Evaluation of HemoCue WBC DIFF system versus Sysmex XE in blood samples from pediatric patients

Anette Friis Larsen1,*, Ole Halfdan Larsen1, Anne Dorthe Møller1, Søren Ladefoged1, Tore Hardlei1

1KBA, Aarhus University hospital, SKS, Aarhus, Denmark

Introduction: The HemoCue WBC DIFF has been demonstrated as a useful point-of-care device performing white blood cell (WBC) differentiation in venous or capillary blood. However, pediatric data are still lacking.

Objectives: This study aimed to compare to the performance of the HemoCue WBC DIFF

system to the Aarhus University Hospital laboratory method, Sysmex XE-2100/5000 in pediatric patients.

Methods: Blood samples were collected from 100 pediatric patients with a median age of 5 years (range:1-12 years) and a median white blood cell count of 6.87 (range: 1.68 -29.53 x 109/l). Whole blood differential including WBCs, neutrophils, lymphocytes, monocytes, eosinophils and basophils were analyzed using the Hemocue WBC DIFF and the Sysmex XE-2100/5000. 10 samples were analyzed in duplicate on the Hemocue WBC DIFF.

Results: The HemoCue WBC DIFF displayed acceptable correlation for WBC (R2=0.99), neutrophils (R2=0.99) in the range of 0.1 - 24.1 x 109/l and lymphocytes (R2=0.95) in the range of 0.6 - 9.8 x 109/l. Evaluation of monocytes, eosinophils, and basophils were challenged by a limited number of samples above the low normal range. Variation in double measurements on the Hemocue WBC Diff was 2.9% (WBC), 5.0% (neutrophils) and 7.2% (lymphocytes).The total number of flags or errors were 30 using the HemoCue WBC diff and 24 using the Sysmex of which 11 was overlapping.

Conclusion: The HemoCue WBC diff displays acceptable performance compared to the Sysmex XE-2100/5000 in the evaluation of WBC, neutrofiles and lymphocytes. Evaluating performance on monocytes, eosinophils, and basophils was challenged due to low ranges in the patient group.

Keywords: Biochemistry, Blood