International Journal of Laboratory Hematology最新文献

{"title":"Acute Promyelocytic Leukemia With a Subgroup Exhibiting Basophilic Differentiation","authors":"Zhan Su, Minghui Hu, Xiangcong Yin","doi":"10.1111/ijlh.70136","DOIUrl":"10.1111/ijlh.70136","url":null,"abstract":"","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 5","pages":"924-925"},"PeriodicalIF":2.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical Considerations in the Implementation of Peripheral Smear Review in the Clinical Laboratory","authors":"Olga Pozdnyakova,&nbsp;Lauren H. Yaeger,&nbsp;Cara Lunn Shirai,&nbsp;Stephanie McFadden,&nbsp;Xueyan Chen,&nbsp;Amrom Obstfeld,&nbsp;Emily F. Mason,&nbsp;Madhu M. Ouseph,&nbsp;Jin-Yeong Han,&nbsp;Gina Zini,&nbsp;Ben Hedley,&nbsp;Michelle Grant,&nbsp;Giuseppe D'Onofrio,&nbsp;John L. Frater,&nbsp;Elizabeth L. Courville","doi":"10.1111/ijlh.70131","DOIUrl":"10.1111/ijlh.70131","url":null,"abstract":"<p>Even in the era of modern automated hematology analyzers, visual peripheral blood smear (PBS) review remains an important component of peripheral blood evaluation in a subset of specimens. Despite published PBS review guidelines, including those issued 20 years ago by the International Consensus Group for Hematology Review (ICGHR), knowledge gaps remain regarding selection and implementation of PBS visual review criteria in clinical laboratories. The purpose of this article, developed by an international working group (the Peripheral Smear Review Working Group [PSRWG]), is to help bridge knowledge gaps by providing practical guidance and items for consideration. PBS review may be indicated for automated analyzer system flags, suspect flags, numerical/definitive flags, or as a component of delta checks. Examples, explanations, and suggestions for each of these categories are provided as are examples of flag modification. Validation of PBS review criteria is a multistep process that includes defining criteria for a positive finding, selecting specimens for study, choosing the slide review method, and determining the statistical approach. Pragmatic approaches and important items to consider are provided for each of these validation steps. PBS visual review workflow must be tailored to the needs of the clinical laboratory/institution. These needs may differ depending on the accrediting agency, laboratory/institutional infrastructure, and population served. A discussion of these variables is provided. In this article, we expand on the proposed ICGHR rules with a discussion of practical considerations in the implementation of PBS review.</p>","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 5","pages":"937-950"},"PeriodicalIF":2.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijlh.70131","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How I Investigate Borderline Prolonged aPTT: An Integrated Laboratory Approach to Mixing Studies and Factor Analysis","authors":"Nikolaos Androulakis,&nbsp;Eleni Nioti,&nbsp;Antonios Dilintas,&nbsp;Christina Kalpadakis","doi":"10.1111/ijlh.70156","DOIUrl":"10.1111/ijlh.70156","url":null,"abstract":"<p>Borderline prolongation of routine clotting assays—particularly the activated partial thromboplastin time (aPTT)—is a common interpretative challenge in laboratory hematology. These reproducible but mildly prolonged results often lie just beyond the upper reference limit and can trigger unnecessary follow-up, delays, or misinterpretation. Conventional tools such as 1:1 mixing studies may appear corrective due to dilutional masking of weak inhibitors, residual anticoagulants, or low-grade lupus anticoagulant (LA) activity, especially in assays with limited sensitivity. In our laboratory, borderline prolongations prompt a structured, hypothesis-driven workflow that escalates interpretative resolution in sequential steps. We begin with verification of analytical validity and exclusion of confounders (e.g., DOACs, pre-analytical errors), then apply conventional mixing studies interpreted via quantitative correction indices (e.g., Rosner, percent correction). When results remain indeterminate or discordant, we escalate to enhanced mixing ratios (e.g., 4:1, 1:4), followed by factor assays and dilutional analysis including parallelism assessment. Here, we outline an integrated decision-support framework for investigating borderline aPTT prolongation. The framework aligns traditional and enhanced mixing strategies with factor-level interpretation into a coherent, stepwise pathway featuring explicit stop–go points. It is intended for use in advanced or referral coagulation laboratories and emphasizes interpretative rigor over binary thresholds. By optimizing existing tools within a layered interpretative structure, this approach seeks to reduce false reassurance and enhance clarity in borderline aPTT interpretation.