Manual methods of characterizing blood cells and blood components can be unreliable and labor-intensive. Re-processing samples and performing additional procedures such as nucleated red blood cell and optical counting are often necessary to collect the data required for disease detection and monitoring. In addition, qualified laboratory technicians are increasing in age and less experienced technologists replacing them are yet to have sufficient training in multiple specializations and complex manual analyses, in order to address the labor requirements in multi-discipline laboratories. In contrast, fully automated hematology analyzers can accommodate a wide range of analyses, significantly minimizing manual intervention and human error.
Another advantage of utilizing hematology analyzers over traditional cell counting lies in their large-scale capacity. Hematology analyzers are capable of processing hundreds of samples simultaneously, making them ideal for high throughput industrial, medical, and research applications. Sophisticated models with improved sensitivity can also detect not just blood cell and platelet count, but also the reticulocyte function and cell size.
Operated by advanced algorithms, modern hematology analyzers also implement data fusion capabilities to integrate information from multiple separate modules and identify patterns which cannot be determined by a singular module. This function leads to convenient detection and correction of interfering elements and lesser need for manual reviews.
These powerful instruments provide laboratory technicians with access to greater and more specific cell information for highly accurate CBC with differential and lower review rates. Hematology analyzers are crucial for streamlining lab processes and improving diagnostic testing. To help you choose from a wide variety of models available, Laboratory App has put together this simple guide for you to identify the most suitable hematology analyzer for your laboratory.
Measurable Properties of Blood
Hematology analyzers determine cell types contained in a blood sample before individually quantifying these cellular elements in order to generate a complete blood count (CBC) with differential. Blood components generally included in a CBC are the following:
White blood cell count (WBC). This is also referred to as the leukocyte count or the number of white blood cells in a blood sample. Normal WBC ranges from 4,300 and 10,800 cells per cubic millimeter (cmm) and is typically used as an indicator of bacterial infection.
White blood cell (WBC) differential count. Cells measured in a WBC differential include neutrophils, lymphocytes, monocytes, eosinophils, and basophils, which are distinguished by their size and shape.
Red blood cell (RBC) count. This indicates the number of red blood cells in a blood sample. In general, the normal RBC count ranges from 4.2 to 5.9 million cells/cmm. Also referred to as the erythrocyte count, this count can be converted to international units as 4.2 to 5.9 x 1012 cells per liter.
Hematocrit (HCT, packed cell volume, PCV). This measures the amount of volume comprising of red blood cells in a sample. Manual counting is typically performed by centrifuging blood samples.
Hemoglobin (Hgb). The amount of hemoglobin in the blood is also tested to assess the blood’s ability to carry oxygen to different parts of the body.
Red blood cell indices. A CBC indicates the mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) which are calculated from the hematocrit and red blood cell count.
Platelet (thrombocyte) count. Platelets or thrombocytes are important in blood clotting. The normal platelet count ranges between 150,000 to 400,000 per cmm.
Mean platelet volume (MPV). This defines the average amount of platelets in a blood sample.
Other Blood Tests Performed Using a Hematology Analyzer
Aside from a complete blood count (CBC) and a three or five part WBC differential, some hematology analyzers are also capable of executing reticulocyte analysis and coagulation tests which are discussed below.
Reticulocyte Analysis. This method is one of the key identifiers to confirm that a person is suffering from anemia. However, reticulocyte analysis is seldom requested by hematology practitioners even when a patient is suspected to have the mentioned disease. This approach is largely attributed to the lack of precision in traditional microscopic counting. However, With the flow cytometric method featured in hematology analyzers, automated reticulocyte enumeration has significantly improved the quality of performance in reticulocyte analysis, which is crucial in identifying medical conditions such as anemia and bone marrow failure.
Coagulation Testing. Coagulation tests are typically carried out to detect blood clotting and assess bleeding issues in patients. There are several types of coagulation tests which may be requested in a clinical setting. The most common of which are the tests below which measures the manner and time it takes for blood to clot:
Prothrombin time (PT)
Partial thromboplastin time (aPTT)
Thrombin time (TT)
Choosing a Hematology Analyzer
An ideal hematology analyzer should be able to improve the efficiency of your hospital, clinical laboratory, or research facility. In order for this to happen, you must find an instrument capable of achieving both your application’s goals and meeting your budgetary constraints. Before deciding to purchase a hematology analyzer, you may want to consider the factors below.
