Assessment of blood sample stability for complete blood count using the Sysmex XN-9000 and Mindray BC-6800 analyzers

Buoro, Sabrina; Mecca, Tommaso; Seghezzi, Michela; Manenti, Barbara; Cerutti, Lorenzo; Dominoni, Paola; Napolitano, Gavino; Resmini, Stefano; Crippa, Alberto; Ottomano, Cosimo; Lippi, Giuseppe

doi:10.1016/j.bjhh.2016.05.010

Acessibilidade / Reportar erro

Brasil

Revista Brasileira de Hematologia e Hemoterapia

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLES • Rev. Bras. Hematol. Hemoter. 38 (3) • Jul-Sep 2016 • https://doi.org/10.1016/j.bjhh.2016.05.010 copy

Assessment of blood sample stability for complete blood count using the Sysmex XN-9000 and Mindray BC-6800 analyzers

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND:

Different hematological analyzers have different analytical performances that are often reflected in the criteria for sample stability of the complete blood count. This study aimed to assess the stability of several hematological parameters using the XN-9000 Sysmex and BC-6800 Mindray analyzers.

METHODS:

The impact of storage at room temperature and 4 °C was evaluated after 2, 4, 6, 8, 24, 36 and 48 h using ten normal and 40 abnormal blood samples. The variation from the baseline measurement was evaluated by the Steel-Dwass-Critchlow-Fligner test and by Bland-Altman plots, using quality specifications and critical difference as the total allowable variation.

RESULTS:

Red blood cells and reticulocyte parameters (i.e. hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, red blood cell distribution width, immature reticulocyte fractions, low-fluorescence reticulocytes, middle-fluorescence reticulocytes, high fluorescence mononuclear cells) showed less stability compared to leukocyte and platelet parameters (except for monocyte count and mean platelet volume). The bias for hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration and red blood cell distribution width coefficient of variation was higher than the critical difference after 8 h using both analyzers.

CONCLUSION:

Blood samples measured with both analyzers do not show analytically significant changes in up to 2 h of storage at room temperature and 4 °C. However, the maximum time for analysis can be extended for up to 8 h when the bias is compared to the critical difference.

Keywords:
XN-9000; BC-6800; Sample stability; Complete blood count; Pre-analytical phase

Parameters	XN-9000	BC-6800	Optimal performance Bias%	Critical Difference% on XN-9000	Critical Difference% on BC-6800
Red blood cell	RBC	RBC	0.9	9.1	9.3
Hemoglobin	HGB	HGB	0.9	7.9	8.1
Hematocrit	HCT	HCT	0.9	8.4	9.5
Mean volume, red blood cells	MCV	MCV	0.6	4.2	5.3
Mean corpuscular hemoglobin	MCH	MCH	0.7	5.0	5.4
Mean corpuscular hemoglobin concentration	MCHC	MCHC	0.4	5.8	6.7
RBC distribution width	RDW-CV	RDW-CV	0.9	9.8	9.9
RBC distribution width	RDW-SD	RDW-SD	NA	NA	NA
Nucleated red blood cell	NRBC	NRBC	NA	NA	NA
White blood cells	WBC	WBC	2.8	30.5	30.6
Neutrophil	NEUT	Neu	4.6	45.4	45.2
Lymphocyte	LYMPH	Lym	3.7	30.2	30.4
Monocyte	MONO	Mon	6.6	53.7	57.4
Eosinophil	EO	Eos	9.9	62.0	58.9
Basophil	BASO	Bas	7.7	77.9	88.1
High fluorescence cells	HFLC	HFC	NA	NA	NA
Platelet	PLT	PLT	3.0	26.1	26.2
Mean volume platelet	MPV	MPV	1.2	12.3	12.6
PLT distribution width	PDW	PDW	NA	NA	NA
Plateletcrit	PCT	PCT	NA	NA	NA
PLT larger cell ratio	P-LCR	P-LCR	NA	NA	NA
Reticulocyte	RET	RET	3.9	31.7	31.1
Immature reticulocyte fraction	IRF	IRF	NA	NA	NA
Low-fluorescence reticulocyte	LFR	LFR	NA	NA	NA
Medium-fluorescence reticulocyte	MFR	MFR	NA	NA	NA
High-fluorescence reticulocyte	HFR	HFR	NA	NA	NA

		Temp	T0 median value (95% CI)	ΔX (TX - T0) Hodges–Lehmann location shift							ΔX with p-value < 0.0001 at the time [h]	B% (95% CI) a time of stability; p-value B% vs. OP-Bias%; Stable until [h]	B% (95% CI); p-value B% vs. CD%; Stable until [h]
				2 h	4 h	6 h	8 h	24 h	36 h	48 h
WBC (109/L)	XN-9000	RT	7.67 (5.91 to 9.40)	0.03	0.05	-0.03	0.06	0.07	-0.08	-0.10	NS	1.4 (-1.0 to 3.7);p=0.2192; 48h	NE
	XN-9000	4°C	7.67 (5.91 to 9.40)	0.13	0.02	0.22	0.14	0.08	0.10	-0.03	NS	3.0 (-1.4 to 7.5);p=0.9109; 48h	NE
	BC-6800	RT	7.15 (5.60 to 7.95)	0.02	0.00	0.04	0.14	0.16	0.19	0.01	NS	-0.2 (-2.5 to 2.0);p=0.0105; 48h	NE
	BC-6800	4°C	7.15 (5.60 to 7.95)	0.01	0.16	0.02	0.03	0.03	0.04	-0.03	NS	0.2 (-1.0 to 1.5);p=0.0013; 48h	NE

