BACKGROUND: Although widely used, the ADVIA 120 hematology analyzer has not been previously validated for determining the differential leukocyte count in goats.
OBJECTIVE: The aim of this study was to compare the differential leukocyte counts provided by the ADVIA 120 (A-diff) and the manual method (M-Diff) in goats.
METHODS: EDTA blood samples that were analyzed within 4 h of collection were used in the study. The following exclusion criteria were applied: inappropriately filled tubes or tubes containing clots, erroneous ADVIA peroxidase cytograms, and blood smears of poor quality. The A-Diff was compared with the M-Diff performed by two independent observers on 200 leukocytes.
RESULTS: Forty samples were included after previously excluding eight samples. The correlation between the A-Diff and M-Diff was very strong for eosinophils (r = .870, p < .001) and strong for lymphocytes (r = .796, p < .001) and neutrophils (r = .730, p < .001), while no significant correlation was observed for monocytes (r = .026, p = .872). The Passing-Bablok regression analyses revealed statistically significant constant errors for neutrophils (5.83%; 95% confidence interval [CI]: 0.41%, 12.18%) and eosinophils (1.89%; 95% CI: 1.17%, 2.71%). Bland-Altman analyses showed a statistically significant negative bias for lymphocytes (-5.0%) and a statistically significant positive bias for eosinophils (2.2%). The very low basophil percentages precluded a meaningful method comparison.
CONCLUSIONS: The ADVIA 120 overall demonstrated good performance for the differential WBC count in goats under the conditions of this study. Therefore, it can be considered suitable for routine hematologic screening in goats. Nonetheless, it should be emphasized that any abnormal result should be confirmed with a blood smear evaluation.

Despite the increasing threat of heatstroke with global warming, pathophysiologic injury continues to be defined. In addition, morphological changes of the peripheral blood cells in heatstroke have not been well characterized. We evaluated pathophysiologic changes in bone marrow and blood cells in a rat heatstroke model using a 39.5 °C climate chamber. After three hours of incubation, blood and bone marrow samples were collected for morphology, and the direct effects of heat on leukocytes in vitro were evaluated using time-lapse observation. The blood cell count and peripheral/bone marrow smear were examined either in a lethal model (core body temperature exceeded 42.5 °C) or in a sublethal model (<41.5 °C). Significant decreases in platelet and white blood counts occurred in the lethal model (>35% and >20% decreases, respectively) and changes were less in the sublethal model. Platelet clumping with the appearance of large platelets was observed. The neutrophils often demonstrated hyper-segmented nuclei, and lymphocytes showed reactive or blast-like changes. Further, the direct effect of heat on leukocytes noted apoptotic cell death at 41.5 °C, but subsequent necrosis at 43 °C. In summary, our rodent model showed that heatstroke causes platelet aggregation, leukocyte injury, and aponecrotic cell death. Such changes were milder and reversible in sublethal heatstroke. The appearance of immature cells may result from damage to the bone marrow microenvironment. These findings may provide useful information for potential diagnostic and therapeutic considerations.

BACKGROUND: The ADVIA 120 is a widely used hematology analyzer, which has not been previously validated for determining differential leukocyte counts in sheep.
OBJECTIVE: We aimed to compare differential leukocyte counts on the ADVIA 120 (A-Diff) with counts obtained using the manual method (M-Diff) in sheep.
METHODS: Ethylenediaminetetraacetic acid-anticoagulated blood samples analyzed within 4 hours of collection were used. Samples with inappropriately filled tubes, detectable clots, overtly erroneous ADVIA peroxidase cytograms, and poor-quality blood smears were excluded from the study. Two independent observers compared the results of the A-Diff with those of the M-Diff. The M-diff was performed by counting 200 leukocytes on a blood smear.
RESULTS: Overall, 88 samples (44 rams and 44 ewes) were included. The correlation between the A-Diff and M-Diff was high for neutrophils (r = .873, P < .001), lymphocytes (r = .863, P < .001), and eosinophils (r = .750, P < .001), and low for monocytes (r = .212, P = .048). The Passing-Bablok regression analyses revealed constant error for eosinophils [1.17%; 95% confidence interval (CI): 0.67%, 1.55%] and proportional error for lymphocytes (0.84; 95% CI: 0.74, 0.95) and eosinophils (0.85; 95% CI: 0.74, 0.96). The Bland-Altman analyses revealed negative biases of 2.4% and 3.0% for neutrophils and lymphocytes, respectively, and positive biases of 3.2% and 0.8% for monocytes and eosinophils, respectively. The extremely low basophil percentages precluded a meaningful method comparison for this leukocyte type.
CONCLUSIONS: The ADVIA 120 appears to perform well for determining neutrophil, lymphocyte, and eosinophil percentages in sheep as compared with the manual method. However, blood smear examinations are recommended for the confirmation of abnormal differential leukocyte count results.

Nowadays, laboratories have more efficient haematology analyzers. These analyzers have to be used in the most efficient and the most adapted way according to the internal organisation of laboratories and prescribers\' expectations. The aim of this study was to evaluate the performance of the blast flag on ADVIA 2120/2120i, and to suggest what to do, depending on the flag intensity, to identify positive samples the most surely and the most rapidly as possible.
Seven hospital laboratories were included in this prospective study, 148 144 samples of hospital patients were tested during this 4 months study.
Sensitivity and specificity of the blast flag are respectively 89,04% and 98,97%. A good correlation between the flag level and the blast count on blood smear is noticed.
This study could be helpful for laboratories using ADVIA 2120/2120i, to adapt their procedures, depending on the level of the flag provided by the analyser.

BACKGROUND: Several diagnoses have been associated with leukemoid reaction (LR). In patients with LR the diagnostic and prognostic value of detailed manual blood smear counts (such as the percentage of band cells or grading of neutrophil toxic changes) has not been studied previously.
METHODS: We prospectively recorded all hospitalized adult (> 18 years old) patients with LR (≥ 30000/ul) of neutrophilic predominance, excluding patients with pre-existing leukocytosis due to hematological malignancies. We examined the diagnoses and prognosis (in-hospital mortality and post-discharge mortality up to a year after the end of the study) of these patients as well as the value of manual peripheral smear review.
RESULTS: We recorded a total of 93 patients with LR from January 2017 to December 2017. Infection was the most common diagnosis (70%), followed by malignancy (7.5%) and bleeding (6.5%). In-hospital mortality (45%) and post-discharge mortality (35% of those discharged) were very high. Among blood smear findings, only neutrophil vacuolation was significantly more common in patients with infections (34%), although it was also observed in many patients without any infection (13%). Blood smear findings were not associated with prognosis.
CONCLUSIONS: Detailed manual smear review is a labor-intensive procedure and it has limited diagnostic and prognostic value in unselected hospitalized patients with neutrophilic LR.