title: Comparison of automated platelet counts and potential effect on transfusion decisions in cancer patients.
abstract: OBJECTIVE
  To evaluate the accuracy of platelet counts from various hematology analyzers using a reference immunologic method.
  
  
  METHODS
  We tested 403 samples with platelet counts less than 50 × 10(9)/L with the Advia (Siemens, Tarrytown, NY), Sysmex (Mundelein, IL), and Abbott (Santa Clara, CA) analyzers.
  
  
  RESULTS
  All methods showed a positive bias, especially at less than 20 × 10(9)/L and less than 10 × 10(9)/L. Undertransfusion risk ranged from 9.1% to 43.3 % in the groups below 20 × 10(9)/L and below 10 × 10(9)/L, respectively. For patients with optical counts more than 10 × 10(9)/L and CD61 less than 10 × 10(9)/L, 64.5% were transfused within 24 hours of the reported count, while 35.5% were transfused in more than 24 hours, after a subsequent optical platelet count of 10 × 10(9)/L or less was reported.
  
  
  CONCLUSIONS
  Although optical and impedance methods were shown to be falsely increased in severely thrombocytopenic samples, further studies are needed to determine if more accurate methods would be clinically useful.
authors.affiliation: Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S632, New York, NY 10065; marionns@mskcc.org.
authors.forename: Steven
authors.initials: S
authors.lastname: Marionneaux
authors.forename: Nenita
authors.initials: N
authors.lastname: Francisco
authors.forename: Virgil
authors.initials: V
authors.lastname: Chan
authors.forename: Justin
authors.initials: J
authors.lastname: Hanenberg
authors.forename: Josephine
authors.initials: J
authors.lastname: Rafael
authors.forename: Conchita
authors.initials: C
authors.lastname: Chua
authors.forename: Rachel
authors.initials: R
authors.lastname: Jia
authors.forename: Jingqui
authors.initials: J
authors.lastname: Yao
authors.forename: Jean
authors.initials: J
authors.lastname: Lynch
authors.forename: Vicky
authors.initials: V
authors.lastname: Chan
authors.forename: Peter
authors.initials: P
authors.lastname: Maslak
mesh_terms: D057205:Automation, Laboratory / Q000295:instrumentation*; D001803:Blood Transfusion; D019411:Clinical Laboratory Techniques / Q000295:instrumentation*; D003657:Decision Making; D006801:Humans; D009369:Neoplasms / Q000097:blood / Q000150:complications / Q000628:therapy*; D016522:Oncology Service, Hospital; D010976:Platelet Count / Q000295:instrumentation*; D013921:Thrombocytopenia / Q000097:blood / Q000175:diagnosis / Q000209:etiology
keywords: Hematology analyzer; Hematology/oncology; Platelet count; Platelet transfusion; Transfusion safety