RBC (1012/L)	XN-9000	RT	4.60 (4.23 to 5.22)	-0.01	-0.01	-0.02	0.01	0.02	0.01	0.00	NS	-0.1 (-0.6 to 0.5)p<0.0001; 48hb	NE
	XN-9000	4°C	4.60 (4.23 to 5.22)	0.12	0.10	0.13	0.15	0.11	0.16	0.15	NS	2.7 (0.9 to 4.5)p=0.0522; 48h	NE
	BC-6800	RT	4.57 (4.20 to 4.89)	0.00	0.09	0.05	-0.08	-0.06	-0.04	-0.04	NS	-0.6 (-3.9 to 2.7);p=0.3477; 48h	NE
	BC-6800	4°C	4.57 (4.20 to 4.89)	0.06	0.08	0.06	0.09	0.09	0.08	0.09	NS	1.6 (0.4 to 2.9);p=0.2163; 24h	NE

Hb (g/L)	XN-9000	RT	142 (126 to 151)	0.10	0.20	0.10	0.20	0.30	0.20	0.10	NS	1.0 (0.6 to 1.4)p=0.5780; 48h	NE
	XN-9000	4°C	142 (126 to 151)	0.40	0.35	0.40	0.30	0.35	0.35	0.40	NS	3.7 (2.0 to 5.4);p<0.0001c	-0.6 (-1.4 to 0.6);p<0.0001; 48hd
	BC-6800	RT	146 (134 to 151)	0.00	0.00	0.00	-0.20	-0.15	-0.20	-0.10	NS	-1.4 (-4.3 to 1.5);p=0.1119; 48h	NE
	BC-6800	4°C	146 (134 to 151)	0.20	0.20	0.10	0.20	0.20	0.20	0.20	NS	1.3 (0.9 to 1.6);p=0.0640; 48h	NE

HT (%)	XN-9000	RT	41.6 (37.2 to 43.7)	-0.37	-0.63	-0.56	-0.40	2.11	3.25	6.12	48h	0.9 (-1.6 to 3.5);p=0.9747; 8h	4.9 (2.2 to 7.6);p<0.0001; 24hd
	XN-9000	4°C	41.6 (37.2 to 43.7)	0.25	0.25	0.40	0.80	0.95	1.35	1.90	NS	2.3 (0.8 to 3.9);p=0.0740; 24h	4.7 (3.3 to 6.4);p<0.0001; 48hd
	BC-6800	RT	41.4 (40.2 to 44.1)	-0.05	0.35	0.20	-0.60	2.15	3.90	6.00	48h	1.9 (-1.0 to 4.8);p=0.4791; 8h	4.9 (1.9 to 8.0)p<0.0001; 24hd
	BC-6800	4°C	41.4 (40.2 to 44.1)	0.20	0.40	0.00	0.50	0.90	1.30	2.00	NS	1.6 (0.7 to 2.6);p=0.1300; 24h	4.1 (3.2 to 5.0);p<0.0001; 48hd

MCV (fL)	XN-9000	RT	87.45 (86.2 to 90.5)	-0.42	-1.24	-1.02	-1.27	3.51	6.10	13.1	24h	0.5 (0.2 to 0.7);p=0.3676; 2h	-1.5 (-2.1 to -0.8);p<0.0001; 8hd
	XN-9000	4°C	87.45 (86.2 to 90.5)	-1.25	-1.30	-1.40	-1.00	0.10	0.50	2.00	NS	0.3 (-0.2 to 0.8);p=0.2932; 24h	2.0 (1.3 to 2.7);p<0.0001; 48hd
	BC-6800	RT	89.8 (88.2 to 92.7)	-0.25	-0.45	-0.50	-0.35	5.70	8.80	13.4	24h	-0.2 (-0.8 to 0.5);p=0.1688; 8h	-0.2 (-0.8 to 0.5);p<0.0001; 8hd
	BC-6800	4°C	89.8 (88.2 to 92.7)	-1.50	-1.40	-1.55	-1.10	-0.15	0.70	1.55	NS	0.8 (0.3 to 1.4);p=0.3793; 36h	2.1 (1.3 to 2.9);p<0.0001; 48hd

MCHa(pg)	XN-9000	RT	30.0 (29.0 to 30.6)	0.30	0.40	0.50	0.40	0.50	0.30	0.30	NS	1.1 (0.6 to 1.6);p=0.1069; 48h	NE
	XN-9000	4°C	30.0 (29.0 to 30.6)	0.40	0.40	0.40	0.30	0.20	0.10	0.20	NS	0.6 (0.1 to 1.1);p=0.7434; 48h	NE
	BC-6800	RT	31.4 (30.7 to 32.3)	-0.20	-0.30	-0.30	-0.30	-0.30	-0.50	-0.30	NS	0.9 (0.2 to 1.6);p=0.5672; 48h	NE
	BC-6800	4°C	31.4 (30.7 to 32.3)	-0.30	-0.30	-0.10	-0.30	-0.30	-0.30	-0.30	NS	0.8 (0.1 to 1.8);p=0.8085; 48h	NE

MCHCa(g/dL)	XN-9000	RT	34.2 (33.4 to 34.4)	0.60	0.80	1.00	0.90	-0.80	-1.90	-4.20	4h	1.7 (1.1 to 2.6);p<0.0001c	-2.4 (-3.5 to -1.3);p<0.0001; 8hd
	XN-9000	4°C	34.2 (33.4 to 34.4)	1.10	0.90	1.10	0.80	0.40	0.10	-0.50	2h	3.1 (2.5 to 3.7);p<0.0001c	1.4 (0.6 to 2.2);p<0.0001; 48hd
	BC-6800	RT	35.6 (33.4 to 36.2)	-0.10	-0.30	-0.10	-0.20	-2.30	-3.50	-4.90	24h	-0.7 (-1.2 to -0.2);p=0.2126; 8h	-0.7 (-1.2 to -0.2);p<0.0001; 8hd
	BC-6800	4°C	35.6 (33.4 to 36.2)	0.20	0.10	0.30	0.00	-0.40	-0.60	-1.10	48h	0.9 (0.3 to 1.4);p=0.1027; 24h	2.9 (2.1 to 3.7);p<0.0001; 48hd

