Int J Lab Hematol
· 2026 Feb · PMID 40947947
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INTRODUCTION: The Scopio Labs X100HT digital morphology system has been designed to automate the classification of white blood cells (WBCs) and identify pathological elements such as blasts, immature myeloid cells, and n...INTRODUCTION: The Scopio Labs X100HT digital morphology system has been designed to automate the classification of white blood cells (WBCs) and identify pathological elements such as blasts, immature myeloid cells, and nucleated red blood cells (NRBCs). This study evaluates its diagnostic performance against manual microscopy, the current gold standard for hematologic morphology. METHODS: A total of 400 peripheral blood smear samples from the routine workload of the Clinical Pathology of "G. Mazzini Hospital" in Teramo were analyzed: 40 from healthy individuals and 360 from patients selected according to internal criteria aligned with the International Consensus Group for Hematology guidelines. Each sample was evaluated using both manual microscopy and the Scopio Labs X100HT Full Field PBS system, in pre-classification and after expert review, by two experienced pathologists. The digital system pre-classified results were compared with manual counts and expert post-classification. RESULTS: The Scopio Labs X100HT system showed a strong correlation with manual microscopy for neutrophils and lymphocytes (r = 0.93), and a moderate correlation for eosinophils (r = 0.80). Agreement between digital pre-classification and expert post-classification was high across all WBC categories (r ranging from 0.84 to 0.98). Receiver operating characteristic (ROC) analysis demonstrated moderate diagnostic accuracy for detecting blasts (AUC = 0.72), immature myeloid cells (AUC = 0.79), and NRBCs (AUC = 0.71), which improved with expert review. CONCLUSION: The Scopio Labs X100HT Full Field PBS system demonstrated reliable performance in WBC differential analysis and identification of abnormal cells. Expert post-classification enhances diagnostic accuracy, supporting its use in clinical workflows alongside traditional hematology analyzers.
Hedley BD, Keeney M, Gambell P
… +4 more, Qu C, Mao J, Davis BH, Wood BL
Int J Lab Hematol
· 2026 Feb · PMID 40936290
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INTRODUCTION: The current reference method for the white blood cell (WBC) differential is manual smear review as outlined in CLSI H20-A2. As with many manual methods, it suffers from a number of challenges including depe...INTRODUCTION: The current reference method for the white blood cell (WBC) differential is manual smear review as outlined in CLSI H20-A2. As with many manual methods, it suffers from a number of challenges including dependence upon the expertise of the interpreter, the quality of the smear and stain, when dysplastic features make cell identification difficult, imprecision with leucopenia, and enumeration bias due to non-uniform cell distribution. METHODS: This study describes an alternative method for establishing the leucocyte differential using a single-tube, 8-color flow cytometric reference method. RESULTS: Data presented is from an international comparison of normal (based on analyzer counts, N = 120) and abnormal (N = 496) clinical samples performed at four institutions using four different models of flow cytometers. Here we demonstrate equivalent performance between the flow cytometric method and the current manual reference method, but show improved performance of the proposed reference method for low/infrequent cell populations, for example, monocytes and basophils. CONCLUSION: The flow cytometric method also performs well in comparison with hematology analyzers in current clinical use, including good correlation for total white blood cell enumeration. The findings indicate that the flow cytometric method, deemed the "ICSH WBC reference," could be used in lieu of CLSI H20-A2 as a reference for white blood cell enumeration and differential counting and specifically for the evaluation of automated differential counters.