1. Trim Down Choices By Identifying the Features Best Suited to Your Application
Open vs. Closed Vial Testing Modes
Open vial testing modes are known for their precision and ability to perform a complete blood count in around a minute. This testing process has been used for a long time and has proven to deliver precise results. In order to decide whether open vial testing mode is better for your analysis, consider the complexity of your samples. In analytical evaluation, open mode testing is more likely to deliver higher precision in results so this sampling mode would be better suited for determining multiple analytes in a single sample. Likewise, open vial sampling complete analyses quicker making them ideal for numerous batches of samples. This specific sampling mode is suitable for high throughput and specialized laboratories.
On the other hand, closed vial processing may be easier to perform. Additionally, this sampling mode is suitable for higher sample volumes per run since spillage and leakage is prevented. Hematology analyzers with closed vial processing capabilities are able to pierce vials automatically, making them a safer choice for operators since they do not come in direct content with the samples. Operators are also protected from harmful aerosols that contaminate the air when the stopper is removed for open vial sampling. For potentially dangerous samples, closed vial testing would be the best method to use.
3-Part vs 5-Part Counting
The most relevant white blood cell types to count are the neutrophils and lymphocytes, which are quantified by a 3-part differential hematology analyzer (along with monocytes). Many clinics and smaller hospitals often use 3-part systems. 3-part hematology analysers are the choice of many since it meets many basic requirements and also comes at a much lower in price. However, specialty clinics and larger hospitals typically use 5-part analyzers which are more precise and can perform complete blood counts. These types of hematology analyzers classify WBC intolymphocyte, monocyte, neutrophil cell, neosinocyte, and basicyte. Many 5-part hematology analyzers are also capable of higher sample quantities and automated sampling processes which accounts for its higher price range.
Automatic Flagging Capabilities
Hematology analyzers are capable of identifying the presence of abnormal cells, which eliminates the need to manually determine and review cells not within the supposed measurements. However, the reliability of a unit’s flagging system may differ depending on the model so it is advisable to check the system’s capability for flagging beforehand and assess the hematology analyzer in terms of sensitivity, specificity, and efficiency. In order to control the quality of your results, programmable models allow you to set range and measurements to flags cells not within your specified limits.
3D VCS Technology
Some automated hematology analyzers are equipped with 3D VCS technology to ensure accurate RBC analysis. This innovation is considered to deliver the highest sensitivity, specificity and efficiency in terms of blood cell analysis. 3D VCS Technology is capable of accurately characterizing the size and internal structure (including chemical composition) of a cell. Moreover, additional data like cellular granularity, nuclear lobularity, and cell surface structure are provided by 3D VCS technology.
2. Decide on a Budget Allocation for your Hematology Analyzer
Keep in mind that hematology analyzers are long-term investments and are designed to be fully functional for numerous years. Consider the practicality of automating blood components counting compared to shouldering the time and labor expense of manually executing the same procedures performed by a hematology analyzer. Since a wide selection of hematology analyzers are currently available on the market, you have to carefully determine your application goals, and the features and add ons required to accomplish them. Compare distributor prices while also taking into account the functionality, capacity, and durability of your potential purchase. Look out for special promotions offered by trusted suppliers to get hematology analyzers at reduced prices too.
To acquire high-capacity hematology analyzers at more affordable prices, you can explore other possibilities such as purchasing a used yet well-functioning unit from trusted companies who ensures that your hematology analyzer is carefully refurbished, well-calibrated, and rigorously tested under strict measures before turning over to you. Hematology analyzers are built to function for numerous years so purchasing used equipment is less risky that you think.
Refurbished equipment is restored to its original operating condition by replacing poor-performing parts with new ones and servicing and repairing the equipment to run like a new unit.
Alternatively, you may avail of rental services if your laboratory workload seldom includes blood counting and monitoring or if you only need to perform blood analysis for a short period of time. Renting is much more affordable than purchasing your own unit. Moreover, this shifts the responsibility of maintenance from the user to the owner guaranteeing that you only work with well-functioning equipment. If in case you receive faulty equipment, you can easily have it replaced or returned.
On the other hand, if you decide to upgrade your hematology analyzer, consider putting up your current unit for sale before purchasing a newer or more advanced model. Other equipment distributors may pay for the value of your instrument. This can in turn be used as credit for new equipment or you may receive it as cash. This way, you can still make money from old equipment instead of simply disposing it.