</p>","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 5","pages":"951-960"},"PeriodicalIF":2.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijlh.70156","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI In Leukemia Diagnostics: Complementing the Pathologist's Role","authors":"Sayandeep K. Das,&nbsp;Kusal K. Das","doi":"10.1111/ijlh.70193","DOIUrl":"10.1111/ijlh.70193","url":null,"abstract":"<p>Artificial intelligence (AI) is reshaping every stage of leukemia diagnostics, from digital morphology and multiparameter flow cytometry to next-generation sequencing, multi-omics analysis, and emerging computational frontiers such as quantum-inspired feature selection. This review outlines how contemporary AI tools can automate labor-intensive quantitation, flag diagnostically salient patterns, and standardize interpretation, while the pathologist or hematologist retains authority over validation, context-specific integration, and clinical decision-making. We present an illustrative “human-in-the-loop” workflow that embeds AI modules within current laboratory information systems, emphasizing points where expert oversight mitigates algorithmic bias and resolves discordant findings. We further map the validator–integrator role across morphology, flow cytometry, and genomic/multi-omic interpretation and provide practical training competencies and use cases for AI-assisted hematopathology. Beyond technical deployment, the article addresses the educational transformation required for sustainable adoption. Drawing on international competency frameworks, including the Digital Health Competencies in Medical Education Framework and recently proposed AI-specific Entrustable Professional Activities, we map core skills that future hematopathologists must master: data-science literacy, critical appraisal of AI outputs, and ethical governance. We highlight evaluated training models such as the Pathology Informatics Essentials for Residents curriculum, Stanford Artificial Intelligence in Machine and Imaging workshops, and College of American Pathologists bootcamps and propose integration strategies adaptable across resource settings. By pairing rigorous validation with targeted education, AI can elevate rather than eclipse the diagnostic role of the leukemia specialist, enabling more timely, reproducible, and personalized patient care.</p>","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 5","pages":"972-987"},"PeriodicalIF":2.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijlh.70193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crystal-Like Inclusions in Chronic Lymphocytic Leukaemia Lymphocytes","authors":"Mònica Vidal-Pla,&nbsp;Isabel Puig-Pey,&nbsp;Anna Cortés-Bosch,&nbsp;Lourdes Sánchez-Navarro","doi":"10.1111/ijlh.70134","DOIUrl":"10.1111/ijlh.70134","url":null,"abstract":"","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 5","pages":"926-927"},"PeriodicalIF":2.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the Performance of Siemens Scopio Digital Morphology on Bone Marrow Aspirates in Onco-Hematology","authors":"Gina Zini,&nbsp;John Marra,&nbsp;Elena Rossi,&nbsp;Silvia Bellesi,&nbsp;Nicoletta Pelliccioni,&nbsp;Giuseppe d'Onofrio,&nbsp;Patrizia Chiusolo","doi":"10.1111/ijlh.70138","DOIUrl":"10.1111/ijlh.70138","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Digital morphology (DM) systems assisted by artificial intelligence are increasingly being introduced into hematology laboratories; however, data on their performance in routine clinical practice for bone marrow aspirates (BMA) remain limited. We evaluated the automated pre-classification generated by a full-field DM system in a large series of BMA samples from patients with onco-hematological disorders.