Horiuchi Y, Ravzanaadii M, Bai J
… +8 more, Matsuzaki A, Kaniyu K, Ando J, Ando M, Nojiri S, Iwasaki Y, Konishi A, Tabe Y
Int J Lab Hematol
· 2026 Feb · PMID 40932175
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BACKGROUND AND OBJECTIVES: We developed an automated morphological image recognition deep learning system (image recognition DLS) of peripheral blood cells, then constructed the diagnostic assist DLS combining image reco...BACKGROUND AND OBJECTIVES: We developed an automated morphological image recognition deep learning system (image recognition DLS) of peripheral blood cells, then constructed the diagnostic assist DLS combining image recognition DLS data with complete blood count (CBC) data. This study aimed to evaluate the clinical performance of the image recognition DLS and the diagnostic assist DLS in routine examinations. METHODS: The image recognition DLS was trained using datasets containing 1 476 727 images of white blood cells (WBCs), nucleated red blood cells (NRBCs), and large platelets to differentiate 14 blood cell types and to recognize 24 morphological characteristics. CBC data were obtained through the automated hematology analyzer (Sysmex XN-9000) and combined with the image recognition DLS data to construct the diagnostic assist DLS. The clinical performance of the image recognition DLS was evaluated using 128 716 blood cell images from 589 smears obtained from healthy subjects, ALL, AML, ML, MPN, and MDS cases in routine examinations. RESULTS: The image recognition DLS classified 14 blood cell types with an accuracy of 97.3%-99.9%. The accuracy of 11 morphological characteristics exceeded 90%. Blast cells were detected accurately on all slides, where they were identified by manual microscopy. Malignant lymphocytes were classified as blasts and/or lymphocytes with the morphological characteristics of each subtype of lymphoma. The diagnostic assist DLS successfully differentiated MDS, achieving an AUC (area under the curve) of 0.99. CONCLUSION: This study demonstrated the potential of the diagnostic assist DLS, utilizing morphological image recognition DLS data combined with CBC parameters, as a promising diagnostic tool.
Jin X, Chen Z, Pan Q
… +5 more, Tian S, Jiang Y, Su C, Zhou W, Jiang H
Int J Lab Hematol
· 2026 Feb · PMID 40931321
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BACKGROUND: T follicular helper (TFH) cell lymphoma is complex, and we hope to provide a new perspective for its diagnosis. METHODS: We analysed the immunophenotypes of 89 mature T-cell lymphomas, including 52 nodal lymp...BACKGROUND: T follicular helper (TFH) cell lymphoma is complex, and we hope to provide a new perspective for its diagnosis. METHODS: We analysed the immunophenotypes of 89 mature T-cell lymphomas, including 52 nodal lymphomas of TFH origin, as well as 32 benign lymph node samples and 30 healthy bone marrow samples, by flow cytometry (FCM). RESULTS: Among pan-T cell markers, CD4CD5CD3 is the typical pattern that distinguishes TFH lymphoma from other T-cell lymphomas. Specific markers with high sensitivity for the diagnosis of TFH lymphoma include programmed cell death protein 1 (PD-1) and inducible synergistic co-stimulation molecules (ICOS), which are expressed at lower levels in neoplastic TFH cells than in benign TFH cells. In contrast, the specificity of C-X-C chemokine receptor type 5 (CXCR5) and CD10 is high, and the proportion of CD10-positive cells in neoplastic TFH samples is greater than that in benign TFH samples. Of the 52 TFH lymphoma samples in our study, 7 presented with abnormalities in B cells or plasmablast cells; we considered these to indicate B-cell proliferation rather than composite lymphoma. CONCLUSION: Immunophenotypic characterization of neoplastic TFH cells by FCM is unique and has diagnostic value. Each specimen of suspected TFH lymphoma should be analyzed for the presence of specific markers, such as PD-1, ICOS, CXCR5, and CD10, and the clonality of B cells and plasmablast cells should be assessed.
