Castegnaro Silvia, Dragone Patrizia, Chieregato Katia, Alghisi Alberta, Rodeghiero Francesco, Astori Giuseppe
Advanced Cellular Therapy Laboratory, Department of Cellular Therapy and Hematology, San Bortolo Hospital, Via Rodolfi 37, 36100 Vicenza, Italy; Hematology Project Foundation, Contrà S. Francesco 41, Vicenza, Italy.
Immunohematology and Transfusion Medicine Service, Department of Transfusion Medicine, San Bortolo Hospital, Vicenza, Italy.
Transfus Apher Sci. 2016 Apr;54(2):266-70. doi: 10.1016/j.transci.2015.10.001. Epub 2015 Oct 22.
Transfusion of blood components is potentially associated to the risk of cell-mediated adverse events and current guidelines require a reduction of residual white blood cells (rWBC) below 1 × 10(6) WBC/unit. The reference method to enumerate rare events is the flow cytometry (FCM). The ADAM-rWBC microscopic cell counter has been proposed as an alternative: it measures leukocytes after their staining with propidium iodide. We have tested the Adam-rWBC for the ability to enumerate rWBC in red blood cells and concentrates. We have validated the flow cytometry (FCM) for linearity, precision accuracy and robustness and then the ADAM-rWBC results have been compared with the FCM. Our data confirm the linearity, accuracy, precision and robustness of the FCM. The ADAM-rWBC has revealed an adequate precision and accuracy. Even if the Bland-Altman analysis of the paired data has indicated that the two systems are comparable, it should be noted that the rWBC values obtained by the ADAM-rWBC were significantly higher compared to FCM. In conclusion, the Adam-rWBC cell counter could represent an alternative where FCM technology expertise is not available, even if the risk that borderline products could be misclassified exists.
血液成分输血可能与细胞介导的不良事件风险相关，当前指南要求将残余白细胞（rWBC）减少至每单位低于1×10⁶个白细胞。用于计数罕见事件的参考方法是流式细胞术（FCM）。已有人提出将ADAM-rWBC显微镜细胞计数器作为替代方法：它通过碘化丙啶染色后测量白细胞。我们测试了ADAM-rWBC在红细胞和浓缩物中计数rWBC的能力。我们验证了流式细胞术（FCM）的线性、精密度、准确性和稳健性，然后将ADAM-rWBC的结果与FCM进行了比较。我们的数据证实了FCM的线性、准确性、精密度和稳健性。ADAM-rWBC显示出足够的精密度和准确性。即使配对数据的Bland-Altman分析表明这两个系统具有可比性，但应注意的是，与FCM相比，ADAM-rWBC获得的rWBC值明显更高。总之，即使存在将临界产品误分类的风险，但在没有FCM技术专业知识的情况下，ADAM-rWBC细胞计数器可能是一种替代方法。
