Aim: A retrospective study assessing whether there is a predictive relationship between the Sysmex XE5000 NEUT-X research parameter and myeloid lineage dysplasia.
Methods: The study period was 14/02/12 to 31/03/12. The target group consisted of initial patient FBC with a NEUT-X ≤ 1299 and one or more of the following; MCV > 96 fL, Absolute Neutrophils <1.5x109/L, Haemoglobin <100 g/L or Platelet count <100x109/L. The control group consisted of two match controls for each target patient. A manual neutrophil differential was performed (under oil, x1000) to determine the percentage of hypogranular neutrophils present. Correlation between the NEUT-X value and microscopically defined hypogranularity of the neutrophils was assessed by simple linear regression. Sensitivity and specificity values were assessed by the use of receiver operating characteristic (ROC) curve analysis.
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Results: 43 patients had a low NEUT-X value. The area under the ROC curve was 0.863 (95% confidence interval: 0.802 to 0.911) demonstrating that NEUT-X has diagnostic utility irrespective of presence of hypogranular neutrophils.
Conclusions: Inclusion of the NEUT-X parameter into film review criteria combined with an alert to perform, if required, a manual neutrophil differential (under oil) to determine the presence of hypogranular neutrophils should aid in the earlier detection of MDS.