RDW-CV (%)	XN-9000	RT	12.9 (12.7 to 13.1)	0.00	0.00	0.10	0.10	0.70	1.20	1.50	24h	0.9 (0.4 to 1.4);p=0.9785; 8h	8.7 (7.6 to 9.8);p<0.0001; 48hd
	XN-9000	4°C	12.9 (12.7 to 13.1)	-0.10	-0.10	-0.10	-0.10	-0.30	-0.30	-0.30	24h	0.9 (0.6 to 1.3);p=0.8055; 8h	2.3 (1.4 to 3.1);p<0.0001; 48hd
	BC-6800	RT	12.9 (12.4 to 13.2)	0.00	0.20	0.30	0.30	1.20	1.60	1.90	24h	0.5 (0.1 to 0.8);p<0.0001; 2hb	2.7 (2.0 to 3.3);p<0.0001; 8hd
	BC-6800	4°C	12.9 (12.4 to 13.2)	0.10	0.20	0.20	0.20	-0.10	0.00	-0.10	NS	0.3 (-0.3 to 1.0);p=0.0912; 48h	NE

RDW-SD (fL)	XN-9000	RT	41.4 (39.4 to 43.2)	-0.10	-0.70	-0.25	-0.55	4.40	7.00	12.0	24h	10.2 (8.6 to 11.8)	CD% data not available
	XN-9000	4°C	41.4 (39.4 to 43.2)	-1.10	-1.20	-1.10	-1.10	-1.20	-1.10	-0.50	NS	0.9 (-0.4 to 2.2)
	BC-6800	RT	40.5 (39.5 to 41.5)	0.00	0.50	0.70	0.90	7.15	10.1	12.8	24h	14.9 (12.5 to 17.4)
	BC-6800	4°C	40.5 (39.5 to 41.5)	-0.15	0.00	0.00	0.10	-0.20	0.50	0.50	NS	0.9 (0.0 to 1.9)
NRBC (109/L)	XN-9000	RT	0.0 (0.0 to 0.0)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	NS	20.0 (-31.7 to 71.7)
	XN-9000	4°C	0.0 (0.0 to 0.0)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	NS	0.0 (-42.9 to 42.9)
	BC-6800	RT	0.0 (0.0 to 0.0)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	NS	0.0 (0.0 to 0.0)
	BC-6800	4°C	0.0 (0.0 to 0.0)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	NS	0.0 (0.0 to 0.0)

RETa(109/L)	XN-9000	RT	48.1 (35.1 to 60.3)	0.63	-0.89	-1.05	-1.50	-3.71	-0.59	-1.77	NS	2.5 (-1.5 to 6.6);p=0.4964; 48h	NE
	XN-9000	4°C	48.1 (35.1 to 60.3)	1.01	1.15	0.36	0.08	-0.07	0.27	-0.11	NS	0.3 (-3.9 to 4.4);p=0.0840; 48h	NE
	BC-6800	RT	37.4 (26.8 to 44.4)	0.85	1.55	0.30	-1.10	0.45	-1.20	-2.60	NS	6.1 (0.3 to 12.0);p=0.4344; 36h	9.8 (4.5 to 15.1);p<0.0001; 48hd
	BC-6800	4°C	37.4 (26.8 to 44.4)	0.00	0.50	-1.30	0.25	1.30	1.65	3.45	NS	5.0 (1.2 to 8.8);p=0.5394; 36h	10.7 (6.2 to 15.2);p<0.0001; 48hd

IRFa(%)	XN-9000	RT	9.3 (6.9 to 10.3)	-0.81	-0.49	-1.08	-1.37	-1.94	-1.85	-2.07	24h	-25.1 (-38.7 to -11.5)	CD% data not available
	XN-9000	4°C	9.3 (6.9 to 10.3)	0.15	-0.98	-0.42	-0.96	-0.64	-0.66	0.45	NS	4.0 (-5.3 to 13.4)
	BC-6800	RT	3.4 (2.5 to 4.3)	0.20	0.20	0.20	-0.20	-0.85	-1.35	-2.00	36h	-90.2 (-110.8 to -69.6)
	BC-6800	4°C	3.4 (2.5 to 4.3)	0.0	-0.80	-0.60	-0.70	0.10	0.50	0.90	NS	22.1 (4.4 to 39.6)
LFRa(%)	XN-9000	RT	90.7 (89.7 to 93.1)	0.81	0.48	1.08	1.37	1.94	1.85	2.07	24h	2.1 (1.0 to 3.2)
	XN-9000	4°C	90.7 (89.7 to 93.1)	-0.16	0.98	0.42	0.96	0.64	0.66	-0.45	NS	-0.5 (-1.4 to 0.4)
	BC-6800	RT	96.5 (95.7 to 97.5)	-0.20	-0.20	-0.20	0.20	0.85	1.35	2.00	36h	2.1 (1.5 to 2.7)
	BC-6800	4°C	96.5 (95.7 to 97.5)	0.00	0.80	0.60	0.70	-0.10	-0.50	-0.90	NS	-0.8 (-1.3 to -0.2)
MFRa(%)	XN-9000	RT	8.4 (6.5 to 8.9)	-0.72	-0.43	-1.02	-1.20	-1.58	-1.70	-1.68	24h	-23.7 (-37.6 to -9.7)
	XN-9000	4°C	8.4 (6.5 to 8.9)	0.15	-0.78	-0.48	-0.82	-0.77	-0.66	0.04	NS	-0.9 (-11.2 to 9.5)
	BC-6800	RT	3.4 (2.5 to 4.3)	0.20	0.20	0.20	-0.20	-0.85	-1.35	-2.00	36h	-90.2 (-67.9 to -35.5)
	BC-6800	4°C	3.4 (2.5 to 4.3)	0.00	-0.80	-0.60	-0.70	0.10	0.50	0.90	NS	22.0 (4.4 to 39.7)
HFRa(%)	XN-9000	RT	0.9 (0.6 to 1.3)	0.00	0.00	-0.10	-0.10	-0.30	-0.10	-0.30	NS	-51.1 (-79.2 to -23.0)
	XN-9000	4°C	0.9 (0.6 to 1.3)	0.10	-0.15	0.10	-0.10	0.10	0.10	0.40	NS	46.8 (21.2 to 72.4)
	BC-6800	RT	0.0 (0.0 to 0.0)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	NS	0.0 (0.0 to 0.0)
	BC-6800	4°C	0.0 (0.0 to 0.0)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	NS	0.0 (0.0 to 0.0)

