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Introduction: Point of care (POC) analyzers are an integral part of the patient care. Transfuse can be an emergency decision, not being a benign act, it is necessary to ensure that the hemoglobin value measured by the POC are comparable with the reference analyzer. The objective is to compare the analytical performance of three POCs: ABL800 Flex, Hemocue and iSTAT and a central laboratory analyzer: XN-10 and the impact on the transfusion decision., Methods: An in vitro study was performed in 50 patients for whom a hemogram had been prescribed on the XN-10, the hemoglobin determination was performed in parallel on the three POCs. Then, retrospective study was performed to compare the hemoglobin values returned for matched samples in routine practice, 5505 for ABL800 Flex, 55 for Hemocue and 70 for iSTAT were analyzed., Results: In vitro study shows systematic biases in the measurement of hemoglobin between the different analyzers, overestimation for the ABL800 Flex and the Hemocue, underestimation for the iSTAT. These biases are accentuated in current practice for iSTAT but decreased for ABL800 Flex. In the transfusion decision range from 70 to 100 g/L, there were 8.6% of clinically discordant results between the reference method and ABL, 34.8% for Hemocue and 21.4% for iSTAT., Conclusion: In addition to systematic biases, many additional factors may be involved for variation in hemoglobin measurement with POC. Thus, in the case of urgent transfusion decisions, sending a hemogram on a central laboratory analyzer seems to be essential, while being compatible with a life-threatening emergency., (© 2023 The Authors. International Journal of Laboratory Hematology published by John Wiley & Sons Ltd.)

Aim: The aim was to assess the flagging performance of Sysmex XN-10 haematology analyser for malaria detection through the parasitic red blood cell ('pRBC') alarm., Methods: We retrospectively studied 584 blood samples performed on the Sysmex XN-10 analyser that were tested for malaria. Sensitivity, specificity, positive and negative predictive values, and prevalence were established for the pRBC alarm., Results: Sensitivity, specificity, and positive and negative predictive values for the pRBC flag were 7.8%, 100%, 100% and 87.7%, respectively. The prevalence of pRBC flag of 0.026% in the overall population was significantly different from the prevalence of 1.027% in the population tested for malaria., Conclusions: Considering the excellent specificity and the low prevalence of the flag in the overall population, we suggest, in case of the presence of pRBC flag, the implementation of a rapid review of the blood smear looking for Plasmodium , mostly if the patient had fever and had not been tested for malaria., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Cytological identification of blasts in cerebrospinal fluid in acute leukemia, lymphoid or myeloid, in adult and child, at diagnosis or during follow up lead to the diagnosis of leukemic meningitidis. Suitable CNS therapy based on a defined "CNS status" following an international standardized classification, lead to decrease cerebrospinal relapses. Established in 1993, this classification allows to treat patients based on their CNS status. Based on the red blood cells count, nucleated cells count and presence of blasts, it requires a standard technical procedure that guarantees the comparability of results coming from different medical laboratory. To improve the quality of cerebrospinal fluid analysis, in acute leukemias, preanalytical guidelines (turn around time), analytical guidelines (cytocentrifugation, adding serum protein, speed and duration of cytocentrifugation) and postanalytical guidelines (duration of conservation) are set by the Groupe francophone d'hématologie cellulaire.