# Evaluating the research parameters available on the Sysmex® XN-series hematology analyzers as markers of dysplasia in peripheral blood

## TL;DR

This study shows that a parameter called Neu-GI from a blood analyzer can help detect blood cell abnormalities linked to a type of blood cancer called MDS.

## Contribution

The study identifies Neu-GI as a highly predictive marker for dysplasia, improving early detection and guiding blood smear reviews.

## Key findings

- Neu-GI had the highest predictive value (AUC=0.98) for detecting dysplasia.
- A Neu-GI value ≤146ch predicts dysplasia with 90% positive predictive value.
- Neu-GI values >152ch indicate a low probability of dysplasia.

## Abstract

Myelodysplastic syndromes (MDS) are clonal hematopoietic disorders characterized by peripheral blood cytopenias, cellular dysplasia and risk for progression into acute leukemia. Recent studies reveal that some research parameters available on Sysmex XN-1000® hematology analyzers, including immature platelet fraction (IPF), Neutrophil Granularity Index (Neu-GI), or platelet distribution width (PDW), show a relationship with dysplasia in peripheral blood. The objective of this study was to examine the association between classic and research blood count parameters and the presence of dysplasia. The secondary objective was to develop a multivariate model that allows the prediction of dysplasia with high probability.

Seventy-five patients older than 60 years with anemia, leukopenia or thrombocytopenia, without vitamin B12 and folate deficiency or hematological diseases underwent testing with the Sysmex XN-1000 analyzer.

Dysplasia was confirmed in 32 % of patients, with significant differences in Neu-GI, PDW and IPF count between the groups of patients with and without dysplasia. Neu-GI was the parameter with the highest predictive value (AUC=0.98), with such value not increasing significantly after the addition of PDW or PIF. A Neu-GI value≤146ch predicts dysplasia with a positive predictive value=90 %.

Neu-GI is the parameter most strongly associated with dysplasia. A Neu-GI value≤146ch indicates a high probability of dysplasia and supports indication for a blood smear review. Additionally, values>152ch indicate a low probability of dysplasia.