title: Performance evaluation of the Sysmex XN-1000 hematology analyzer in assessment of the white blood cell count differential in pediatric specimens.
abstract: BACKGROUND
  The automated XN-1000 hematology analyzer enables to perform a blood cell count and a leukocyte differential. When abnormal cells were detected, a flag was generated by the analyzer and a manual microscopic examination of the corresponding blood film was performed.
  
  
  METHODS
  We compared the white blood cell differentials provided by the automated hematology analyzer XN-1000 in a pediatric population (n = 765) with those obtained through microscopic examination by cytologists and those obtained using a previous version of this analyzer, the XE-2100. Leukocytes count as well as flags sensitivity and specificity was analyzed.
  
  
  RESULTS
  The leukocytes count provided by the analyzer is in good accordance with the differential obtained by manual count in children older than 3 months. The sensitivity for blast detection is 99% and the detection of reactive cells is 63%. The flag specificity remains low (<35%) for blood samples collected from infants between 8 days and 2 years of age, but increases up to 67% thereafter. The results obtained with the XN-1000 analyzer show an improvement in comparison with those obtained with the XE-2100 analyzer.
  
  
  CONCLUSIONS
  The automated WBC differential provided by the XN-1000 analyzer in the pediatric setting is accurate, but a meticulous microscopic examination of blood smears remains necessary for infants up to 3 months of age to validate the analyzer flags.
authors.affiliation: Service d'Hématologie Biologique, Hôpital R. Debré, AP-HP, Paris, France.
authors.forename: P-H
authors.initials: PH
authors.lastname: Becker
authors.affiliation: Service d'Hématologie Biologique, Hôpital R. Debré, AP-HP, Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Fenneteau
authors.affiliation: Service d'Hématologie Biologique, Hôpital R. Debré, AP-HP, Paris, France.|Université Paris Diderot Sorbonne Paris Cité, Paris, France.|CRI, Faculté Bichat-Claude Bernard, INSERM U1149, Paris, France.|Laboratoire d'excellence GR-Ex, Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Da Costa
mesh_terms: D000293:Adolescent; D057205:Automation, Laboratory; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007958:Leukocyte Count / Q000295:instrumentation / Q000379:methods* / Q000592:standards*; D007962:Leukocytes / Q000166:cytology* / Q000473:pathology*; D008297:Male; D008853:Microscopy / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Automated blood cells analyzers; Sysmex XN-1000; WBC differentials; flags; pediatrics