Assessment of the Reliability of the Sysmex XE-5000 Analyzer to Detect Platelet Clumps

Objective: Platelet counts generated by automated analyzers on blood specimens that contain platelet clumps are often inaccurate and require verification by blood-smear review. In this study, we assessed the reliability of the Sysmex XE-5000 instrument to detect platelet clumps.

Method: We reviewed automated complete blood count (CBC) results and the findings of the microscopic review of corresponding blood smears of 600 blood specimens specifically selected from the routine laboratory workload. The sensitivity, specificity, efficiency, positive predictive value (PPV), and negative predictive value (NPV) of its 2 platelet-associated flags (abnormal platelet-size distribution [PAD] flag and platelet-clumps [CLP] flag) were determined.

Results: The respective values for the sensitivity, specificity, efficiency, and PPV were 42%, 83%, 63%, and 1% for the PAD flag and 57%, 99%, 78%, and 37% for the CLP flag. The NPV was 100%.

Conclusion: The overall reliability of the CLP flag is superior than that of the PAD flag but there is room for further improvement.