Gurumurthy G, Lemma M, Reynolds L
… +2 more, Grainger J, Thachil J
Int J Lab Hematol
· 2026 Feb · PMID 40923134
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BACKGROUND: Coagulation screening, consisting of prothrombin time (PT) and activated partial prothrombin time (aPTT), is routinely performed in paediatrics to identify bleeding disorders or guide peri-procedural manageme...BACKGROUND: Coagulation screening, consisting of prothrombin time (PT) and activated partial prothrombin time (aPTT), is routinely performed in paediatrics to identify bleeding disorders or guide peri-procedural management. We evaluated the trends in utilisation and diagnostic yield of PT and aPTT testing as part of coagulation screening in a tertiary paediatric centre. METHODS: All PT and aPTT samples received from June to September 2024 were analysed. Total requests, sample rejection rates, abnormal result patterns (isolated PT, isolated APTT, combined), and clinical correlations were recorded. Laboratory cutoffs were PT > 12.5 s and APTT > 30.0 s. Youden's Index determined cutoffs associated with inherited bleeding disorders. RESULTS: A total of 2808 coagulation profiles from 1207 patients were received, with 15.7% (442/2808) rejected in 268 patients. Of these, 31.7% (85/268) of patients were not re-tested. Among valid requests, 17.0% (402/2366) were abnormal (128 isolated APTT, 173 isolated PT, 101 combined). In a subgroup of 337 randomly selected patients, 28.8% (97/337) had deranged results, leading to 12 new haematological and 34 acute diagnoses. Youden's index determined isolated APTT > 31.4 s associated with inherited disorders (AUC > 0.8). The same was not identified with isolated PT (PT > 13.0 s, AUC < 0.6). CONCLUSION: A substantial proportion of samples received are rejected, and some abnormal results remain unaddressed. Most abnormal findings are clinically significant, particularly when APTT > 33.1 s. There is scope to refine utilisation in paediatric practice.
Maddirala BP, Oberoi G, Kakarla A
… +4 more, Chandrasekhar B, Gupta A, Nakra R, Lal V
Int J Lab Hematol
· 2026 Feb · PMID 40922620
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CONTEXT: Early detection of acute leukemia (AL) is crucial for timely intervention and improved outcomes. Machine learning (ML) models provide a promising approach for early screening and rapid diagnosis of AL, minimizin...CONTEXT: Early detection of acute leukemia (AL) is crucial for timely intervention and improved outcomes. Machine learning (ML) models provide a promising approach for early screening and rapid diagnosis of AL, minimizing delays in referral. OBJECTIVES: To assess the utility of leukocyte cell population data (CPD) through ML models for detecting AL. To subclassify AL into acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) using CPD morphometry at a pre-microscopic level. To perform feature analysis on the ML prediction model. METHODS: We analyzed 1211 cases, including 810 confirmed AL cases (by morphology, immunophenotype, or molecular methods) and 401 benign cases. Leukocyte parameters and CPD from a Sysmex XN1000 analyzer (WDF Channel) were used for classification. ML models-LightGBM, CatBoost, TabNet, and XGBoost-were trained, and the optimal model was selected based on accuracy from 5-fold cross-validation. Feature contributions were evaluated using SHAP. RESULTS: Heat maps and UMAP projections effectively differentiated AL from benign cases and AML from ALL. XGBoost achieved the best performance with 88% sensitivity and 94% specificity. ROC-AUC scores were 0.88 for AML, 0.87 for ALL, and 0.99 for benign. Key features identified included NE-WY, MO-WZ, LYMPH, NE-WZ, NEUT, and MONO#. CONCLUSION: ML models based on leukocyte and CPD parameters enhance the predictability of AL detection and lineage differentiation at a pre-microscopic level. Integrating these models into hematology analyzers provides a cost-effective, novel tool for detection and differentiation. Interpretable predictions assist experts, reducing subjectivity and expediting final diagnosis through immunophenotyping and molecular studies.