3. Review Your Application Demands
Identify the hematology analyzer features which would give you the most value. What areas of blood processing are you expecting to turnover to your hematology analyzer? If you’re looking for a basic unit capable of delivering accurate and reliable results, consider units which can process 60 samples per hour and generate in 45 seconds.
If you prefer models capable of delivering intuitive and hands-free operations, consider going for more advanced, fully-automated equipment ideal for in vitro diagnostic use.
The most important WBC cells to count are neutrophils, lymphocytes and monocytes. A 3-part differential analyzer can able to cover the examination of these cells. However, if your application requires complete WBC analysis, you will be needing a 5-part differential hematology analyzer in order to characterize eosinophils and basophils, as well.
Latest hematology analyzer models also come complete with algorithms designed to flag abnormal or atypical lymphocytes for further investigation. Abnormal cells are more challenging to detect microscopically so if you would like to automate this laboratory task, you may want to choose a hematology analyzer like the Sysmex SF-3000 or the Sysmex K-4500 which are equipped with an abnormal value flagging system.
Here are some additional questions you can ask yourself while shopping around for a new unit:
Which authorizing agency approved of this product? What authorization type was it prescribed? What year was the product given regulatory authorization?
What will be the primary use of my hematology analyzer? Is this unit compatible with what I need it to do?
What types of specimens or samples will I be using with the product? Can this unit process these?
What types of diseases, analytes, or conditions do I normally test for? Can this unit help detect them?
How fast does this unit bring back the first result? How are the test results made available?
What is this product’s maximum capacity and throughput?
What automation and connectivity features are available?
How long is the typical training time for this unit?
What types of technical support is available?
What features, capabilities, or accessories make this unit different from the other equipment on the market?
4. Technologies Employed in Hematology Analyzers
Cell counting, CBC analysis, and differential WBC measurements are core operations of a hematology analyzer. These equipment use different methods to determine cellular information and count. It is crucial that you understand the methods used by your hematology analyzer to gather data in order know its functional capacities. For instance, an electrical impedance-based method returns results on RBC, WBC, and platelet count as they pass through an aperture. This method delivers CBCs and three-part WBC differentials but does not have the ability to differentiate similar-sized yet different types of granular leukocytes. Additionally, electrical impedance does not hold the same level of increased sensitivity and specificity laser and fluorescent cytometry possess when it comes to separating WBC populations. Flow cytometry, however, is not perfect either. Hematology analyzers based on this method are more likely to encounter fluctuations and instability in data. Moreover, equipment that uses this method are more difficult to troubleshoot and will likely require a trained professional.
Traditionally, characterizing the quantity and size of cells is performed through electrical impedance. However, more sophisticated and reliable flow techniques have emerged. Below we go into more detail about the main main technologies used in hematology analyzers - electrical impedance which is based on the Coulter Principle and flow cytometry, which uses flow cells and lasers to determine cell count, size, and structure.
Electrical impedance (Coulter Principle)
Many standard hematology analyzers rely on electrical impedance to determine the number of RBCs, WBCs, and platelets in a blood sample. Based on the Coulter principle, electrical impedance occurs when cells pass through a narrow aperture break and electric circuit to confirm the presence and size of a cell. Changes in impedance is associated with cell volume, resulting in a derivative of cell count and measure. Hematology analyzers utilizing this technology produces CBCs and three-part WBC differentials. However, it cannot be used to identify granular leukocytes: eosinophils, basophils, and neutrophils of similar sizes.
Flow cytometry is an effective method used in determining cells in a volume of sample. This platform enables the performance of numerous highly-specialized assays. Proper execution of this method allows for rapid measurement of singular or a large number of cells including leukocyte and lymphocyte populations and subpopulations. This procedure utilizes laser in order for suspended cells to pass through a flow cell at a rate of 20,000 cells per second.
Modern hematology analyzers integrate fluorescent reagents with laser flow cytometry in order to extend flow cytometry usage in recognizing specific cell populations. Detectors process the fluorescence and light-scattering characteristics of each cell to characterize density and other cell properties.
5. Consider Workspace and Equipment Capacity
Before purchasing a hematology analyzer, it is necessary to consider your laboratory’s available work space, as well as the features and capacity you require your unit to have. Bulkier hematology analyzers are generally more heavy-duty, capable of completing multiple parameters and processing hundreds of samples for every operation. In contrast, many hematology analyzers are designed to be space-saving in order to fit in smaller laboratory spaces.
