title: Validity of Selected WBC Differentiation Flags in Sysmex XT-1800i.
abstract: BACKGROUND
  Automatic Cell Counter devises make the CBC differential very easy and delivering the results in few second. However, the problem with this device is facing a flag requires a time-consuming microscopic review of the specimen which causes unacceptable wait times for patient as well as costs for laboratories. In this study, we calculated the validity of WBC diff flags in Sysmex XT-1800i. In addition, we verified the correlation between manual and automated samples.
  
  
  METHODS
  Overall, 1095 flagged samples were selected in the period of 6 weeks (Imam Hospital complex, Tehran Iran, 2014). The results of both automated and manual counting of the samples were carefully studied and compared. Totally, 624 NRBC flags, 450 Blast flags, 155 abnormal WBC Scatter gram flags, 140 Eosinophilia flags and 468 Monocytosis flags were identified.
  
  
  RESULTS
  Considering NRBC and blast flags there was a significant difference between our manual counted and automated counted NRBCs and blasts (P<0.05). There was no significant difference between automated and manual counting of flags for WBC Scatter gram. A significant difference between automated and manual counting data in flags, eosinophilia and monocytosis was foun (P<0.05).
  
  
  CONCLUSIONS
  We propose the NRBC flags to be ignored and report negative except for the neonatal ward, and the Blasts flags to be ignored and report negative in all the cases. The WBC Scatter gram should be report positive. For eosinophilia and monocytosis flags, we propose, the Sysmex results should be considered correct and the manual checking would not be necessary.
authors: Dept. of Pathology, Tehran University of Medical Sciences, Tehran. Iran.
authors: Parya
authors: P
authors: Bameni Moghaddam
authors: Dept. of Pathology, Tehran University of Medical Sciences, Tehran. Iran.
authors: Fatemeh
authors: F
authors: Mahjoub
authors: Dept. of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors: Amirhossein
authors: A
authors: Emami
authors: Dept. of Pathology ,Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran; Thrombosis Hemostasis Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Alireza
authors: A
authors: Abdollahi
keywords: Blasts; NRBC; Sysmex cell count; WBC differentiation; WBC flags