Use of the reticulocyte channel warmed to 41 °C of the XN-9000 analyzer in samples with the presence of cold agglutinins

• Main Authors: Vincenzo Roccaforte, Flavia Sciarini, Vanessa Proserpio, Ruggero Buonocore, Emanuela Marina Zavaroni, Silvia Burati, Marco Bussetti, Giammaria Liuzzi, Rosalba Monica Russo, Wanda Patrizia Porreca, Maria Luisa De Angelis, Carlo Federico Perno, Claudio Bonato, Stefano Pastori
• Format: Article
• Language: English
• Published: Elsevier 2021-04-01
• Series: Hematology, Transfusion and Cell Therapy
• Subjects: Cold agglutinins; Sysmex; XN-9000; RET channel; Autoimmune hemolytic anemia
• Online Access: http://www.sciencedirect.com/science/article/pii/S2531137920300249

Objectives: The purpose of this study was to compare data obtained from the reticulocyte channel (RET channel) heated to 41 °C with those obtained from impedance channel (I-Channel) at room temperature in the samples with the mean corpuscular hemoglobin concentration (MCHC) < 370 g/L and in samples with the MCHC > 370 g/L, in the presence of cold agglutinins. Methods: In this study, 60 blood samples (group 1) with the MCHC < 370 g/L (without cold agglutinins) and 78 blood samples (group 2) with the MCHC > 370 g/L (with cold agglutinins) were used to compare the two analytical channels of the XN-9000 analyzer in different preanalytical conditions. The parameters evaluated in both groups were the following: red blood cell (RBC), hemoglobin (HGB), hematocrit (HCT), mean cell volume (MCV), RBC-most frequent volume (R-MFV), mean hemoglobin concentration (MCH) and mean cellular hemoglobin concentration (MCHC). Results: The results of this study showed an excellent correlation with both channels of the XN-9000 analyzer in samples with and without cold agglutinins, except for the MCHC. The bias between the values obtained in the I-channel and those obtained in the RET channel of both groups was insignificant and remained within the limits of acceptability, as reported by Ricos et al. for all considered parameters, except for MCHC. Conclusions: The presence of cold agglutinins in blood samples can be detected by a spurious lowering of the RBC count and by a spurious increase in the MCHC. The RET channel represents a great opportunity to correct the RBC count in a rapid manner without preheating. However, neither methodology can completely solve the residual presence of cold agglutinins in all samples, despite the MCHC values being < 370 g/L.