Comparative analysis of platelet counts using Beckman Coulter DxH-900, Mindray BC-6800 Plus, CellaVision DM9600 and the flow cytometry reference method: addressing the challenge of giant platelets

• Alba Leis Sestayo ^[1] ; Alicia Martínez Iribarren ^[2] ; Rebeca Jurado Tapiador ^[3] ; Laura Jiménez Añón ^[2] ; Jennifer Rodríguez Domínguez ^[2] ; Ghali Ech Cherif El Kettani ^[2] ; Xavier Tejedor Ganduxé ^[2] ; Cristian Morales Indiano ^[2]
  1. [1] Clinical Analysis and Biochemistry Department, Germans Trias i Pujol University Hospital, Carretera de Canyet, s/n, 08916 Badalona, Badalona, Spain,
  2. [2] Clinical Analysis and Biochemistry Department, Germans Trias i Pujol University Hospital, Badalona, Spain
  3. [3] Hematology Laboratory, ICO-IJC-Hospital Germans Trias I Pujol, UAB, Badalona, Spain

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• Localización: Advances in Laboratory Medicine / Avances en Medicina de Laboratorio, ISSN-e 2628-491X, Vol. 7, Nº. 1, 2026, págs. 59-63
• Idioma: inglés
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  • Objectives: To evaluate the analytical performance of platelet counts obtained by impedance- and optical-based methods on the DxH-900 and BC-6800 Plus analyzers, and by digital morphology using the CellaVision DM9600, in comparison with the international reference method (IRM), in samples with thrombocytopenia and both normal-sized and giant platelets.

    Methods: Platelet counts were analyzed in peripheral blood samples from patients with thrombocytopenia and normal platelet counts, including cases with normal-sized and giant platelets. Each sample was tested using two automated analyzers: the DxH-900 (impedance) and the BC-6800 Plus (impedance and optical). Results were compared with the IRM based on flow cytometry, performed on the DxFlex analyzer. Precision was assessed. The methods were compared by Passing-Bablok regression and bias calculation. Additionally, platelet morphology was reviewed digitally using CellaVision DM9600.

    Results: All methods demonstrated high precision and strong correlation with IRM in samples with normal-sized platelets. However, significant discrepancies were observed in the presence of giant platelets. Impedance methods showed higher imprecision (CV>10 %) and underestimated platelet counts with a negative bias exceeding −25 %.

    Conversely, the optical method showed better correlation (r=0.9888) and precision (CV=1.6 %), although it overestimated counts with a positive bias of 19.4 %. Digital morphology also demonstrated strong agreement with IRM.

    Conclusions: These findings highlight the analytical limitations of routine technologies in challenging samples and emphasize the importance of method selection for accurate platelet reporting. A correction factor for optical counts and the integration of digital morphology could enhance diagnostic reliability in cases involving giant platelets.