6. Take Service Life and Maintenance Into Account
High quality hematology analyzers can be quite expensive but are guaranteed to function properly for many years. If you’re planning on purchasing a brand new unit, choose models that are covered by a multi-year warranty. Used hematology analyzers may also be acquired from reputable manufacturers who provide customers with warranties from a few months to multiple years, depending on the equipment type. As much as possible, only seek out ISO:Certified equipment providers to ensure that you will only be receiving high quality and reliable instruments and/or parts.
Another factor to consider in terms of durability is the maintenance effort required to retain your unit’s good condition. Hematology analyzers with reliable and highly-automated systems tend to require zero to little maintenance. Likewise, hematology analyzers with automated or no calibration required also ensure that the unit is always accurate and ready for use.
If in case your Hematology Analyzer malfunctions, seek the advice of qualified professionals first. There are instances when your unit would only require simple repairs. In such cases, follow the instructions of manufacturer-compliant engineers or refer to the manual that comes with your equipment if the error you encountered is covered in its maintenance or repairs sections. However, extensive repairs should be left at the hands of factory trained engineers who are equipped with a specialized technical background and are used to repairing sophisticated lab equipment on a daily basis. Additionally, your equipment services provider must have access to the appropriate hematology analyzer replacement parts compatible with your equipment. In many cases, malfunctioning components must be replaced with new ones to enable your equipment to function like new.
Evaluating your Hematology Analyzer’s performance
There are several measures which can serve as bases for optimal operational performance. To assess the efficiency and reliability of your hematology analyzer, you should take the following factors into consideration:
Precision. A hematology analyzer must deliver results according to the precision limits declared by the manufacturer across all of its operating modes. Laboratories must monitor both short-term (between operations) and long-term reproducibility (daily) of the hematology analyzer by checking the precision across repeated measures.
Carryover. Studying the carryover is performed to determine concentration of the analyte carried by the hematology analyzer to into a subsequent cytopenic specimen. This is commonly tested by the manufacturer through running an identified high-concentration sample followed by a low-concentration sample. After which, the percent of the carryover will be calculated.
Sample Stability. The technology behind hematology analyzers may influence the stability of the sample. This is due to the fact that different types of hematology analyzers are used for varying blood testing methods. To guarantee stable sample results, it is necessary to ensure that your device is suitable for assessing blood parameters you are using it for.
Comparison of Results. If similar types of hematology analyzers are accessible, you can perform identical operations complete with the same test parameters and device settings to evaluate the accuracy of your new hematology analyzer. Logically, having good concordance among well-calibrated hematology analyzers suggest that your blood analysis is accurate.
Choose a Reliable Manufacturer
Whether you’re getting your hematology analyzer directly from the manufacturer or from a trusted distributor, always choose reliable brands known for deliver quality equipment. You can easily find information about the manufacturers online. To get you started, you can read reviews, look up their company history, and check out suppliers and distributors that carry their products. Listed below are some of the most trusted manufacturers of hematology analyzers.
- Sysmex - This is a Japanese brand whose line of business ranges from the development, manufacture, and global distribution of diagnostic instruments, reagents, and related software.
- Diagnostica Stago - Established in 1945, Diagnostica Stago is a leader in the In Vitro Diagnosis(IVD) industry and is dedicated to bringing specialized products used for Thrombosis and Hemostasis such as the STart 4 Hemostasis Analyzer.
- Horiba - With a long-standing experience and multiple specializations in manufacturing, Horiba, together with their wide network of 7,399 employees, delivers numerous products from automotive emission systems to environmental and medical analyzers such as the ABX Micros 60 Hematology Analyzer.
- Beckman Coulter - Spanning 80 years of experience in the clinical industry, Beckman Coulter is a world leader dedicated to delivering products used for assessing, diagnosing, and monitoring health conditions. One their most popular hematology analyzers include the Beckman Coulter AcT diff 2.
- CDS - Clinical Diagnostic Solutions (CDS) is a subsidiary of Boule Diagnostics AB, a world-class provider of hematology instruments and supplies. CDS manufactures diagnostic equipment and supplies for industry leaders in the diagnostic field. However, CDS remains to be the exclusive distributor of the CDS Medonic Series.
If you still haven’t pinpointed the specific hematology analyzer you like, as well as the manufacturer you trust to supply your device, you can try shopping through distributor sites which offers a wide selection of hematology analyzers from different manufacturer brands.