		Temp	T0 median value (95% CI)	ΔX (TX - T0) Hodges–Lehmann location shift		ΔX with p-value < 0.0001 at the time [h]	B% (95% CI) a time of stability; p-value B% vs. OP-Bias%; Stable until [h]	B% (95% CI); p-value B% vs. CD%; Stable until [h]
				4 h	8 h
WBC (109/L)	XN-9000	RT	5.3 (4.3 to 7.2)	0.00	-0.10	NS	-0.8 (-6.8 to 5.2);p=0.2229; 8h	NE
	XN-9000	4°C	8.6 (6.5 to 10.1)	0.06	0.04	NS	0.6 (-4.5 to 5.6);p=0.37625; 8h	NE
	BC-6800	RT	5.4 (4.1 to 7.1)	0.05	-0.10	NS	2.3 (-0.9 to 5.5);p=0.3274; 8h	NE
	BC-6800	4°C	8.5 (6.4 to 9.9)	0.20	-1.22	NS	1.8 (0.7 to 2.9);p=0.0774; 4h	18.4 (7.2 to 29.7);p<0.0001; 8ha

RBC (1012/L)	XN-9000	RT	4.8 (3.8 to 5.6)	0.01	-0.16	NS	-4.0 (-17.8 to 9.8);p=0.4582; 8h	NE
	XN-9000	4°C	3.6 (3.5 to 3.9)	-0.02	-0.02	NS	-0.4 (-2.1 to 1.2);p=0.1161; 8h	NE
	BC-6800	RT	4.6 (3.7 to 5.3)	-0.02	-0.01	NS	0.3 (-1.1 to 1.8);p=0.4194; 8h	NE
	BC-6800	4°C	3.5 (3.3 to 3.8)	-0.01	0.26	NS	8.5 (-0.5 to 17.5);p=0.0945; 8h	NE

Hb(g/L)	XN-9000	RT	141.0 (123.0 to 152.0)	0.10	-0.70	NS	-5.2 (-19.7 to 9.2);p=0.3370; 8h	NE
	XN-9000	4°C	113.0 (101.0 to 116.0)	0.00	0.00	NS	0.5 (-0.4 to 1.3);p=3067; 8h	NE
	BC-6800	RT	141.0 (123.0 to 154.0)	-0.10	-0.20	NS	-0.8 (-4.3 to 2.7);p=0.3108; 8h	NE
	BC-6800	4°C	111.0 (103.0 to 117.0)	0.00	1.30	NS	1.6 (0.07 to 3.12);p=0.3546; 8h	NE

HT(%)	XN-9000	RT	40.7 (35.3 to 46.5)	0.40	-1.40	NS	-3.5 (-17.4 to 10.3);p=0.5044; 8h	NE
	XN-9000	4°C	33.9 (31.5 to 35.5)	0.00	0.00	NS	0.1 (-0.7 to 0.9);p=0.0614; 8h	NE
	BC-6800	RT	39.7 (34.5 to 44.3)	0.00	0.00	NS	1.3 (-0.3 to 2.9);p=0.5982; 8h	NE
	BC-6800	4°C	32.6 (30.6 to 34.4)	0.00	0.02	NS	8.6 (-0.5 to 17.7);p=0.0921; 8h	NE

MCV(fL)	XN-9000	RT	84.8 (84.0 to 88.4)	0.60	0.30	NS	0.5 (0.1 to 0.8);p=0.4860; 8h	NE
	XN-9000	4°C	89.9 (87.7 to 92.5)	0.40	0.40	NS	0.5 (-0.3 to 1.4);p=0.8606; 8h	NE
	BC-6800	RT	85.8 (84.5 to 88.7)	0.60	0.80	NS	0.5 (0.4 to 0.7);p=0.3379; 4h	1.0 (0.8 to 1.2);p<0.0001; 8ha
	BC-6800	4°C	92.4 (87.1 to 93.5)	0.20	0.10	NS	0.1 (0.0 to 0.3);p<0.0001; 8hb	NE

MCH (pg)	XN-9000	RT	28.9 (27.3 to 29.8)	0.07	-0.33	NS	1.2 (0.1 to 2.4);p=0.3425; 8h	NE
	XN-9000	4°C	29.6 (27.2 to 30.9)	0.20	0.00	NS	-0.1 (-1.0 to 0.8);p=0.0961; 8h	NE
	BC-6800	RT	30.3 (28.9 to 31.4)	0.00	0.10	NS	-1.1 (-4.0 to 1.8);p=0.2119; 8h	NE
	BC-6800	4°C	31.3 (28.2 to 32.4)	0.10	0.85	NS	0.20 (-0.07 to 0.05);p=0.1530; 4h	3.9 (2.8 to 5.4)p<0.0001; 8ha

MCHC (g/dL)	XN-9000	RT	33.6 (32.5 to 34.5)	-0.10	-0.60	NS	0.5 (-0.3 to 1.2);p=0.8634; 4h	NE
	XN-9000	4°C	32.9 (32.4 to 33.5)	0.02	-0.20	NS	0.6 (0.3 to 0.9);p=0.1932; 8h	NE
	BC-6800	RT	35.3 (34.7 to 35.6)	-0.35	-0.40	NS	-2.1 (-5.0 to 0.8);p=0.812; 8h	NE
	BC-6800	4°C	34.1 (33.7 to 34.3)	0.10	0.85	8h	0.0 (-0.3 to 0.3);p<0.0001b; 4h	3.8 (1.6 to 6.1);p<0.0001; 8ha