Jury V, Talon L, Tourret E
… +2 more, Lebreton A, Sinegre T
Int J Lab Hematol
· 2026 Feb · PMID 40905368
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BACKGROUND: Preanalytical conditions, particularly centrifugation protocols, are critical for producing high-quality platelet-poor plasma in hemostasis testing. Centrifuge braking is debated due to its potential impact o...BACKGROUND: Preanalytical conditions, particularly centrifugation protocols, are critical for producing high-quality platelet-poor plasma in hemostasis testing. Centrifuge braking is debated due to its potential impact on platelet remixing. OBJECTIVES: To evaluate the effect of centrifuge braking on residual platelet counts and a broad panel of hemostasis assays using both fresh and double-centrifuged plasma. METHODS: Fifty-six adult patients provided surplus citrate plasma samples. Three centrifugation protocols were assessed: 2000 g for 15 min with braking (B+/2000/15), 2500 g for 10 min with braking (B+/2500/10), and 2500 g for 10 min without braking (B-/2500/10). Routine assays were performed on fresh plasma. Specialized assays (factors VIII, IX, XI, XII, VWF, protein C, protein S, antithrombin, APC resistance, DRVVT, antiphospholipid antibodies) were performed on frozen plasma after double-centrifugation. Platelet counts and assay concordance were evaluated. RESULTS: Residual platelet counts were significantly higher in the B+/2500/10 protocol (9 [6-13] × 10/L) compared to B-/2500/10 (2 [2-4] × 10/L, p < 0.001) and B+/2000/15 (3 [2-4] ×10/L, p < 0.01). All frozen samples had platelet counts < 10 × 10/L. Routine coagulation assays were unaffected by protocol choice, except for a slight but statistically significant increase in factor V with braking. Specialized assays showed no meaningful differences across protocols, with the exception of a minor DRVVT confirmation time reduction in the braking group. CONCLUSION: Braking during centrifugation reduces processing time but modestly increases residual platelet counts. Nonetheless, it does not compromise the performance of hemostasis assays when protocols are appropriately validated. These findings support the use of braking in clinical laboratories.
Gupta SK, Leons GK, Sharma P
… +7 more, Rani L, Bakhshi S, Gupta R, Roy A, Gajendra S, Sahoo RK, Pushpam D
Int J Lab Hematol
· 2026 Feb · PMID 40899517
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INTRODUCTION: B-cell acute lymphoblastic leukemia (B-ALL) is genetically heterogeneous. We assessed the utility of FusionPlex ALL targeted RNA sequencing panel in detecting gene fusions and other genomic lesions in B-ALL...INTRODUCTION: B-cell acute lymphoblastic leukemia (B-ALL) is genetically heterogeneous. We assessed the utility of FusionPlex ALL targeted RNA sequencing panel in detecting gene fusions and other genomic lesions in B-ALL. METHODS: The high-risk B-ALL, negative for common recurrent gene fusions (RGF), that is, BCR::ABL1, ETV6::RUNX1, TCF3::PBX1 and KMT2A::AFF1, were analysed with RNA-based targeted sequencing 81-gene-panel FusionPlex ALL (IDT, USA). Multiplex ligation-dependent probe amplification (MLPA) was used for IKZF1 deletions and flow-cytometry for CRLF2 expression and ploidy analysis. RESULTS: Out of 32 samples, 27 were high-risk B-ALL cases (median age 16 (1-41) years) and 5 B-ALL controls with known fusions for validation. The fusions were detected in 6/27 (22%) RGF-negative B-ALL cases; 2 with EPOR::IGH and 1 each P2RY8::IGH, PAX5::ETV6, SNX2::ABL1, IKZF1::CIITA. In addition, IKZF1 and/or PAX5 gene deletions resulting in the formation of oncogenic/novel isoforms were detected in 75% (15/20) samples positive on MLPA. Flow-cytometry CRLF2 overexpression was noted in 60% (9/15) tested samples which correlated well with targeted RNAseq CRLF2 gene expression. CONCLUSION: The targeted sequencing approach can help in detecting known and novel fusions in B-ALL, novel breakpoints in the known fusions, gene deletions as oncogenic/novel isoforms and CRLF2 expression.
