Diagnostic Testing of Hematology Analyzer Equipped with WPC Channel Scattergram in Determining Strains of Hematological Malignancies

Abstract

Determination of myeloid and lymphoid strains of hematological malignancies is often difficult when determination is solely based on morphology. ADVIA hematology analyzer and WPC channels are said to have the ability to differentiate acute leukemia strains. There is no data regarding the diagnostic values of WPC channels in determining the strain of both acute and chronic hematological malignancies. This study aims to analyze the diagnostic value of WPC channels in determining myeloid and lymphoid strains in both acute and chronic hematological malignancies in comparison to immunophenotyping, which is considered as the gold standard in strain identification. Peripheral blood and BMA specimens from patients with suspected acute and chronic hematological malignancies were subjected to immunophenotyping and testing using WPC Sysmex XN-1000 simultaneously. The strains of hematological malignancies produced from the two examinations were then statistically analyzed to determine their sensitivity and specificity. There was a total of 86 samples of hematological malignancies used in this research. With WPC channel-based strain interpretation, results showed that 54 samples were in accordance with the results obtained from immunophenotyping, meanwhile 25 samples could not be interpreted/inconclusive. Inconclusive samples were further analyzed by examining the dominant abnormal population contained in the WPC scattergram, which resulted in a lower number of inconclusive samples, namely 5 samples. After further analysis was carried out on the inconclusive samples, the results of the diagnostic test for WPC channel-based strain identification showed sensitivity of 85.71% and specificity of 91.89% in determining hematological malignancies of myeloid and lymphoid strains, with diagnostic accuracy reaching 91.65% in comparison to immunophenotyping. In conclusion, the WPC channels have the ability determine strains of both acute and chronic hematological malignancies with high diagnostic value in comparison to strain identification using immunophenotyping.