title: Automated Nucleated RBC Measurement Using the Sysmex XE-5000 Hematology Analyzer: Frequency and Clinical Significance of the Nucleated RBCs.
abstract: OBJECTIVE
  We validated the automatic nucleated RBC (nRBC) count on a Sysmex XE-5000 hematology analyzer (Sysmex Corporation, Kobe, Japan) and then evaluated the frequency of nRBCs in our patient population.
  
  
  METHODS
  We correlated automated nRBC enumeration by the Sysmex XE-5000 hematology analyzer on 463 peripheral blood (PB) samples with the manual nRBC count. Results from 360,504 consecutive blood samples were reviewed to determine the frequency of nRBCs in various patient populations in our hospital.
  
  
  RESULTS
  There was a strong correlation between the automated and manual nRBC count (Pearson's r = 0.97). Frequency of nRBCs varied in different patient populations and was significantly higher in the presence of other morphology flags or abnormal CBC parameters. Low-level nRBCs (0.2%-1.3%) were detected in 0.5% of samples with otherwise normal parameters.
  
  
  CONCLUSIONS
  The automated method offers many advantages for high-throughput laboratories, including faster turnaround time, labor savings, and high reliability. Automated nRBC measurement allowed us to recognize a group of individuals who have low-level circulating nRBCs with otherwise normal CBC parameters. Nucleated RBC levels below 1.5% as detected by the automated count may be present in patients without increased erythropoiesis or a pathologic bone marrow process.
authors.affiliation: From the Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors.forename: David H
authors.initials: DH
authors.lastname: Hwang
authors.affiliation: From the Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors.forename: David M
authors.initials: DM
authors.lastname: Dorfman
authors.affiliation: From the Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Dick G
authors.initials: DG
authors.lastname: Hwang
authors.affiliation: From the Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Senna
authors.affiliation: From the Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. opozdnyakova@partners.org.
authors.forename: Olga
authors.initials: O
authors.lastname: Pozdnyakova
mesh_terms: D057205:Automation, Laboratory; D004900:Erythroblasts / Q000166:cytology*; D004906:Erythrocyte Count / Q000295:instrumentation* / Q000379:methods / Q000592:standards; D006801:Humans; D015203:Reproducibility of Results
keywords: Automated nRBC count; Sysmex XE-5000; nRBC