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Use of Sysmex XN‐10 red blood cell parameters for screening of hereditary red blood cell diseases and iron deficiency anaemia

Abstract : Introduction In daily practice in haematology laboratories, red blood cell (RBC) abnormalities are frequent and their management is a real challenge. The aim of this study is to establish a "decision tree" using RBC and reticulocyte parameters from the SYSMEX XN-10 analyser to distinguish between patients with a hereditary RBC disease from iron deficiency anaemia and other patients. Methods We analysed results of complete RBC counts in a cohort composed of 8217 adults divided into 5 different groups: iron deficiency anaemia (n = 120), heterozygous haemoglobinopathy (n = 92), sickle cell disease syndrome (n = 56), hereditary spherocytosis (n = 18) and other patients (n = 7931). A Classification And Regression Tree (CART) analysis was used to obtain a two-step decision tree in order to predict these previous groups. Results Five parameters and the calculated RBC score were selected by the CART method: mean corpuscular haemoglobin concentration, percentage of microcytes, distribution width of the RBC histogram, percentage of nucleated red blood cells, immature reticulocytes fraction and finally RBC Score. When applying the tree and recommended flowchart, 158/166 of the RBC hereditary disease patients and 114/120 iron deficiency anaemia patients are detected. Overall, the correct classification rate reached 99.4%. Sensitivity and specificity for RBC disease detection were 95.2% and 99.9%, respectively. These results were confirmed in an independent validation cohort. Conclusion Based on the XN-10 RBC and reticulocyte parameters, we propose a two-step decision tree delivering a good prediction and classification of hereditary RBC diseases. These results can be used to optimize additional reticulocyte analysis and microscopy review.
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Submitted on : Monday, March 15, 2021 - 5:02:15 PM
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Vanessa Nivaggioni, Lakhdar Bouriche, Sylvie Coito, Anne-Sophie Le Floch, Manal Ibrahim-Kosta, et al.. Use of Sysmex XN‐10 red blood cell parameters for screening of hereditary red blood cell diseases and iron deficiency anaemia. International Journal of Laboratory Hematology, Wiley, 2020, 42 (6), pp.697-704. ⟨10.1111/ijlh.13278⟩. ⟨hal-03169858⟩

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