RDW-CV (%)	XN-9000	RT	13.3 (13.1 to 15.9)	0.20	0.35	NS	2.8 (-9.7 to 15.4);p<0.7469; 8h	NE
	XN-9000	4°C	14.2 (13.4 to 14.6)	0.10	0.10	NS	0.7 (0.1 to 1.2);p=0.4190; 8h	NE
	BC-6800	RT	13.4 (13.0 to 15.6)	0.30	0.50	NS	2.1 (1.8 to 2.4);p<0.0001c	3.6 (2.9 to 4.2);p<0.0001; 8ha
	BC-6800	4°C	13.7 (13.4 to 14.1)	0.10	0.25	NS	0.9 (0.5 to 1.2);p=0.9609; 4h	2.1 (1.2 to 2.9); p<0.0001; 8ha

RDW-SD (fL)	XN-9000	RT	42.3 (41.1 to 44.3)	1.00	1.85	NS	3.6 (-9.0 to 16.2);p=0.6544; 8h	CD% data not available
	XN-9000	4°C	44.2 (43.1 to 48.4)	0.50	0.60	NS	1.2 (-0.2 to 2.5);p=0.6629; 8h
	BC-6800	RT	41.5 (40.3 to 43.3)	1.20	2.00	8h	4.3 (3.6 to 5.1)
	BC-6800	4°C	42.7 (41.9 to 47.8)	0.40	0.90	NS	2.0 (1.0 to 2.9)
NRBC (109/L)	XN-9000	RT	0.0 (0.0 to 0.0)	0.00	0.01	8h	103.3 (41.9 to 164.8)
	XN-9000	4°C	0.0 (0.0 to 0.0)	0.01	0.02	4h	129.9 (95.5 to 164.4)
	BC-6800	RT	0.0 (0.0 to 0.0)	0.00	0.00	NS	78.6 (26.4 to 130.8)
	BC-6800	4°C	0.0 (0.0 to 0.0)	0.00	0.02	8h	124.0 (78.5 to 169.6)

RET (109/L)	XN-9000	RT	53.1 (46.3 to 72.1)	0.11	-3.39	NS	-4.4 (-24.8 to 16.1);p=0.3996; 8h	NE
	XN-9000	4°C	54.0 (46.0 to 68.1)	1.20	1.50	NS	3.0 (-0.1 to 6.1);p=0.5427; 8h	NE
	BC-6800	RT	41.5 (31.9 to 55.2)	2.30	3.55	NS	7.3 (3.3 to 11.4);p=0.0912; 8h	NE
	BC-6800	4°C	52.2 (41.1 to 60.1)	1.14	3.45	NS	5.4 (-5.2 to 16.0);p=0.7652; 8h	NE

IRF(%)	XN-9000	RT	6.6 (4.1 to 7.9)	0.00	0.60	NS	6.1 (-28.3 to 40.5)	CD% data not available
	XN-9000	4°C	15.5 (11.5 to 20.5)	0.20	0.10	NS	-0.1 (-6.5 to 6.3)
	BC-6800	RT	1.7 (0.9 to 2.5)	-0.20	-0.30	NS	-8.5 (-28.5 to 11.5)
	BC-6800	4°C	8.4 (5.0 to 12.9)	-0.60	-0.80	NS	-21.5 (-44.7 to 1.7)
LFR(%)	XN-9000	RT	93.4 (92.1 to 95.9)	0.00	-0.60	NS	-0.7 (-6.5 to 5.0)
	XN-9000	4°C	84.6 (79.5 to 88.5)	-0.20	-0.10	NS	-0.7 (-2.6 to 1.1)
	BC-6800	RT	98.3 (97.5 to 99.1)	0.20	0.30	NS	0.1 (-0.5 to 0.6)
	BC-6800	4°C	91.7 (87.1 to 95.0)	0.60	0.80	NS	0.7 (0.2 to 1.2)
MFR(%)	XN-9000	RT	6.1 (4.0 to 6.9)	0.15	0.60	NS	6.8 (-22.5 to 36.2)
	XN-9000	4°C	12.0 (10.6 to 13.8)	-0.55	-0.40	NS	-5.6 (-10.7 to -0.5)
	BC-6800	RT	1.7 (0.9 to 2.5)	-0.20	-0.30	NS	-8.9 (-28.9 to 11.1)
	BC-6800	4°C	8.0 (5.0 to 11.6)	-0.30	-0.60	NS	-18.9 (-42.5 to 4.8)
HFR(%)	XN-9000	RT	0.5 (0.1 to 1.0)	0.00	0.00	NS	6.9 (-56.2 to 70.0)
	XN-9000	4°C	2.8 (1.4 to 7.9)	0.40	0.30	NS	19.0 (-2.1 to 40.1)
	BC-6800	RT	0.0 (0.0 to 0.0)	0.00	0.00	NS	2.6 (-1.7 to 6.9)
	BC-6800	4°C	0.0 (0.0 to 1.2)	0.00	0.00	NS	-38.8 (-70.2 to -7.4)

		Temp	T0 median value (95% CI)	ΔX (TX - T0) Hodges–Lehmann location shift							ΔX with p < 0.0001 at the time [h]	B% (95% CI) a time of stability; p-value B% vs. OP-Bias%; Stable until [h]	B% (95% CI); p-value B% vs. CD%; Stable until [h]
				2 h	4 h	6 h	8 h	24 h	36 h	48 h
NE(109/L)	XN-9000	RT	4.4 (3.5 to 4.7)	0.01	0.08	-0.02	0.00	0.21	0.06	0.00	NS	0.5 (-3.1 to 4.1);p=0.0273; 48h	NE
	XN-9000	4°C	4.4 (3.5 to 4.7)	0.07	0.07	0.09	0.06	0.04	0.14	0.13	NS	2.5 (-3.4 to 8.3);p=0.4509; 48h	NE
	BC-6800	RT	4.0 (3.0 to 4.6)	0.17	0.12	0.09	0.21	0.40	0.27	0.42	NS	3.5 (0.9 to 6.1);p=0.3950; 48h	NE
	BC-6800	4°C	4.0 (3.0 to 4.6)	0.02	0.10	0.00	0.05	0.23	0.34	0.51	NS	11.0 (7.1 to 14.8);p=0.1137; 24h	NE

