{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T05:50:59Z","timestamp":1785563459981,"version":"3.56.0"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Sysmex XN\u20109100<jats:sup>\u2122<\/jats:sup> (Sysmex, Kobe, Japan) system has an optional White Progenitor Cell (WPC) channel. While the White Differentiation (WDF) channel reports a combined flag for blasts\/abnormal lymphocytes, WPC channel specifies flagging into a separate flag for each cell type or removes the flag entirely. Aim of this study was to evaluate the added value of this WPC channel in the detection of malignant samples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Routine blood samples analyzed on Sysmex XE\u20105000 with flagging for either blasts, abnormal lymphocytes, or atypical lymphocytes (n\u00a0=\u00a0630) were selected for testing on Sysmex XN\u20109100, resulting in a reflex WPC analysis in 420 samples. All samples were microscopically evaluated with DI\u201060 digital cell imaging analyzer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>WPC reflex testing resulted in a suspect flag (\"blasts\" and\/or \"abnormal lymphocytes\") in 334 samples, which was confirmed microscopically in 38% (128\/334). In all true positive samples, WPC correctly classified the initial WDF flag in either \"blasts\" flag or \"abnormal lymphocytes?\" flag in 75%. Only 12% (50\/420) of WDF \"blasts\/abnormal lymphocytes\" positive samples became negative after WPC reflex testing. Subgroup analysis showed differences between the \"pediatric\" versus \"adult\" groups and the \"hematological\/chemotherapy\" versus \"nonhematological\/nonchemotherapy\" groups in specificity and smear reduction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Overall, WPC reflex testing showed good sensitivity (99%); however, the specificity remains poor (29%). Using reflex WPC to the WDF channel resulted in a 12% reduction of the smear review rate. Although the WPC channel offers different interesting advantages, additional topics and a specific workflow should be applied to optimize the use of this channel.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijlh.13352","type":"journal-article","created":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T17:00:38Z","timestamp":1601571638000},"page":"191-198","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The integration of Sysmex XN\u20109100\u2019 WPC channel reflex testing in the detection of reactive versus malignant blood samples"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6128-2027","authenticated-orcid":false,"given":"Siska","family":"Blomme","sequence":"first","affiliation":[{"name":"Clinical Department of Laboratory Medicine University Hospitals Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Boeckx","sequence":"additional","affiliation":[{"name":"Clinical Department of Laboratory Medicine University Hospitals Leuven Leuven Belgium"},{"name":"Departement of Oncology KU Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Brusselmans","sequence":"additional","affiliation":[{"name":"Clinical Department of Laboratory Medicine University Hospitals Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Claerhout","sequence":"additional","affiliation":[{"name":"Clinical Department of Laboratory Medicine University Hospitals Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3105-6117","authenticated-orcid":false,"given":"Christine","family":"Van Laer","sequence":"additional","affiliation":[{"name":"Clinical Department of Laboratory Medicine University Hospitals Leuven Leuven Belgium"},{"name":"Departement of Cardiovascular Sciences Center for Molecular and Vascular Biology KU Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12461"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12421"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12254"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/jmicro\/dfv023"},{"key":"e_1_2_9_6_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_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2018.01.014"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2012-200930"},{"key":"e_1_2_9_9_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 hematology analyzers","volume":"23","author":"Kawauchi S","year":"2013","journal-title":"Sysmex J Int"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2014-202640"},{"issue":"9","key":"e_1_2_9_11_1","first-page":"1503","article-title":"Performance of the XN\u20102000 WPC channel flagging to differentiate reactive and neoplastic leukocytosis","volume":"54","author":"Schuff\u2010Werner P","year":"2016","journal-title":"Clin Chem Lab Med"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.13069"},{"key":"e_1_2_9_13_1","volume-title":"Instruction for use XN\u2010series (for XN\u20109000 system)","author":"Sysmex corporation","year":"2011"},{"key":"e_1_2_9_14_1","unstructured":"Clinical and Laboratory Standards Institute.Reference leukocyte differential count (proportional) and evaluation of instrument methods. CLSI document (H20\u2013A2). Wayne PA;2007."},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2016.01.016"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2016.08.020"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.22335"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2005.033787"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12372"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12562"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12261"}],"container-title":["International Journal of Laboratory Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijlh.13352","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ijlh.13352","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ijlh.13352","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T14:30:59Z","timestamp":1693578659000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijlh.13352"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10]]},"references-count":20,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1111\/ijlh.13352"],"URL":"https:\/\/doi.org\/10.1111\/ijlh.13352","archive":["Portico"],"relation":{},"ISSN":["1751-5521","1751-553X"],"issn-type":[{"value":"1751-5521","type":"print"},{"value":"1751-553X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10]]},"assertion":[{"value":"2020-06-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}