Detection of blast cells on the Mindray MC-80 automatic blood cell analyzer

Background. Detection of blast cells in peripheral blood is crucial for the diagnosis, monitoring, and evaluation of treatment efficacy in hematological diseases. The introduction of digital morphology can improve the standardization of laboratory processes; however, the results of automatic preclassification require evaluation of their comparability with expert morphological assessment. Objective. To evaluate the comparability of the results of automatic blast cell preclassification and counting using the Mindray MC-80 digital morphology analyzer with the results of expert morphological verification of digital images of peripheral blood smears. Materials and Methods. The study included 205 patients with various hematological pathologies and the presence of blasts in their peripheral blood. Blast cell counts were assessed using the Mindray MC-80 and by expert verification by a morphologist. Statistical analysis included Spearman correlation, Passing-Bablok regression, and Bland-Altman analysis. Results. Blasts were detected in all smears by expert morphological verification, while automatic counting detected them in 95.1 % of cases. A highly statistically significant correlation was found between the methods: r=0.806; p<0.0001. Mindray MC-80 statistically significantly overestimated the blast count compared to EV. According to the regression model constructed on the Bland-Altman plot, the average difference between the results of Mindray MC-80 automatic preclassification and expert verification was 2.1 cells (95 % CI of the mean difference 1.2–3.0) with an average blast count of 0.5 per 200 leukocytes and increased to 5.5 cells (95 % CI of the mean difference 3.3–7.7) with an average blast count of 29.5 per 200 leukocytes. The regression limits of agreement, calculated as the 95 % predictive interval for individual differences, ranged from –5.4 to +9.6 cells and from –2.2 to +13.2 cells for the indicated levels, respectively. Conclusion. Mindray MC-80 can be used for preliminary digital pre-classification and screening detection of blasts; however, automated counting requires mandatory expert verification by a morphologist, especially when making clinical decisions near diagnostic thresholds.

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