LY(109/L)	XN-9000	RT	2.3 (1.7 to 2.5)	-0.02	-0.02	-0.07	-0.05	0.00	0.03	0.05	NS	1.1 (-1.7 to 3.9);p=0.0626; 48h	NE
	XN-9000	4°C	2.3 (1.7 to 2.5)	-0.03	0.01	-0.02	0.00	-0.09	-0.06	-0.11	NS	7.6 (3.1 to 12.1);p=0.0885; 48h	NE
	BC-6800	RT	2.0 (1.6 to 2.3)	0.01	0.00	0.02	0.02	0.02	0.00	-0.01	NS	1.0 (-2.7 to 4.7);p=0.1480; 48h	NE
	BC-6800	4°C	2.0 (1.6 to 2.3)	-0.01	-0.02	-0.03	0.00	-0.13	0.12	0.24	NS	0.3 (-2.9 to -3.47);p=0.0372; 8h	16.4 (11.1 to 21.7);p<0.0001; 48hb

MOa(109/L)	XN-9000	RT	0.6 (0.6 to 0.9)	0.00	0.00	-0.01	-0.01	-0.12	-0.15	-0.03	NS	16.0 (5.0 to 27.0);p=0.0884; 48h	NE
	XN-9000	4°C	0.6 (0.6 to 0.9)	0.02	0.00	0.02	0.02	-0.01	-0.06	-0.17	NS	8.8 (1.94 to -15.7);p=0.5053; 24h	28.1 (19.1 to 37.1);p<0.0001; 48hb
	BC-6800	RT	0.5 (0.4 to 0.7)	0.00	0.00	0.01	0.00	-0.04	-0.04	-0.12	48h	12.3 (5.1 to 19.4);p=0.1128; 36h	33.2 (24.7 to 41.6);p<0.0001; 48hb
	BC-6800	4°C	0.5 (0.4 to 0.7)	0.02	0.03	0.02	0.01	-0.01	-0.07	-0.13	48h	3.4 (-1.5 to 8.2);p=0.1816; 24h	36.7 (28.6 to 44.8);p<0.0001; 48hb

EO (109/L)	XN-9000	RT	0.2 (0.1 to 0.3)	0.00	0.01	0.02	0.03	-0.02	-0.05	-0.01	NS	14.5 (2.0 to -26.9);p=0.4507; 48h	NE
	XN-9000	4°C	0.2 (0.1 to 0.3)	0.00	0.00	0.01	0.00	0.01	0.00	0.00	NS	0.4 (-11.7 to 12.5);p=0.1175; 48h	NE
	BC-6800	RT	0.1 (0.1 to 0.3)	0.01	0.00	0.01	0.01	0.00	0.01	0.00	NS	6.1 (-1.2 to 13.4);p=0.2908; 48h	NE
	BC-6800	4°C	0.1 (0.1 to 0.3)	0.01	0.01	0.00	0.01	0.01	0.01	0.01	NS	10.01 (0.9 to 19.3);p=0.966; 48h	NE

BA (109/L)	XN-9000	RT	0.1 (0.0 to 0.1)	0.00	0.00	0.00	0.00	0.01	0.01	0.01	NS	20.2 (-4.5 to 44.9);p=0.3032; 48h	NE
	XN-9000	4°C	0.1 (0.0 to 0.1)	0.00	0.00	0.00	0.00	0.00	0.00	0.01	NS	26.1 (1.3 to 50.9);p=0.1362; 48h	NE
	BC-6800	RT	0.0 (0.0 to 0.0)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	NS	3.8 (-9.9 to 17.4);p=0.5552; 48h	NE
	BC-6800	4°C	0.0 (0.0 to 0.0)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	NS	10.5 (-10.8 to 30.9);p=0.7777; 48h	NE

HFC (109/L)	XN-9000	RT	0.0 (0.0 to 0.0)	0.00	0.00	0.00	0.00	-0.01	-0.01	-0.01	NS	-88.3 (-134.8 to -41.9)	CD% data not available
	XN-9000	4°C	0.0 (0.0 to 0.0)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	NS	-26.7 (-73.9 to 20.6)
	BC-6800	RT	0.0 (0.0 to 0.0)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	NS	-28.7 (-84.4 to 27.1)
	BC-6800	4°C	0.0 (0.0 to 0.0)	0.00	0.00	0.00	0.00	0.00	0.00	0.00	NS	-58.0 (-112.1 to -3.9)

PLT (109/L)	XN-9000	RT	262.0 (231.0 to 299.0)	-1.0	3.0	-3.0	-1.0	-19.0	-15.0	-10.0	NS	5.2 (1.9 to 8.5);p=0.1847; 48h	NE
	XN-9000	4°C	262.0 (231.0 to 299.0)	-14.5	-16.5	-20.5	-19.0	-21.0	-19.5	-23.0	NS	6.0 (4.0 to 8.0);p<0.0001c	9.5 (6.1 to 12.8);p<0.0001; 48hb
	BC-6800	RT	250.0 (227.0 to 279.0)	9.0	7.0	12.0	6.5	3.0	7.0	5.0	NS	4.0 (1.2 to 6.8);p=0.0045; 48h	NE
	BC-6800	4°C	250.0 (227.0 to 279.0)	4.0	3.0	4.0	-1.0	-3.0	-2.0	-5.0	NS	-0.6 (-2.9 to 1.7);p=0.4497; 48h	NE

