Wonbae Lee

White blood cell differential counts in severely leukopenic samples: a comparative analysis of different solutions available in modern laboratory hematology

Background We evaluated the efficacy of white blood cell (WBC) differential counts in severely leukopenic samples by the Hematoflow method and by automated hematology analyzers and compared the results with manual counts. Methods EDTA-anticoagulated blood samples (175 samples) with WBC counts of 40-990/µL were selected. Hematoflow differential counts were performed in duplicates employing flow cytometry using the CytoDiff reagent and analysis software. Differential counts were also performed using the DxH 800 (Beckman Coulter) and XE-2100 (Sysmex) automated hematology analyzers. The sum of the manual counts by a hematology technician and a resident were used as the manual counts. Results The total analysis time and hands-on time required by the Hematoflow method were shorter than those required by manual counting. Hematoflow counts were reproducible, showed a good correlation with automated analyzers, and also showed strong correlation with manual counts (r > 0.8) in neutrophils, lymphocytes, and monocytes. None of the cases containing less than 4% blasts as analyzed by the Hematoflow method had blasts in the manual counts, but 8 cases of 21 cases (38.1%) with over 4% blasts by Hematoflow had blasts in manual counts. Conclusion Hematoflow counts of severely leukopenic samples were reproducible and showed a good correlation with manual counts in terms of neutrophil, lymphocyte, and monocyte counts. The Hematoflow method also detected the presence of blasts. Manual slide review is recommended when over 4% blasts are found by Hematoflow.

Development of a cervical cancer progress prediction tool for human papillomavirus-positive Koreans: A support vector machine-based approach

Objectives To develop a Web-based tool to draw attention to patients positive for human papillomavirus (HPV) who have a high risk of progression to cervical cancer, in order to increase compliance with follow-up examinations and facilitate good doctor–patient communication. Methods Records were retrospectively analysed from women who were positive for HPV on initial testing (before any treatment). Information concerning age, Papanicolaou (PAP) smear result and presence of 15 high-risk HPV genotypes was used in a support vector machine (SVM) model, to identify the patient features that maximally contributed to progression to high-risk cervical lesions. Results Data from 731 subjects were analysed. The maximum number of correct cancer predictions was seen when four features (PAP, HPV16, HPV52 and HPV35) were used, giving an accuracy of 74.41%. A web-based high-risk cervical lesion prediction application tool was developed using the SVM model results. Conclusions Use of the web-based prediction tool may help to increase patient compliance with physician advice, and may heighten awareness of the significance of regular follow-up HPV examinations for the prevention of cervical cancer, in Korean women predicted to have heightened risk of the disease.

A CASE OF ESSENTIAL THROMBOCYTHEMIA IN AN 8-YEAR-OLD BOY

Thrombocytosis in childhood is not rare but essential thrombocythemia is an extremely rare myeloproliferative disorder in childhood. The authors report a case of essential thrombocythemia in an 8-year-old boy who was diagnosed during further evaluation of an incidental finding of thrombocythemia in a school health examination.