Interchangeability of multiple Sysmex XN10 and XN20 modules for six types of leukocytes

• Published in: International journal of laboratory hematology 2022-04, Vol.44 (2), p.273-280
• Main Authors: Koch, Sheila Perez Rovsing, Thomasen, Isa Neimann, Nielsen, Jesper Østrup, Philipsen, Jens Peter, Smith, Julie
• Format: Article
• Language: English
• Subjects: Bias; Hematology; Immunoglobulins; imprecision; Laboratories; Leukocytes (basophilic); Leukocytes (eosinophilic); Leukocytes (granulocytic); Leukocytes (neutrophilic); Lymphocytes; Monocytes; Neutrophils; Patients; Sysmex XN9000; WBC; white blood cells
• ISSN: 1751-5521; 1751-553X
• DOI: 10.1111/ijlh.13748

Introduction Differential counts of leukocytes are frequent, and often several automated blood cell counters are needed in contemporary laboratories. However, these modules are often individually quality assured. Our aim was therefore to validate the interchangeability of five hematology modules in a large modern laboratory and to compare them with our gold standard (GS) manual white blood cell differential count. Methods At Copenhagen University Hospital, we compared five Sysmex XN‐modules for neutrophils, lymphocytes, monocytes, eosinophils, basophils, and immature granulocytes (IG). We analyzed control samples in three levels to evaluate intra‐ and intermodular precision. Bias between modules was evaluated by analyzing 93 random patient samples within reference intervals. XN‐modules’ mean counts were compared with GS. Results We found acceptable intramodular CV% (0.92%–8.76%), only neutrophils and eosinophils exceeded state‐of‐the‐art imprecision or desirable specifications for medium control levels. Intermodular CV% showed significance difference for only monocytes (ANOVA, P