706 and 0,782) and basophils were moderate correlation (r = 0,376).
WBC | Instrument Yumizen H2500 | |||||
WBC | 305.90 | D | 10^3/mm3 | 3.50 | - | 10.00 |
TNC | 307.12 | 10^3/mm3 | 3.50 | - | 10.00 | |
ERY | Instrument Yumizen H2500 | |||||
RBC | 2.75 | 10^6/mm3 | 4.20 | - | 6.0 | |
HGB | 8.6 | g/dL | 13.0 | - | 17.0 | |
HCT | 24.4 | % | 40.0 | - | 54.0 | |
MCV | 88.8 | fL | 80.0 | - | 100.0 | |
MCH | 31.4 | pg | 27.0 | - | 34.0 | |
MCHC | 35.4 | g/dL | 32.0 | - | 35.0 | |
RDW-CV | 17.0 | % | 12.0 | - | 18.0 | |
RDW-SD | 51.0 | fL | 37.0 | - | 56.0 | |
MIC% | 6.8 | % | 0.0 | - | 20.0 | |
MAC% | 3.3 | % | 2.0 | - | 10.0 | |
PLT | Instrument Yumizen H2500 | |||||
PLT | 182 | 10^3/mm3 | 150 | - | 400 | |
PLTO | 190 | 10^3/mm3 | 150 | - | 400 | |
MPV | 10.0 | fL | 7.4 | - | 12.0 | |
PCT | 0.182 | % | 0.150 | - | 0.400 | |
PDW | 18.3 | fL | 11.0 | - | 20.0 | |
DIF | Instrument Yumizen H2500 | |||||
NEU% | 22.7 | % | 40.0 | - | 75.0 | |
LYM% | 1.4 | % | 15.0 | - | 45.0 | |
MON% | 6.4 | % | 4.0 | - | 13.0 | |
EOS% | 4.5 | % | 0.5 | - | 7.0 | |
BAS% | 8.3 | % | 0.0 | - | 2.0 | |
ALY% | 0.2 | % | 0.0 | - | 2.5 | |
LIC% | 56.7 | % | 0.0 | - | 3.0 | |
IML% | 4.6 | % | 0.0 | - | 0.2 | |
IMM% | 23.0 | % | 0.0 | - | 0.5 | |
IMG% | 29.1 | % | 0.0 | - | 2.0 | |
NRBC% | 0.4 | % | 0.0 | - | 2.0 | |
NEU# | 69.49 | 10^3/mm3 | 1.50 | - | 7.00 | |
LYM# | 4.39 | 10^3/mm3 | 1.00 | - | 4.00 | |
MON# | 19.54 | 10^3/mm3 | 0.20 | - | 0.80 | |
EOS# | 13.89 | 10^3/mm3 | 0.00 | - | 0.50 | |
BAS# | 25.25 | 10^3/mm3 | 0.0 | - | 0.20 | |
ALY# | 0.69 | 10^3/mm3 | 0.0 | - | 0.20 | |
LIC# | 173.34 | 10^3/mm3 | 0.0 | - | 0.20 | |
IML# | 14.18 | 10^3/mm3 | 0.0 | - | 0.05 | |
IMM# | 70.23 | 10^3/mm3 | 0.0 | - | 0.10 | |
IMG# | 88.93 | 10^3/mm3 | 0.0 | - | 999.90 | |
NRBC# | 1.22 | 10^3/mm3 | 0.0 | - | 0.15 |
Comments:
Sep. Neutro/Eosino
Sep. Mono/Neutro
Left Neutro
Right Neutro
Right Mono
WBC instability (DIFF)
WBC out of linearity
WBC noise (DIFF)
WBC abnormal DIFF
Table 1. Correlation between leukocytes and differential count of Yumizen H1500/2500 and Sysmex XN-1000 tools
Parameters (n=57) | Correlation coefficient (R)* | p-value |
---|---|---|
WBC | 0.990 | 0.000 |
Lymph | 0.892 | 0.000 |
Mono | 0.717 | 0.000 |
Neut | 0.706 | 0.000 |
Eos | 0.782 | 0.000 |
Baso | 0.376 | 0.000 |
*Spearman's Correlation Test |
Table 2. Comparison between leukocytes and differential count of Yumizen H1500/2500 with peripheral blood smear and bone marrow
Parameters | Yumizen H1500/2500 (n=57) | ||||
---|---|---|---|---|---|
Acute | Chronic | p-value | |||
Mean | SD | Mean | SD | ||
WBC | 64.09 | 96.33 | 223.59 | 118.28 | <0.001 |
Neut | 42.00 | 22.24 | 11.58 | 19.79 | <0.001 |
Lymph | 21.93 | 21.49 | 6.83 | 6.33 | 0.001 |
Mono | 19.23 | 12.86 | 6.83 | 6.33 | 0.001 |
Eos | 0.97 | 1.76 | 2.78 | 1.52 | <0.001 |
Baso | 2.96 | 4.80 | 10.75 | 8.60 | 0.013 |
*Mann-Whitney Test |
Table 3. Comparison between leukocytes and differential count of Sysmex XN-1000 with peripheral blood smear and bone marrow
Parameters | Sysmex XN-1000 (n=57) | ||||
---|---|---|---|---|---|
Acute | Chronic | p-value | |||
Mean | SD | Mean | SD | ||
WBC | 72.39 | 116.08 | 248.31 | 163.98 | <0.001 |
Neut | 27.24 | 23.91 | 72.18 | 24.28 | <0.001 |
Lymph | 41.63 | 22.92 | 10.30 | 20.43 | <0.001 |
Mono | 29.69 | 20.70 | 9.35 | 9.92 | 0.001 |
Eos | 1.26 | 2.69 | 2.82 | 2.81 | 0.009 |
Baso | 0.55 | 1.01 | 5.02 | 5.05 | <0.001 |
*Mann-Whitney Test |
The results of the leukocyte differential count showed the same cell types found in the morphology of the peripheral blood smear and bone marrow aspiration. The correlation between the two hematology analyzers showed that the results of the differential count were either increasing or decreasing even though the methods of the two hematology analyzers were different.
There was no difference in the leukocyte differential count parameters between both hematology analyzers and had a significant positive correlation with the morphology of the peripheral blood smear and bone marrow aspiration.
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