Barion BG, Stefanello B, de Paula MLSA
… +5 more, Saraiva TS, Villaça PR, Rocha V, Orsi FA, da Rocha TRF
Int J Lab Hematol
· 2026 Feb · PMID 40873063
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INTRODUCTION: The International Society of Thrombosis and Hemostasis (ISTH) guidelines suggest a three-step evaluation for the detection of lupus anticoagulant (LA), including screening, mixing, and confirmation. Accordi...INTRODUCTION: The International Society of Thrombosis and Hemostasis (ISTH) guidelines suggest a three-step evaluation for the detection of lupus anticoagulant (LA), including screening, mixing, and confirmation. According to the guidelines, the LA assay based on activated partial thromboplastin time (APTT) should include an initial screening step followed by a confirmatory step that uses a higher concentration of phospholipids in either bilayer or hexagonal form. For the activator, the guidelines recommend using silica, though ellagic acid is also an option. In this context, HemosIL Silica Clotting Time (SCT, Instrumentation Laboratory) is the only assay that fully complies with the guidelines. However, there are other assays available using different reagents, such as Dade Actin FSL/FS (Siemens Healthcare Diagnostics) and PTT-LA/Staclot LA (Diagnostica Stago), and the relevance of these differences in LA detection is not known. METHODS: This study compared the performance of the three platforms. RESULTS: Out of 136 samples, the majority were from females (82%) with a median age of 41 years (IQR 32-50); 44 (32%) had a history of thrombosis, and 28 (21%) were on anticoagulants. PTT-LA/Staclot LA had the highest sensitivity (100%) and specificity (100%). There was an almost perfect agreement between PTT-LA/Staclot LA and Dade Actin FSL/FS (kappa 0.812). HemosIL SCT sensitivity was 100% and the specificity was 74%, which was increased to 99% by increasing the phospholipid concentration of the screening step. CONCLUSION: We observed a good agreement between PTT-LA/Staclot LA and Dade Actin FSL/FS, and fair to moderate agreement with HemosIL SCT, whose performance improved with increasing phospholipid concentration. These results demonstrate that all three assays are comparable for APTT-LA detection.
Promsuwicha O, Owattanapanich W, Kankhaw S
… +2 more, Ruchutrakool T, Kungwankiattichai S
Int J Lab Hematol
· 2025 Dec · PMID 40855844
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INTRODUCTION: The European LeukemiaNet (ELN) 2022 classification introduced significant modifications to acute myeloid leukemia (AML) categorization, including refined criteria for AML with myelodysplasia-related cytogen...INTRODUCTION: The European LeukemiaNet (ELN) 2022 classification introduced significant modifications to acute myeloid leukemia (AML) categorization, including refined criteria for AML with myelodysplasia-related cytogenetic abnormalities (AML-MRC). While cytogenetic analysis is essential for a definitive diagnosis, the question remains whether flow cytometry can aid in the initial identification of this AML subgroup. This study aimed to characterize the immunophenotypic profiles of AML-MRC and validate previously reported immunophenotypic patterns of AML with t(8;21) and inv(16) using flow cytometry. METHODS: This retrospective study analyzed 911 non-acute promyelocytic leukemia (APL) AML cases. Flow cytometric immunophenotyping was performed using a comprehensive panel of 23 markers. Statistical analysis included univariate and multivariate logistic regression to identify discriminatory markers. RESULTS: Among 911 patients, 241 (26.5%) were classified as AML-MRC. AML-MRC patients were significantly older (mean age: 55.9 vs. 47.9 years, p < 0.001) and presented with lower WBC counts (median: 8.9 vs. 24.2 × 10^9/L, p < 0.001) compared to non-MRC cases. AML-MRC demonstrated higher expression of CD34 (75.9% vs. 57.6%, p < 0.001), CD41a (10.8% vs. 4.5%, p = 0.002) and CD235a (5.8% vs. 1.2%, p < 0.001), with CD235a showing the highest discriminatory power (OR 4.458, 95% CI 1.720-11.552). For core-binding factor AML, AML with t(8;21) exhibited characteristic expression of CD19 (46.3% vs. 9.4%, p < 0.001) and CD56 (72.5% vs. 34.5%, p < 0.001), while AML with inv(16) showed distinctive CD34 (88.9% vs. 61.7%, p = 0.004) and CD14 (59.3% vs. 18.1%, p < 0.001) expression patterns. CONCLUSION: This study identifies markers that distinguish AML-MRC, including CD235a, CD41a, and CD34. This suggests that acute erythroid leukemia and acute megakaryocytic leukemia are subsets within the AML-MRC category. Additionally, the study validates previously reported immunophenotypic characteristics of AML with t(8;21) and inv(16).
