Is the Blood Basophil Count Sufficiently Precise, Accurate, and Specific? Three Automated Hematology Instruments and Flow Cytometry Compared

We compared the performance of the basophil count of 3 hematology instruments with a flow cytometric method (FCM in which CD123 and CD 193 were used as basophil markers. By analyzing 112 patient samples, we found the AD VIA 120 (Siemens Healthcare Diagnostics, Deerfield, IL) and CELL-DYN Sapphire (Abbott Diagnostics, Santa Clara, CA) to underestimate the number of basophils by approximately 50% and the Sysmex XE-2100 (Sysmex, Kobe, Japan) and AD VIA to overestimate the basophil count in some samples with pathologic leukocytes. All 3 instruments had large (25%-50%) analytic within-run coefficients of variation. Compared with the FCM, we found a relatively good correlation for the CELL-DYN basophil count (r = 0.81), an intermediate correlation for the Sysmex (r = 0.64), and a poor correlation for the AD VIA (r = 0.24). When excluding the 52 samples flagged for the presence of pathologic leukocytes, these correlations were found to be 0.84, 0.90, and 0.57, respectively. The basophil count of the 3 instruments is, at least presently, of unsatisfactory quality.