Performance of automated slidemakers and stainers in a working laboratory environment - routine operation and quality control

Abstract

The automated slidemaker/stainers of the four Beckman Coulter LH755 hematology systems in our laboratory are operated as analyzers, with similar requirements for setup, maintenance and quality control. A study was performed to confirm that these slide maker/stainers in routine use produce peripheral blood films that are completely satisfactory for microscopy and without cells, particularly abnormal cells, being pulled to the edges or sides of the film outside the usual working area. One hundred and thirty-nine automated blood films that had been produced during routine operation were compared with well-prepared manual films from the same patients. None of the films was unacceptable for microscopy. The distributions of normal white cell types within the counting areas of automated films compared with manual films, for all 139 samples for WBC from 1.0 to 352.8 x 10(9)/l; for blasts and promyelocytes in the 65 samples in which they occurred and for nucleated red blood cells in the 58 samples in which they occurred all fell within the expected limits of 200 cell differential counts of CLSI H20-A. Red cell morphology and the occurrence of WBC clumps, platelet clumps and smudge cells were comparable between the automated and manual films of all samples. We conclude that automated slidemaker/stainers, as typified by those of the Beckman Coulter LH755 system, are capable of producing blood films comparable with well-prepared manual films in routine laboratory use; and that the maintenance and quality control procedures used in our laboratory ensure consistent high quality performance from these systems.

Figure 2

Examples of blood films produced by the automated slidemaker/stainers. The second blood film shows the ‘line’ of cells in the tail observed on a few of the automated blood films.

Figure 1

Examples of manually prepared blood films.

Figure 3

Comparison of neutrophil counts from automated slides with neutrophil counts from manual slides. Points represent averages of 200 cell counts by two observers on 139 patient samples. Lines represent the 95% confidence envelope for imprecision of 200 cell differential counts from CLSI H20-A.

Figure 4

Comparison of lymphocyte counts from automated slides with lymphocyte counts from manual slides. Points represent averages of 200 cell counts by two observers on 139 patient samples. Lines represent the 95% confidence envelope for imprecision of 200 cell differential counts from CLSI H20-A.

Figure 5

Comparison of monocyte counts from automated slides with monocyte counts from manual slides. Points represent averages of 200 cell counts by two observers on 139 patient samples. Lines represent the 95% confidence envelope for imprecision of 200 cell differential counts from CLSI H20-A.

Figure 6

Comparison of eosinophil counts from automated slides with eosinophil counts from manual slides. Points represent averages of 200 cell counts by two observers on 139 patient samples. Lines represent the 95% confidence envelope for imprecision of 200 cell differential counts from CLSI H20-A.

Figure 7

Comparison of basophil counts from automated slides with basophil counts from manual slides. Points represent averages of 200 cell counts by two observers on 139 patient samples. Lines represent the 95% confidence envelope for imprecision of 200 cell differential counts from CLSI H20-A.

Figure 8

Comparison of counts of blasts and promyelocytes between automated slides and manual slides. Points represent averages of 200 cell counts by two observers on 65 patient samples. Lines represent the 95% confidence envelope for imprecision of 200 cell differential counts from CLSI H20-A.

Comparison of NRBC counts from automated slides with NRBC counts from manual slides. Points represent averages of 200 cell counts by two observers on 58 patient samples. Lines represent the 95% confidence envelope for imprecision of 200 cell differential counts from CLSI H20-A.