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Comparative evaluation of nucleated red blood cell (nrbc) counting by Abbott Cell-Dyn Sapphire hematology analyzer and microscopy

Introduction. The detection and quantification of NRBC is important in two perspectives: clinically and analytically. With exception of newborns that has referent range less then 5 NRBCs/100 white blood cells (WBCs), the presence of circulating NRBCs in peripheral blood is abnormal finding and is typically associated with significant pathology. Additionally, the ability to count NRBC is important in context of being able to detect their interference in leukocyte count determined on hematology analyzers. AIM: The aim of the study was to investigate the accuracy of automated NRBC count determined on Abbott CELL-DYN Sapphire analyzer: 1. in peripheral blood of newborns that may be important for clinicians in everyday experience in the Department of Neonatology of Sestre milosrdnice University Hospital, 2. in peripheral blood of patients from Emergency of our Hospital with unknown hematological disorder. Methods. We determined complete blood count (CBC) + Resistant RBC (L++) on Abbott CELL-DYN Sapphire analyzer in samples of newborns and CBC in samples of adult patients from Emergency. Abbott CELL-DYN Sapphire is new generation of cell analyzers that uses a variety of analytical technologies including laser based optical, impedance and fluorescence detection system. NRBC is integral part of the blood count. NRBCs /100 WBCs were measured by microscopy examination per 200 WBC on peripheral blood film by technicians educated in neonatal hematology. We analyzed 743 blood samples. Analysis has been done for all newborns in the time period of two months (n=690) at first 24 h of life and for patients from Emergency with anemia unknown etiology (n=53) with positive results of NRBCs. Automated NRBC counts were compared with manual NRBC counts by linear regression. Results. The following NRBC count results were obtained: an acceptable correlation R2= 0.671 between automated cell analyzers NRBC and microscopy. Standard protocol for quality control of instrument has been run with commercial control material CELL-DYN29 Plus Control and statistically, 99% of control results fall within ± ; 1SD, CV 2, 65-3, 76. Conclusions. The automated NRBC count should replace our traditional manual NRBC count because the automated count has higher precision and is less timeconsuming and labor – intensive for samples of newborns. For adult patients from Emergency it is very important information that should be proven microscopy.

nucleated red blood cell; automated counts; manual count

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