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We analyzed 350 BMA samples during routine diagnostic activity; they were evaluated using the Siemens Scopio X100 HT system. Automated results were compared with conventional optical microscopy (OM), which served as the reference method for bone marrow differential counts. Results obtained in pre-classification and post-classification were analyzed separately across major cellular lineages and clinically relevant blast thresholds.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Sixteen markedly hypercellular samples could not be quantitatively evaluated. In the 334 evaluable BMA samples, the granulocytic series showed very strong correlation between DM and OM at pre-classification (&lt;i&gt;r&lt;/i&gt; = 0.85, 95% CI 0.82–0.88), with further improvement after post-classification (&lt;i&gt;r&lt;/i&gt; = 0.93, 95% CI 0.91–0.94). Erythroblast percentage showed strong correlation at pre-classification (&lt;i&gt;r&lt;/i&gt; = 0.78, 95% CI 0.74–0.82) and very strong correlation after post-classification (&lt;i&gt;r&lt;/i&gt; = 0.93, 95% CI 0.92–0.95). Lymphocyte percentage showed moderate correlation at pre-classification (&lt;i&gt;r&lt;/i&gt; = 0.55, 95% CI 0.47–0.62) and strong correlation after post-classification (&lt;i&gt;r&lt;/i&gt; = 0.78, 95% CI 0.73–0.82). Blast percentage showed strong correlation overall at pre-classification (&lt;i&gt;r&lt;/i&gt; = 0.73, 95% CI 0.67–0.77), with very strong correlation in samples with &lt; 5% blasts (&lt;i&gt;r&lt;/i&gt; = 0.91, 95% CI 0.88–0.93), but lower correlation in samples with &gt; 5% blasts (&lt;i&gt;r&lt;/i&gt; = 0.59, 95% CI 0.48–0.68), improving after post-classification (&lt;i&gt;r&lt;/i&gt; = 0.84, 95% CI 0.78–0.88). Low-frequency cell populations and challenging hypercellular smears remained more problematic and required expert morphologic review.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In routine BMA evaluation, the Scopio DM system provided good overall performance for the major marrow lineages, with clear improvement after expert post-classification. Its main value lies in supporting a supervised diagnostic workflow rather than replacing expert microscopic assessment, particularly in challenging samples and in low-fre","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 5","pages":"1000-1007"},"PeriodicalIF":2.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijlh.70138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the BT-50 Automatic Quality Control Unit on the XN9000 Hematology Analyzer","authors":"Congyu Zou,&nbsp;Yan Wei,&nbsp;Yuyin Liu,&nbsp;Xiaoqian Zeng","doi":"10.1111/ijlh.70184","DOIUrl":"10.1111/ijlh.70184","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to explore the application of BT50-based automatic quality control in the XN9000 hematology analyzer line, comparing its benefits and limitations with manual QC procedures, and to identify potential improvements, thereby providing a reference for the development of automated QC in clinical laboratories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Both manual and automatic QC procedures were performed for blood cell analysis. Manual QC data (January 1, 2024, to July 31, 2024) and automatic QC data (August 1, 2024, to February 28, 2025) were collected from the Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. SPSS 18.0 software was used for the statistical analysis. The parameters analyzed included the coefficient of variation (CV), daily QC completion time, first sample review time, and staff workload.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>(1) Compared to manual QC, no statistically significant differences were observed in the CV values of any parameters between the two methods (Mann–Whitney <i>U</i> test, <i>p</i> &gt; 0.05 for all). (2) The median completion time for automatic QC was 42 min earlier than that for manual QC, with automatic QC finishing at 07:48:47 (IQR: 07:47:55, 07:48:46) and manual QC finishing at 08:30:34 (IQR: 08:24:17, 08:37:32). (3) With a daily work start time of 08:00, the median first sample review time was advanced by 20 min under automatic QC, with manual QC reviewed at 08:48:00 (IQR: 08:36:00, 08:50:30) and automatic QC reviewed at 08:28:00 (IQR: 08:21:30, 09:07:30). (4) The automatic QC system significantly reduced the number of manual steps, including those for storage, rewarming, mixing, and post-analysis storage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Implementing the automatic QC system facilitates earlier report review, reduces workload, enhances operational efficiency, and maintains CV values within acceptable laboratory standards.