Pouplard C, Charuel N, Archer E
… +8 more, Vayne C, Bauters A, Jaouen S, Savard P, Maucorps L, Guery EA, Gruel Y, Rollin J
Int J Lab Hematol
· 2026 Feb · PMID 40854821
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BACKGROUND: Immunoassays detecting anti-PF4/H antibodies must be sensitive to exclude heparin-induced thrombocytopenia (HIT), and optical density (OD) values are useful for confirming HIT, but no calibration is currently...BACKGROUND: Immunoassays detecting anti-PF4/H antibodies must be sensitive to exclude heparin-induced thrombocytopenia (HIT), and optical density (OD) values are useful for confirming HIT, but no calibration is currently available. OBJECTIVES: To study the impact of OD values on the performance of the Asserachrom HPIA IgG in a cohort of patients with suspected HIT, and the value of a calibration performed with 5B9, a HIT monoclonal antibody. METHODS: The HPIA IgG was performed in 170 patients with a high or intermediate probability of HIT. Results were expressed in OD or '5B9 equivalent' units, using a calibration done with 5B9. HIT was confirmed when HPIA and SRA/PF4 tests were positive. RESULTS: HIT was excluded in 97 cases because HPIA and SRA/PF4 were negative. The HPIA was positive in 73 cases and HIT confirmed in 43 cases (SRA/PF4+). Applying an OD threshold of 1.05, the NPV and PPV of the test were 98% and 83%, respectively. Calibration of HPIA with 5B9 did not improve its performance, since similar AUC values (ROC curves) were obtained whether results were expressed in OD values or in equivalent units of 5B9. Bayesian analysis showed that in patients with an intermediate pre-test probability of HIT, the post-test probability equalled 1% when OD was less than 1, and 100% when OD was over 2. CONCLUSION: 5B9 as a calibrator failed to improve the performance of HPIA, but this assay can reliably exclude (when negative) or confirm HIT (when OD > 2), without requiring a functional assay.
Chauhan R, Puri V, Acharya S
… +9 more, Dass J, Ranjan R, Sharma P, Viswanathan GK, Aggarwal M, Kumar P, Dhawan R, Seth T, Mahapatra M
Int J Lab Hematol
· 2025 Dec · PMID 40851336
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Recent review collated 22 rare and novel alpha globin gene variants amongst the Indian population published in the literature in the last 52 years. We report another rare high-oxygen affinity alpha-globin variant hemoglo...Recent review collated 22 rare and novel alpha globin gene variants amongst the Indian population published in the literature in the last 52 years. We report another rare high-oxygen affinity alpha-globin variant hemoglobinopathy in a compound heterozygous state with α thalassemia. The patient, a 42-year-old male, came for evaluation of JAK2 p.V617F negative erythrocytosis requiring multiple phlebotomies in the last 4-5 years. On laboratory investigations for high-oxygen affinity hemoglobinopathy, he was found to have an unknown peak eluting as a left shoulder hump of the Adult hemoglobin (HbA0) in Cation exchange High-Performance Liquid Chromatography (CE-Hb-HPLC). His family study revealed the variant hemoglobinopathy coexisting with a single alpha-globin deletion in the mother, sibling, and two children. Next-generation sequencing (NGS), Gap Polymerase chain reaction (GAP-PCR), and multiplex ligation probe amplification (MLPA) on the extracted DNA of the index case showed compound heterozygous state for Hb Milledgeville and -α thalassemia. This is the first report of a rare high-oxygen-affinity alpha hemoglobin variant Hb Milledgeville from India.
