{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:45:51Z","timestamp":1785804351386,"version":"3.56.0"},"reference-count":21,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Light microscopy is still the gold standard method for schistocyte counting in the blood smear. Some hematology analyzers can quantitatively determine fragmented red blood cells (FRC) as part of the full blood count. We examined the usefulness of two quantitative schistocyte methods on Sysmex XN\u20103100, comparing them with the standard reference method (SCHISTO\u2010LM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>FRC count was performed by fluorescent flow cytometry in the reticulocyte channel. A locally designed method was applied on DI\u201060 digital morphology analyzer (SCHISTO\u2010DI), allowing schistocyte quantification according to ICSH recommendations, using the RBC menu. FRC\u2009\u2265\u20091.0% and schistocytes\u2009&gt;\u20092\/high\u2010power field were considered positive. Measurements were performed in 91 blood samples\/peripheral blood smears of 54 patients with a suspicion of thrombotic microangiopathy (TMA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significantly higher FRC (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), SCHISTO\u2010DI (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and SCHISTO\u2010LM (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were found in TMA\u2010positive patients compared to TMA\u2010negative and patients in remission. Stratification of TMA\u2010positive patients by TMA type revealed no significant differences for all tests. Both positive SCHISTO\u2010LM and SCHISTO\u2010DI were recorded in 15\/91 samples (sensitivity\u2009=\u2009100%, 95% CI\u2009=\u200978.2\u2013100.0 and negative predictive value (NPV)\u2009=\u2009100%, 95% CI\u2009=\u200994.4\u2013100.0). False\u2010negative FRC results were detected in 5\/15 schistocyte\u2010positive samples (sensitivity\u2009=\u200966.7%, 95% CI\u2009=\u200938.4\u201388.2; NPV\u2009=\u200992.9%, 95% CI\u2009=\u200986.3\u201396.4). The highest agreement was revealed between SCHISTO\u2010DI and SCHISTO\u2010LM (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.637). SCHISTO\u2010DI demonstrated the best AUC for discrimination between TMA\u2010positive and TMA\u2010negative patients (0.942; 95% CI\u2009=\u20090.843\u20130.987), and similar AUC (0.818; 95% CI\u2009=\u20090.700\u20130.905) as SCHISTO\u2010LM (0.820; 95% CI\u2009=\u20090.702\u20130.906) for discrimination between TMA\u2010positive and patients with TTP\/aHUS in remission.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite the slightly lower sensitivity of FRC, the newly designed SCHISTO\u2010DI method demonstrated excellent sensitivity and NPV for schistocyte detection, concordant with SCHISTO\u2010LM results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijlh.70208","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:11:13Z","timestamp":1785802273000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Usefulness of Automated Hematology System Sysmex XN\u20103100 for the Quantification of Schistocytes and Early Detection of the Underlying Thrombotic Microangiopathy"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0248-4278","authenticated-orcid":false,"given":"Marija","family":"Milo\u0161","sequence":"first","affiliation":[{"name":"Department of Laboratory Diagnostics University Hospital Centre Zagreb  Zagreb Croatia"},{"name":"Faculty of Pharmacy University of Mostar  Mostar Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Matkovi\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy and Biochemistry University of Zagreb  Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koraljka Gjadrov","family":"Kuve\u017edi\u0107","sequence":"additional","affiliation":[{"name":"Department of Pathology and Cytology University Hospital Centre Zagreb  Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun\u010dica","family":"Ries","sequence":"additional","affiliation":[{"name":"Department of Pathology and Cytology University Hospital Centre Zagreb  Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9637-5277","authenticated-orcid":false,"given":"Marijana","family":"Medi\u0107","sequence":"additional","affiliation":[{"name":"Division of Intensive Care Medicine, Department of Internal Medicine University Hospital Centre Zagreb  Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3755-4477","authenticated-orcid":false,"given":"Dra\u017een","family":"Pulani\u0107","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine University Hospital Centre Zagreb  Zagreb Croatia"},{"name":"School of Medicine University of Zagreb  Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8327-9913","authenticated-orcid":false,"given":"D\u00e9sir\u00e9e Coen","family":"Herak","sequence":"additional","affiliation":[{"name":"Department of Laboratory Diagnostics University Hospital Centre Zagreb  Zagreb Croatia"},{"name":"Faculty of Pharmacy and Biochemistry University of Zagreb  Zagreb 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