Accuracy of platelet counting by automated hematologic analyzers in acute leukemia and disseminated intravascular coagulation: potential effects of platelet activation.
Platelet counting in patients with acute leukemia or disseminated intravascular coagulation (DIC) may have a risk for erroneous counts owing to the presence of nonplatelet particles or platelet activation. We evaluated automated platelet counting methods using the Abbott Cell-Dyn Sapphire (Abbott Diagnostics, Santa Clara, CA), Sysmex XE-2100 (Sysmex, Kobe, Japan), ADVIA 2120 (Siemens Diagnostics, Tarrytown, NY), and Beckman Coulter LH 750 (Beckman Coulter, Miami, FL) compared with the international reference method (IRM). Automated platelet counting methods were inaccurate compared with the IRM, without evidence of interfering nonplatelet particles. It is interesting that platelet activation markers were associated with DIC severity and erroneous platelet counting, suggesting that platelet activation is a potential source of inaccuracy. Furthermore, the artifactual in vitro platelet activation induced a high degree of intermethod variation in platelet counts. The inaccuracy of automated platelet counts increased the risk for misdiagnosis of DIC. More attention needs to be given to the accuracy of platelet counts, especially in clinical conditions with florid platelet activation.
Kim
Seon Young
SY
Dept of Laboratory Medicine, Seoul National University College of Medicine, 101, Daehang-no Jongno-gu, Seoul 110-744, Republic of Korea.
Kim
Ji-Eun
JE
Kim
Hyun Kyung
HK
Han
Kyou-Sup
KS
Toh
Cheng Hock
CH
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057205:Automation, Laboratory; D002648:Child; D002675:Child, Preschool; D003951:Diagnostic Errors; D004211:Disseminated Intravascular Coagulation / Q000097:blood*; D005260:Female; D006801:Humans; D007938:Leukemia / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015539:Platelet Activation; D010976:Platelet Count / Q000379:methods* / Q000592:standards