{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:00:55Z","timestamp":1785510055267,"version":"3.56.0"},"reference-count":11,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,9,26]],"date-time":"2017-09-26T00:00:00Z","timestamp":1506384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Automated hematology analyzers generate white blood cell (<jats:styled-content style=\"fixed-case\">WBC<\/jats:styled-content>) suspect flags to indicate smears requiring manual review. In a human immunodeficiency virus (<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>) patient population with a high frequency of abnormal specimens, the usefulness of these flags depends on their sensitivity and specificity. The white cell precursor (<jats:styled-content style=\"fixed-case\">WPC<\/jats:styled-content>) channel on the Sysmex <jats:styled-content style=\"fixed-case\">XN<\/jats:styled-content>\u20109000 analyzer (Sysmex Corporation, Kobe, Japan) has recently been introduced in order to distinguish immature cells such as blasts and abnormal lymphocytes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The efficiency of the flags generated by <jats:styled-content style=\"fixed-case\">WPC<\/jats:styled-content> reflex testing was compared to the white cell differential (<jats:styled-content style=\"fixed-case\">WDF<\/jats:styled-content>) on the Sysmex <jats:styled-content style=\"fixed-case\">XN<\/jats:styled-content>\u20109000 in 400 routine <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> samples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A flag was generated by the <jats:styled-content style=\"fixed-case\">WDF<\/jats:styled-content> channel in 346 (86.50%) samples. Addition of the <jats:styled-content style=\"fixed-case\">WPC<\/jats:styled-content> to the <jats:styled-content style=\"fixed-case\">WDF<\/jats:styled-content> resulted in a 20.99% reduction in the smear review rate. <jats:styled-content style=\"fixed-case\">WPC<\/jats:styled-content> analysis correctly identified the initial <jats:styled-content style=\"fixed-case\">WDF<\/jats:styled-content> flag in 59 (60.82%) samples with \u2018blasts?\u2019 or \u2018abnormal lympho?\u2019 flags. <jats:styled-content style=\"fixed-case\">WPC<\/jats:styled-content> showed an excellent sensitivity of 100%. However, the specificity remained poor. On investigation, samples with chronic infection\/inflammation (35.00%) and lymphopenia (63.25%) were associated with a high false positive rate of 76.32% and 55.56%, respectively. <jats:styled-content style=\"fixed-case\">WPC<\/jats:styled-content> analysis removed 45 (51.72%) coexisting \u2018atypical lympho?\u2019 false positive <jats:styled-content style=\"fixed-case\">WDF<\/jats:styled-content> flags. The \u2018atypical lympho?\u2019 flag showed an increased sensitivity and specificity of 88.46% and 74.67%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>White cell precursor reflex testing showed improved flagging efficiency for the \u2018atypical lympho?\u2019 flag, which was a good indicator of reactive lymphocytes during chronic infection\/inflammation. Nevertheless, the false positive rate for \u2018abnormal lympho\/blasts?\u2019 was high in the presence of lymphopenia and infection.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcla.22335","type":"journal-article","created":{"date-parts":[[2017,9,26]],"date-time":"2017-09-26T07:23:15Z","timestamp":1506410595000},"source":"Crossref","is-referenced-by-count":7,"title":["Performance evaluation of the white cell precursor channel on the Sysmex <scp>XN<\/scp> hematology analyzer in <scp>HIV<\/scp> specimens"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1534-2930","authenticated-orcid":false,"given":"Elise","family":"Schapkaitz","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine and Haematology University of Witwatersrand Medical School  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phoyisile","family":"Khoza","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Haematology National Health Laboratory Service  Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPE5R4SOQBUULZ"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2014-202640"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12478"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12254"},{"key":"e_1_2_6_6_1","volume-title":"Reference Leukocyte (WBC) Differential Count (Proportional) and Evaluation of Instrumental Methods","author":"Koepke A","year":"2007"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1532\/LH96.05019"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPDLR4KGKAFW4W"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12461"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-12-128"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPDUZVRN5VY9WZ"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2016.08.020"}],"container-title":["Journal of Clinical Laboratory Analysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjcla.22335","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcla.22335","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T12:16:40Z","timestamp":1695471400000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcla.22335"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,26]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,5]]}},"alternative-id":["10.1002\/jcla.22335"],"URL":"https:\/\/doi.org\/10.1002\/jcla.22335","archive":["Portico"],"relation":{},"ISSN":["0887-8013","1098-2825"],"issn-type":[{"value":"0887-8013","type":"print"},{"value":"1098-2825","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9,26]]},"article-number":"e22335"}}