RESEARCH ARTICLE
RESEARCH ARTICLE
A comparative study of blood cell count in four automated hematology analyzers: An evaluation of the impact of preanalytical factors
Abstract
Abstract
Differential white blood cell counts are frequently used in diagnosis, patient stratification, and treatment selection to optimize therapy responses. Referral laboratories are often used but challenged with use of different hematology platforms, variable blood shipping times and storage conditions, and the different sensitivities of specific cell types. To extend the scientific literature and knowledge on the temporal commutability of blood samples between hematology analyzers, we performed a comparative ex-vivo study using four of the most utilized commercial platforms, focusing on the assessment of eosinophils given its importance in asthma management. Whole blood from healthy volunteers with and without atopy (n equals six plus six) and participants with eosinophilic asthma (n equals six) were stored under different conditions (at four, twenty, thirty, and thirty-seven degrees Celsius, with or without agitation) and analyzed at different time points (three, six, twenty-four, forty-eight, and seventy-two hours post-sampling) in parallel on the Abbott CELL-DYN Sapphire, Beckman Coulter DxH nine hundred, Siemens ADVIA two thousand one hundred I and Sysmex XN-one thousand V. In the same blood samples, eosinophil-derived neurotoxin, eosinophil activation and death markers were analyzed. All platforms gave comparable measurements of cell differentials on fresh blood within the same day of sampling. However, by twenty-four hours, significant temporal and temperature-dependent differences were observed, most markedly for eosinophils. None of the platforms performed perfectly across all temperatures tested during the seventy-two hours, showing that handling conditions should be optimized depending on the cell type of interest and the hematology analyzer. Neither disease status (healthy versus asthma) nor agitation of the sample affected the cell quantification result or EDN release. The eosinophil activation markers measured by flow cytometry increased with time, were influenced by temperature, and were higher in those with asthma versus healthy participants. In conclusion, hematology analyzer, time window from sampling until analysis, and temperature conditions must be considered when analyzing blood cell differentials, particularly for eosinophils, via central labs to obtain counts comparable to the values obtained in freshly sampled blood.