MPVa(fL)	XN-9000	RT	10.8 (10.2 to 11.3)	0.40	0.50	0.60	0.60	1.30	1.50	0.90	24h	3.7 (2.9 to 4.5); p<0.0001c	9.2 (6.9 to 1.0);p<0.0001; 48hb
	XN-9000	4°C	10.8 (10.2 to 11.3)	0.00	-0.10	0.20	0.10	0.50	0.60	0.90	48h	0.8 (-0.4 to 1.5);p=0.1719. 8h	5.7 (4.3 to 7.0);p<0.0001; 48hb
	BC-6800	RT	9.5 (9.1 to 9.9)	0.60	0.80	1.00	0.80	0.80	0.80	1.10	4h	6.1 (4.9 to 7.2); p<0.0001c	8.8 (5.7 to 11.9);p<0.05; 24hb
	BC-6800	4°C	9.5 (9.1 to 9.9)	0.60	0.50	0.70	0.60	0.90	1.00	1.20	24h	1.3 (1.1 to 1.4);p=0.5307; 48h	1.3 (1.1 to 1.4);p<0.0001; 48hb

PDWa(fL)	XN-9000	RT	12.5 (11.8 to 14.0)	0.70	0.90	1.00	0.90	1.30	3.40	2.05	24h	19.7 (14.7 to 24.3)	CD% data not available
	XN-9000	4°C	12.5 (11.8 to 14.0)	0.20	-0.20	0.40	0.00	1.00	1.30	2.00	48h	13.7 (10.9 to 16.4)
	BC-6800	RT	10.95 (10.40 to 11.30)	0.80	1.10	1.20	1.10	1.30	1.20	1.50	24h	1.3 (0.5 to 2.0)
	BC-6800	4°C	10.95 (10.40 to 11.30)	1.00	0.60	1.25	1.30	1.60	1.60	2.10	24h	1.7 (1.1 to 2.3)
PCTa(%)	XN-9000	RT	0.28 (0.25 to 0.33)	0.01	0.01	0.01	0.01	0.02	0.03	0.02	NS	7.2 (3.9 to 10.5)
	XN-9000	4°C	0.28 (0.25 to 0.33)	-0.02	-0.02	0.02	-0.02	-0.01	-0.01	0.00	NS	-2.3 (-4.8 to 0.3)
	BC-6800	RT	0.2 (0.2 to 0.3)	0.02	0.02	0.03	0.03	0.02	0.02	0.03	NS	15.4 (10.5 to 20.4)
	BC-6800	4°C	0.2 (0.2 to 0.3)	0.02	0.01	0.02	0.01	0.02	0.03	0.30	NS	11.6 (8.5 to 14.7)
P-LCRa(%)	XN-9000	RT	32.3 (27.4 to 36.0)	3.65	4.20	5.00	4.45	10.70	12.00	7.40	24h	30.3 (23.2 to 37.3)
	XN-9000	4°C	32.3 (27.4 to 36.0)	0.05	-0.70	1.25	0.40	3.55	5.00	6.95	48h	20.1 (18.1 to 22.2)
	BC-6800	RT	23.4 (19.8 to 25.5)	3.80	5.00	6.00	5.30	5.05	5.00	6.80	6h	30.1 (19.1 to 41.0)
	BC-6800	4°C	23.4 (19.8 to 25.5)	3.95	3.00	4.65	4.20	6.40	6.90	8.25	24h	33.0 (28.0 to 38.0)

		Temp	T0 median value (95% CI)	ΔX (TX - T0) Hodges–Lehmann location shift		ΔX with p-value < 0.0001 at the time [h]	B% (95% CI) a time of stability; p-value B% vs. OP-Bias%; Stable until [h]	B% (95% CI); p-value B% vs. CD%; Stable until [h]
				4 h	8 h
NE (109/L)	XN-9000	RT	2.9 (2.3 to 4.5)	-0.03	-0.09	NS	0.2 (-8.9 to 9.3);p=0.3146; 8h	NE
	XN-9000	4°C	5.8 (4.2 to 7.6)	0.07	0.03	NS	1.0 (-1.2 to 3.1);p=0.015; 8h	NE
	BC-6800	RT	3.0 (2.3 to 4.6)	0.01	-0.03	NS	1.2 (-1.8 to 4.3);p=0.0324; 8h	NE
	BC-6800	4°C	5.9 (4.3 to 7.7)	0.12	-0.87	NS	2.2 (0.8 to 3.6);p=0.0017; 4h	18.7 (6.9 to 30.6);p<0.0001; 8ha

LY (109/L)	XN-9000	RT	1.6 (0.9 to 2.2)	0.02	-0.02	NS	-2.8 (-33.2 to 27.5);p=0.6514; 8h	NE
	XN-9000	4°C	1.2 (1.0 to 1.8)	-0.01	0.00	NS	-1.7 (-15.1 to 11.8);p=0.4237; 8h	NE
	BC-6800	RT	1.6 (0.9 to 2.2)	-0.02	-0.04	NS	4.4 (0.2 to 8.5);p=0.7316; 8h	NE
	BC-6800	4°C	1.2 (0.9 to 1.7)	-0.01	-0.17	NS	0.9 (-1.9 to -3.7);p=0.0559; 4h	13.3 (4.7 to 21.4);p<0.0001; 8ha

MO (109/L)	XN-9000	RT	0.5 (0.4 to 0.7)	0.01	-0.02	NS	-4.9 (-17.0 to 7.2);p=0.0618; 8h	NE
	XN-9000	4°C	0.8 (0.6 to 0.9)	0.01	-0.02	NS	2.3 (-4.2 to 8.7);p=0.1814; 8h	NE
	BC-6800	RT	0.4 (0.3 to 0.5)	0.01	-0.01	NS	5.5 (-0.6 to 11.7);p=0.7159; 8h	NE
	BC-6800	4°C	0.6 (0.5 to 0.7)	0.02	-0.13	NS	3.0 (-0.2 to 6.2);p=0.0279; 4h	25.1 (7.9 to 42.3);p<0.0001; 8ha

