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Technological Advancement In Hematology Counters

Hematology analyzers are the workhorses of a pathological laboratory. A key challenge of hematology analyzers is discrimination among different cellular elements that fall in similar regions of a histogram, making it difficult to differentiate one from another. Another key limitation of most analyzers is that data obtained in each module is analyzed independently. Often information from one module can be useful for the detection of interfering particles in another module, but the opportunity is missed because there is no communication between the modules.

High-end 5-part differential analyzers deliver reliable cell counts identifying lymphocytes, monocytes, neutrophils, eosinophils, and basophils. Atypical lymphocytes and immature granulocytes are emerging as sixth and seventh parameters. While electrical impedance still has a firm foothold in determining the overall number and size of cells, flow cytometry techniques have proven their worth in differentiating white blood cells and identifying abnormal cells. The increasing sophistication of flow cytometry techniques on the analyzer will push some tests back to the hematology analyzer.

Manufacturers often market their instruments by focusing on the particular package of technologies they use to differentiate from the rest of the analyzers. However, the benefits of this package of technologies is not well explained to the end user and hence the value derived out of this is not differentiated. For instance, some analyzers determine leukocyte differentials by inserting a fluorescent dye into the cell nucleus and measuring how strongly it fluoresces. Another may measure enzyme activity in a cell placed in a particular substrate. The newer technology is the volume conductivity and scatter (VCS) method that analyses cells in their near-native state.

The new technologies are great as they are evolving toward flow cell-based technologies, where cells are interrogated one by one through optical systems that can measure many new parameters which, at the beginning, were never measured. Also, many manufacturers have started incorporating microfluidics in the hematology analyzers greatly shrinking the size of the analyzer and reducing the sample volume required to run the test. This also greatly reduces the reagent consumption making it cost-effective and environment friendly.

Instrument manufacturers also promote automation systems to high-volume laboratories to help with staff shortages. Middleware allows laboratories to set up rules for auto-validation and suspect flags based on sample location or patient population. The important thing is not just to auto-validate normal samples, but to reduce the number of false positive flagging. The bottom line is, reducing the amount of time someone goes to the microscope.

Automation will continue to grow in the hematology laboratory as the number of technologists continue to decrease. The need for today is to have sophisticated systems where you can put your samples on and only be available to look at those truly abnormal samples. The ability to automate for walk-away systems to improve productivity is a big area. However, hematology is becoming a very competitive market, and sometimes pricing rather than best available technology does influence the purchasing of the analyzers.

In summary, technological advances in hematology analyzers today are allowing the laboratorial access to more cellular information than was ever available before. This can be used to improve cellular counting and decrease the rate of unnecessary manual reviews. Current research is beginning to demonstrate that this information also has great potential to identify cellular changes that typically occur in several important medical conditions – bringing us all one step closer to using hematology analyzers as more than simple cell counters, but instead as powerful tools for the management of any medical condition that impacts blood cells. The use of these technologies can translate into a smoother workflow for the laboratory and an improved diagnostic quality of care for patients.

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