Mishra P, Thosani P, Patra M
… +3 more, Tripathi P, Dube M, Singh B
Int J Lab Hematol
· 2025 Dec · PMID 40826816
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BACKGROUND: Cell Population Data (CPD), derived from next-generation hematology analyzers, is emerging as a promising tool for diagnosis of early sepsis. This preliminary case-control study assessed the diagnostic utilit...BACKGROUND: Cell Population Data (CPD), derived from next-generation hematology analyzers, is emerging as a promising tool for diagnosis of early sepsis. This preliminary case-control study assessed the diagnostic utility of CPD and its association with sequential organ failure assessment (SOFA) scores and procalcitonin levels in sepsis patients. METHODS: Seventy-two sepsis patients and 72 age- and sex-matched non-septic controls were enrolled. CPD parameters were measured using a Sysmex XN-1000 analyzer. Univariate and multivariate analyses, including PCA, PLS-DA, and OPLS-DA, were used to distinguish between groups. ROC analysis evaluated diagnostic performance. Spearman's rank correlation assessed associations between CPD, SOFA scores, and procalcitonin. RESULTS: Several CPD parameters-LY-X, LY-Z, MO-X, MO-Y, NE-WX, NE-WY, NE-WZ, LY-WX, LY-WY, and LY-WZ-were significantly elevated in sepsis. Multivariate analysis identified MO-X, MO-WY, LY-X, and LY-Z as strong discriminators (VIP > 1.15). ROC analysis showed MO-X (> 119.6) had 95.83% sensitivity, 73.61% specificity (AUC 0.876), and IG% (> 0.6) had 83.33% sensitivity, 80.56% specificity (AUC 0.880). IG count (> 40/μL) showed 81.94% sensitivity, 81.32% specificity (AUC 0.859); LY-X (> 79.3) had 93.06% sensitivity, 48.61% specificity (AUC 0.685); and MO-WY (> 752) had 84.72% sensitivity, 45.83% specificity (AUC 0.597). SOFA score correlated with MO-X (r = 0.40, p = 0.007), LY-X (r = 0.40, p = 0.008) and LY-Z (r = 0.39, p = 0.009), while procalcitonin correlated with MO-X (r = 0.30, p = 0.03) and HFLC (r = 0.40, p = 0.005). CONCLUSION: CPD is a promising, cost-effective biomarker for diagnosis and severity assessment of sepsis, but inter-equipment variability and current "research use only" status warrant further clinical validation.
Girard S, Berda-Haddad Y, Brouzes C
… +5 more, Badaoui B, Boussaroque A, Janel A, Chatelain B, Baccini V
Int J Lab Hematol
· 2025 Oct · PMID 40819933
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Mean corpuscular haemoglobin concentration (MCHC) is determined by the ratio of haemoglobin concentration to haematocrit. Managing increased MCHC presents significant challenges, mainly due to variations in analytical me...Mean corpuscular haemoglobin concentration (MCHC) is determined by the ratio of haemoglobin concentration to haematocrit. Managing increased MCHC presents significant challenges, mainly due to variations in analytical methods and pathophysiological conditions. Depending on the haematological analyser (HA), MCHC can be measured directly or calculated. It is important that all people involved in hematocytometry must identify and correct artefacts to ensure accurate erythrocyte parameters. In order to harmonise and standardise haematology practices in all laboratories, the French-speaking Cellular Haematology Group (GFHC) has reviewed the interferences and pathophysiological situations that could increase MCHC, and the advice on how to manage cases of elevated MCHC. We will review current techniques, such as impedance and optical methods, for accurate determination of MCHC. We will also examine the interferences that can artificially increase MCHC; and the pathophysiological conditions responsible for such increases. Finally, we will present guidelines for the management of elevated MCHC, including strategies to bypass interferences and determine which erythrocyte parameters can be reliably reported, as well as the acceptable MCHC values for various pathophysiological variations.