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Characterization of errors and predictability of disease using the Advia 120 hematology analyzer leukocyte differential




Ryseff, Julia Kathryn, author
Bohn, Andrea, advisor
Weiser, Glade, committee member
Vap, Linda, committee member
Veir, Julia, committee member

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Automated instrumentation has allowed for enhanced speed, precision and cost-effective measures in the reporting of hematological data. These instruments have expanded the information attainable beyond simple numerical data through advanced techniques such as flow cytometry and cytochemical staining to produce specialized parameters and scatterplots as novel data delivery systems. The Advia 120 hematology analyzer leukocyte differentiation method produces several novel parameters, including two channel (perox and baso) cytograms and several indicators of intracellular myeloperoxidase activity. These parameters can be diagnostically useful in assessing the idiosyncratic species and mechanical issues that arise during routine operation, as well as provide discriminatory information related to variety of disease processes (inflammation, neoplasia, etc).The purpose of this study was to identify specific cytogram misclassification patterns and errors that would have the greatest impact on clinical operation or interpretation of hematologic data. In addition, the analyzer phenomenon of pseudobasophilia was investigated for its potential use in raising clinical awareness of circulating atypical cells and their intrinsic properties. Lastly, the peroxidase indices MPXI, neut-x and neut-y were investigated for their diagnostic potential in identifying systemic inflammation and myeloid leukemias. The results of this study detailed several cytogram patterns and their causes and misclassifications, of which recognition and understanding promote awareness to the existence of certain hematological findings otherwise not documented in numerical data as well as to the limitations inherent in instrumentation. The analyzer phenomenon of pseudobasophilia was demonstrated in canine samples and was highly associated with the presence of atypical cells, commonly leukemia, in circulating blood. Lastly, the myeloperoxidase indices failed to demonstrate any benefit in differentiating hematologic changes associated with systemic inflammation and myeloid leukemias.


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Advia 120
left shift
toxic changes


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