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 5","pages":"1062-1068"},"PeriodicalIF":2.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148355289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altitude-Related Laboratory Changes and a Novel Hemoglobin Estimation Model: A Retrospective Analysis in Children and Adults","authors":"Aykut Yucal,&nbsp;Melike Yucal","doi":"10.1111/ijlh.70183","DOIUrl":"10.1111/ijlh.70183","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Hypobaric hypoxia at higher residential altitudes may modify routine laboratory parameters and complicate their interpretation in emergency care. We examined associations between altitude (0–2500 m) and laboratory findings and developed a hemoglobin estimation model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center, retrospective cross-sectional study included 2302 patients aged ≥ 1 year admitted to the Emergency Department of Kars Harakani State Hospital on January 1–3 and July 1–3, 2024. Patients were categorized as children (1–17 years) or adults (≥ 18 years). Hematological and biochemical results were retrieved from electronic records. Altitude–laboratory associations were analyzed using correlation and linear regression. A multivariable regression model was constructed to identify determinants of hemoglobin variation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 2302 admissions, 30.8% were pediatric. Hemoglobin, hematocrit, erythrocyte indices, pO₂, and SaO₂ demonstrated the most consistent altitude-related patterns. In adults, altitude showed positive associations with glucose, urea, creatinine, COHb, MetHb, calcium, ALT, AST, bilirubin, and selected erythrocyte and platelet indices, and negative associations with SaO₂, pO₂, PLT, PCT, GFR, and HCO₃ (all <i>p</i> &lt; 0.05). Most parameters were not significantly associated with altitude in children. SaO₂ and pO₂ were lower in summer than winter (<i>p</i> &lt; 0.05). The final model explained 83% of hemoglobin variability, incorporating altitude, age, sex, smoking, pregnancy, malignancy, and chronic disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Residential altitude was associated with measurable variation in hematological, biochemical, and oxygenation parameters among emergency department patients. Altitude should be considered when interpreting laboratory results in clinical practice. The proposed hemoglobin model integrates altitude and clinical variables to characterize hemoglobin variability within this cohort.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 5","pages":"1047-1061"},"PeriodicalIF":2.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Marked Bone Marrow Eosinophilia Post-Azacitidine + Ivosidenib Treatment for Acute Myeloid Leukemia","authors":"Christopher Liwski,&nbsp;Curtis Marcoux,&nbsp;David M. Conrad","doi":"10.1111/ijlh.70111","DOIUrl":"10.1111/ijlh.70111","url":null,"abstract":"&lt;p&gt;Various histomorphologic changes can arise in the bone marrow after induction therapy for acute myeloid leukemia (AML). Common changes include regenerative hematopoiesis, suppressed hematopoiesis, dysplasia, fibrosis, and necrosis [&lt;span&gt;1&lt;/span&gt;]. Certain cell populations may also be increased as part of a regenerative and/or reactive response to therapy, such as macrophages and lymphoid cells [&lt;span&gt;1&lt;/span&gt;], the latter of which tend to be less sensitive to chemotherapy. Eosinophilia is not a typical bone marrow finding associated with induction therapy. In general, bone marrow eosinophilia warrants a broad differential diagnosis, including drug reactions, allergic reactions, infections, and neoplastic processes. We describe an unusual case of marked bone marrow eosinophilia in a 70-year-old female after treatment for AML.