EO (109/L)	XN-9000	RT	0.1 (0.0 to 0.4)	0.01	0.01	NS	43.4 (-16.0 to 102.7);p=0.2463; 8h	NE
	XN-9000	4°C	0.1 (0.1 to 0.1)	0.01	0.02	NS	8.9 (1.7 to 16.0);p=0.7689; 4h	31.5 (16.2 to 46.7);p<0.0001; 8ha
	BC-6800	RT	0.1 (0.0 to 0.4)	0.01	0.01	NS	29.0 (-6.0 to 65.2);p=0.0716; 4h	29.6 (-6.2 to 65.3);p<0.05; 8ha
	BC-6800	4°C	0.1 (0.1 to 0.2)	0.01	0.00	NS	7.3 (-19.7 to 34.4);p=0.8439; 8h	NE

BA (109/L)	XN-9000	RT	0.0 (0.0 to 0.0)	0.00	0.01	NS	32.7 (-8.2 to 73.6);p=0.2113; 8h	NE
	XN-9000	4°C	0.0 (0.0 to 0.0)	0.00	0.01	NS	15.5 (-2.0 to 33.0);p=0.3737; 4h	30.3 (17.8 to 42.8);p<0.0001; 8ha
	BC-6800	RT	0.0 (0.0 to 0.0)	0.00	0.00	NS	0.7 (-15.9 to 17.3);p=0.3829; 8h	NE
	BC-6800	4°C	0.0 (0.0 to 0.0)	0.00	0.00	NS	7.1 (-16.1 to 30.4);p=0.9604; 8h	NE

HFC (109/L)	XN-9000	RT	0.0 (0.0 to 0.0)	0.00	0.00	NS	-40.0 (-125.8 to 45.8)	CD% data not available
	XN-9000	4°C	0.0 (0.0 to 0.0)	0.00	0.00	NS	-21.3 (-54.8 to 12.3)
	BC-6800	RT	0.0 (0.0 to 0.0)	0.00	0.00	NS	33.3 (-26.1 to 92.8)
	BC-6800	4°C	0.0 (0.0 to 0.0)	0.00	0.00	NS	4.3 (-59.0 to 67.5)

PLT (109/L)	XN-9000	RT	264 (211 to 309)	0.8	16.4	NS	4.0 (-7.6 to 15.5);p=0.8577; 8h	NE
	XN-9000	4°C	237 (188 to 270)	1.1	-1.7	NS	-0.6 (-5.7 to 4.4);p=0.1548; 8h	NE
	BC-6800	RT	249 (209 to 286)	0.5	-8.0	NS	-3.7 (-7.5 to 0.1);p=0.7113; 8h	NE
	BC-6800	4°C	235 (178 to 276)	-2.0	-9.0	NS	-8.2 (-17.7 to 1.3);p=0.2672; 8h	NE

MPV (fL)	XN-9000	RT	10.7 (10.2 to 11.3)	0.10	0.05	NS	0.3 (-4.0 to 4.6);p=0.6606; 8h	NE
	XN-9000	4°C	11.2 (10.6 to 12.0)	0.11	0.30	NS	1.0 (0.3 to 1.6);p=0.4789; 4h	2.6% (1.4 to 3.8);p<0.0001; 8ha
	BC-6800	RT	9.7 (8.7 to 10.2)	0.30	0.40	NS	2.6 (1.5 to 3.7);p<0.0001b	3.7% (2.7 to 4.7);p<0.0001; 8ha
	BC-6800	4°C	9.9 (9.4 to 10.5)	0.20	0.50	NS	2.7 (2.1 to 3.3);p<0.0001b	4.7% (3.7 to 5.9);p<0.0001; 8ha

PDW (fL)	XN-9000	RT	13.0 (11.3 to 15.1)	0.29	0.10	NS	0.3 (-7.4 to 8.1)	CD% data not available
	XN-9000	4°C	13.2 (12.2 to 15.1)	0.20	0.60	NS	4.6 (2.1 to 7.2)
	BC-6800	RT	15.9 (15.4 to 16.1)	-0.05	0.00	NS	0.0 (-0.6 to 0.5)
	BC-6800	4°C	15.8 (15.7 to 16.1)	0.00	0.00	NS	0.1 (-0.5 to 0.7)
PCT (%)	XN-9000	RT	0.3 (0.3 to 0.3)	0.00	0.01	NS	4.4 (-6.1 to 14.9)
	XN-9000	4°C	0.3 (0.2 to 0.3)	0.00	0.01	NS	2.1 (-3.4 to 7.5)
	BC-6800	RT	0.2 (0.2 to 0.2)	0.00	0.00	NS	-0.1 (-4.0 to 3.8)
	BC-6800	4°C	0.2 (0.2 to 0.3)	0.00	0.00	NS	-4.2 (-13.8 to 5.4)
P-LCR (%)	XN-9000	RT	31.3 (25.9 to 36.5)	1.36	0.72	NS	1.7 (-9.7 to 13.1)
	XN-9000	4°C	34.3 (29.4 to 40.3)	0.74	2.24	NS	6.5 (3.7 to 9.4)
	BC-6800	RT	23.8 (15.5 to 29.7)	-0.20	-0.30	NS	9.2 (6.7 to 11.7)
	BC-6800	4°C	24.5 (21.0 to 29.4)	1.40	3.95	NS	12.8 (8.8 to 16.7)

Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular R. Dr. Diogo de Faria, 775 cj 114, 04037-002 São Paulo/SP/Brasil, Tel. (55 11) 2369-7767/2338-6764 - São Paulo - SP - Brazil
E-mail: secretaria@rbhh.org

Acompanhe os números deste periódico no seu leitor de RSS

[1] *
Corresponding author at: Clinical Chemistry Laboratory, Papa Giovanni XXIII Hospital, Square OMS, 1 -24127 Bergamo, Italy. E-mail address: sbuoro@asst-pg23.it (S. Buoro).