{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T05:50:57Z","timestamp":1785563457030,"version":"3.56.0"},"reference-count":12,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,1,30]],"date-time":"2016-01-30T00:00:00Z","timestamp":1454112000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>With the introduction of the Sysmex XN haematology analyser, the white blood cell differentiation channel (WDF) and abnormal cell detection channel (WPC) have been added with algorithms for flagging blasts and abnormal or atypical lymphocytes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this study, 2011 samples were evaluated on a Sysmex XN2000 analyser and microscopically reviewed using a CellaVision DM96 digital microscope.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A reference group of apparently healthy blood donors (<jats:italic>n<\/jats:italic> = 262) demonstrated in only three samples a positive suspect flag, which could not be confirmed microscopically. Positive WBC suspect flags were demonstrated in 3% of the 2011 samples. From the 55 samples with positive WBC suspect flags, an automatic reflex test was performed within the WPC. The WPC reflex test resulted in 10\u00d7 Blast?, 15\u00d7 Abnormal lymph? and 15\u00d7 Atypical lymph? flags, which could be confirmed microscopically in 33% of these cases. A negative flagging was demonstrated in 15 cases. Microscopic evaluation demonstrated no abnormalities in these 15 cases. However, laboratory technicians also reported the presence of abnormal lymphocytes in 158 samples <jats:italic>without<\/jats:italic> an Abnormal lymph? flag.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In conclusion, the combined use of WDF and WPC resulted in a reduction of approximately 25% of the number blood smears. As a result of the various techniques for light microscopy and haemocytometry, the adequacy of the XN flagging for abnormal and atypical lymphocytes cannot be established with certainty. To improve the quality of the reported results, it is recommended that laboratory technicians incorporate the haemocytometry results and the flagging information in the microscopic slide review.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijlh.12461","type":"journal-article","created":{"date-parts":[[2016,1,30]],"date-time":"2016-01-30T09:34:44Z","timestamp":1454146484000},"page":"160-166","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Flagging performance of the Sysmex <scp>XN<\/scp>2000 haematology analyser"],"prefix":"10.1111","volume":"38","author":[{"given":"M.","family":"Schoorl","sequence":"first","affiliation":[{"name":"Department of Clinical Chemistry, Haematology &amp; Immunology Medical Centre Alkmaar in Noordwest Ziekenhuisgroep Alkmaar The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Schoorl","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, Haematology &amp; Immunology Medical Centre Alkmaar in Noordwest Ziekenhuisgroep Alkmaar The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Chevallier","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, Haematology &amp; Immunology Medical Centre Alkmaar in Noordwest Ziekenhuisgroep Alkmaar The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Elout","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, Haematology &amp; Immunology Medical Centre Alkmaar in Noordwest Ziekenhuisgroep Alkmaar The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"van Pelt","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, Haematology &amp; Immunology Medical Centre Alkmaar in Noordwest Ziekenhuisgroep Alkmaar The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,1,30]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"9","volume-title":"Sysmex Clinical Case report","author":"Miyachi H","year":"2013"},{"key":"e_1_2_7_3_1","volume-title":"Instruction for Use XN series (for XN\u20102000 system)","author":"Sysmex Corporation","year":"2011"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2012-200930"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCP7D8ECZRXGWCG"},{"key":"e_1_2_7_6_1","first-page":"31","article-title":"Principles of measurement in hematology analyzers manufactured by Sysmex Corporation","volume":"9","author":"Fujimoto K","year":"1999","journal-title":"Sysmex J Int"},{"key":"e_1_2_7_7_1","first-page":"1","article-title":"The positions of normal leukocytes on the scattergram of the newly developed abnormal cell\u2010detection channel of the XN\u2010series multi\u2010parameter automated haematology analyzers","volume":"23","author":"Kawauchi S","year":"2013","journal-title":"Sysmex J Int"},{"key":"e_1_2_7_8_1","first-page":"1","article-title":"Comparison of the Leukocyte differentiation Scattergrams Between the XN\u2010Series and the XE\u2010Series of Hematology Analyzers","volume":"24","author":"Kawauchi S","year":"2014","journal-title":"Sysmex J Int"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cyto.a.22262"},{"key":"e_1_2_7_10_1","unstructured":"Clinical and Laboratory Standards Institute (CLSI).Reference Leukocyte (WBC) differential count (proportional) and evaluation of instrumental methods; Approved standard \u2010 Second edition. 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