Utility of WBC Scatterplots and Suspect Flags Generated by Beckman Coulter LH-750 Hematology Analyzer in the Characterization of Leukemias and Related Hematological Malignancies
摘要
Numerical data, flags and WBC scatterplots generated by automated hematology analyzers can aid in the early detection of leukemias. This study was done to assess the utility of automated data in leukemia characterization. This observational cross-sectional study included blood samples from patients with suspected or confirmed hematological malignancies. Blood samples were run on Beckman Coulter LH 750 5-part automated hematology analyzer. Routine CBC parameters, WBC suspect flags and scatterplots were studied. The study included 396 patients with leukemias and related hematological malignancies. Automated differential count showed increasing neutrophil percentage in AML subtypes according to the maturation. Mean monocyte percentage of 37.3 was seen in patients with AML M4/M5. Thirty one (79.5%) of the 39 patients with AML M4/M5 showed the monoblast (MO) flag. Patients with ALL and CLL showed variant lymphocyte and/or LY Blast flags. Ten abnormal WBC scatterplot patterns were seen. Most (80%) patients with APML showed a characteristic scatterplot pattern. Patients with AML M4/M5 showed consistent monocytic and monocytic/granulocytic patterns. WBC scatterplots showed a sensitivity of 92.5% and specificity of 91.5% to detect abnormal cell populations indicative of leukemias. Patients with ALL and CLL showed mainly lymphoid dominant scatterplot patterns. Patients with CML also showed a characteristic granulocytic predominant plot. Automated WBC data has utility in identifying abnormal leukemia WBC populations. For APML and CML, characteristic WBC scatterplots were seen. In other leukemias, overlap patterns exist which can be delineated further by flagging data and differential percentages.