New parameters of hematology analyzers and their clinical significance

Speaker: Johannes (Hans) Hoffmann (DE)
Moderator: Giuseppe Lippi (IT)

Date: 12th Fbruary 2019 at 18:00 CET

Abstract

Modern hematology analyzers do much more than just counting blood cells. Practically all instruments currently available also perform a white blood cell (WBC) differential and they produce flags or alerts for possible morphological abnormalities. Hematology analyzers have completely replaced traditional methods of cell counting and microscopic blood smear examination for the vast majority of blood samples.

In addition to these capabilities, hematology analyzers generate an ever-increasing amount of raw data, which can be transformed into cell parameters, for which no historical equivalent exist. This trend already started in the early days when measuring and reporting mean red cell volume (MCV) became possible. MCV has evidently established its clinical significance, due to the crucial role in classifying anemia. After MCV, many other parameters have been developed, not only for red blood cells, but also for platelets and white blood cells. However, in contrast to MCV, the clinical relevance of many of the new parameters is still unclear. Hematology analyzer manufacturers are generally launching these new parameters as research tools, without the slightest clue whether they can be of clinical value. This then opens possibilities for laboratory professionals examining the potential clinical significance of such parameters. Unfortunately, this type of research is plagued by serious challenges: most of the new parameters are not internationally standardized, limiting their widespread use in clinical practice. Sometimes the parameters depend on a certain technology, meaning that only laboratories using a specific make of hematology analyzer can use the parameter. And last but not least, some parameters are even specific for one individual hematology analyzer; other analyzers of the same model may produce different results and thus require separate clinical validation. An example of the latter are the so-called cell population data that have attracted a lot of interest in recent years; some interesting and promising applications were described, but one should also be aware of the limitations of this type of parameters.

The primary aim of this presentation is to discuss the technological principles used by the major hematology analyzers and to demonstrate how these technologies generate new cellular parameters. The second part will focus on understanding the potential use and limitations of new parameters, which are essential for researchers who are interested in investigating their clinical application.