&lt;/p&gt;&lt;p&gt;At the time of diagnosis, the patient presented with spontaneous bruising and pancytopenia and had 38% circulating blasts. An initial bone marrow biopsy showed 47% myeloblasts, dyserythropoiesis, dysmegakaryopoiesis, and a normal XX karyotype. Next-generation sequencing identified pathogenic variants in &lt;i&gt;IDH1&lt;/i&gt;, &lt;i&gt;DNMT3A&lt;/i&gt;, and &lt;i&gt;STAG2&lt;/i&gt;, consistent with AML, myelodysplasia-related (AML-MR). The patient underwent induction therapy with azacitidine and the IDH1 inhibitor ivosidenib. She tolerated the treatment well, reporting only mild headaches after the first cycle of therapy. A day +35 bone marrow exam showed neutrophil dysplasia, but no evidence of residual AML. Interestingly, the bone marrow was notably hypercellular (Figure 1A). The aspirate predominantly contained eosinophils and eosinophil precursors with cytoplasmic vacuolization, large specific granules, and occasional “Harlequin” eosinophils that also contained basophilic primary granules (Figure 1B–D). There was no peripheral blood eosinophilia. A follow-up bone marrow examination performed after the third cycle of therapy (day +105) showed ~7% eosinophils, decreased granulopoiesis, dysplastic megakaryocytes, and 1% blasts, consistent with morphologic remission (Figure 2).&lt;/p&gt;&lt;p&gt;This case is unique in the presentation of marked eosinophilia after a single cycle of azacitidine + ivosidenib. In this context, eosinophilia was considered indicative of a reactive or regenerative process in response to therapy. This interpretation was further supported by the transient nature of the eosinophilia. The patient had no recent travel history and there were no skin changes, respiratory distress, gastrointestinal symptoms, or constitutional symptoms that can be seen with various infections, neoplasms, allergic reactions, drug hypersensitivities and other conditions that may produce eosinophilia. The absence of peripheral blood eosinophilia would also make a chronic eosinophilic leukemia unlikely. Although some myeloid neoplasms may present with increased marrow eosinophils without peripheral blood eosinophilia, including AML with &lt;i&gt;CBFB::MYH11&lt;/i&gt; fusion an","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 5","pages":"921-923"},"PeriodicalIF":2.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijlh.70111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Vortexing as a Practical Solution for Resolving Platelet Clumping in hematology laboratories","authors":"Neha Seth,&nbsp;Zarrin Hossein-Zadeh,&nbsp;Syed Hassaan Ahmed Qasid,&nbsp;Angela Gi,&nbsp;Xinmin Zhang,&nbsp;Hong Hong,&nbsp;Peihong Hsu","doi":"10.1111/ijlh.70086","DOIUrl":"10.1111/ijlh.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Platelet clumping is a pre-analytical artifact that leads to spurious thrombocytopenia, complicating laboratory interpretation and triggering unnecessary clinical interventions. Vortexing has been proposed as a corrective measure, yet the optimal duration, its applicability to transported samples, and its impact on WBC and RBC parameters remain poorly defined. This study aims to evaluate the efficacy and safety of vortexing across different durations to establish it as a standardized intervention in hematology laboratories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 730 EDTA-anticoagulated blood samples were analyzed. Samples were vortexed at 3200 rpm for 30 s, 1, or 2 min, using a fixed-speed vortex mixer. Platelet counts and interpretative messages were compared before and after vortexing using the Sysmex XN-10 platform. Stability of WBC and RBC parameters was also assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Vortexing significantly reduced platelet clumping flags, with 66% overall resolution and the highest effect in the 101–150 × 10⁹/L group (74%). Platelet counts improved across all durations, with 2 min yielding the highest median increase (+39.0 × 10⁹/L, <i>p</i> = 2.70 × 10⁻¹²). The Kruskal-Wallis test confirmed statistically significant differences among vortexing durations (<i>p</i> = 1.24 × 10⁻⁵). WBC and RBC parameters remained stable post-vortexing, supporting the method's safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Vortexing is a reliable, reproducible, and practical method for resolving platelet clumping in EDTA samples without compromising sample integrity. Its implementation can reduce redraws, minimize manual smear reviews, and streamline sample processing in high-volume hematology laboratories.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14120,"journal":{"name":"International Journal of Laboratory Hematology","volume":"48 4","pages":"765-772"},"PeriodicalIF":2.2,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}