Flow Cytometric Reticulocyte Counting: Parallel Evaluation of Five Fully Automated Analyzers: An NCCLS-ICSH Approach

We performed a parallel evaluation of 5 automated reticulocyte analyzers. The guidelines were those proposed by the National Committee for Clinical Laboratory Standards and the International Council for Standardisation in Haematology. Duplicate analyses were performed for 225 healthy subjects and 115 patients affected by various diseases. The reference intervals were different for each method (ADVIA 120, 27-125 × 10³/μL [27-125 × 10⁹/L]; CELL DYN 4000, 25-108 × 10³/μL [25-108 × 10⁹/L]; GEN-S, 20-85 × 10³/μL [20-85 × 10⁹/L]; SE 9500 RET, 23-95 × 10³/μL [23-95 × 10⁹/L]; and VEGA RETIC, 30-130 × 10³/μL [30-130 × 10⁹/L]). The comparisons of percentage counts with the microscopic reference method were satisfactory for all automated methods. However, a tendency to overestimate at low counts was noted. This progressively increased from the SE 9500 RET to the VEGA RETIC. The imprecision was excellent for all the methods at normal and high concentrations. This was higher at low concentrations. When compared with the microscopic reference, the analyzers showed satisfactory sensitivity at low counts and excellent sensitivity at high counts. The overall agreement varied from 74.8% for the GEN-S to 86.1% for the SE 9500 RET.