title: Enumeration of residual white blood cells in leukoreduced blood products: Comparing flow cytometry with a portable microscopic cell counter.
abstract: Transfusion of blood components is potentially associated to the risk of cell-mediated adverse events and current guidelines require a reduction of residual white blood cells (rWBC) below 1 × 10(6) WBC/unit. The reference method to enumerate rare events is the flow cytometry (FCM). The ADAM-rWBC microscopic cell counter has been proposed as an alternative: it measures leukocytes after their staining with propidium iodide. We have tested the Adam-rWBC for the ability to enumerate rWBC in red blood cells and concentrates. We have validated the flow cytometry (FCM) for linearity, precision accuracy and robustness and then the ADAM-rWBC results have been compared with the FCM. Our data confirm the linearity, accuracy, precision and robustness of the FCM. The ADAM-rWBC has revealed an adequate precision and accuracy. Even if the Bland-Altman analysis of the paired data has indicated that the two systems are comparable, it should be noted that the rWBC values obtained by the ADAM-rWBC were significantly higher compared to FCM. In conclusion, the Adam-rWBC cell counter could represent an alternative where FCM technology expertise is not available, even if the risk that borderline products could be misclassified exists.
authors.affiliation: Advanced Cellular Therapy Laboratory, Department of Cellular Therapy and Hematology, San Bortolo Hospital, Via Rodolfi 37, 36100 Vicenza, Italy; Hematology Project Foundation, Contrà S. Francesco 41, Vicenza, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Castegnaro
authors.affiliation: Immunohematology and Transfusion Medicine Service, Department of Transfusion Medicine, San Bortolo Hospital, Vicenza, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Dragone
authors.affiliation: Advanced Cellular Therapy Laboratory, Department of Cellular Therapy and Hematology, San Bortolo Hospital, Via Rodolfi 37, 36100 Vicenza, Italy; Hematology Project Foundation, Contrà S. Francesco 41, Vicenza, Italy.
authors.forename: Katia
authors.initials: K
authors.lastname: Chieregato
authors.affiliation: Immunohematology and Transfusion Medicine Service, Department of Transfusion Medicine, San Bortolo Hospital, Vicenza, Italy.
authors.forename: Alberta
authors.initials: A
authors.lastname: Alghisi
authors.affiliation: Advanced Cellular Therapy Laboratory, Department of Cellular Therapy and Hematology, San Bortolo Hospital, Via Rodolfi 37, 36100 Vicenza, Italy; Hematology Project Foundation, Contrà S. Francesco 41, Vicenza, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Rodeghiero
authors.affiliation: Advanced Cellular Therapy Laboratory, Department of Cellular Therapy and Hematology, San Bortolo Hospital, Via Rodolfi 37, 36100 Vicenza, Italy. Electronic address: astori@hemato.ven.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Astori
mesh_terms: D005260:Female; D005434:Flow Cytometry / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007958:Leukocyte Count / Q000295:instrumentation / Q000379:methods; D047589:Leukocyte Reduction Procedures; D007962:Leukocytes / Q000166:cytology*; D008297:Male
keywords: Apheresis; Automated blood cell counters; Flow cytometry; Leukoreduction; Quality control