Toward new insights on the white blood cell differential by flow cytometry: A proof of concept study on the sepsis model

Authors

  • Mikael Roussel,

    Corresponding author
    1. CHU Rennes, Laboratoire d'Hématologie, Pôle de Biologie, F-35033 Rennes, France
    • Laboratoire d'Hématologie, Pôle de Biologie, CHU de Rennes, 2 rue Henri Le Guilloux, 35 033 Rennes Cedex 9, France
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    • M.R. and A.G. contributed equally to this work

  • Antoine Gros,

    1. CHU Rennes, Maladies Infectieuses et Réanimation Médicale, Pôle de Médecines Spécialisées, F-35033 Rennes, France
    2. INSERM, CIC 02-03, EHESP, F-35043 Rennes, France
    3. Université Rennes 1, F-35043, Rennes, France
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    • M.R. and A.G. contributed equally to this work

  • Arnaud Gacouin,

    1. CHU Rennes, Maladies Infectieuses et Réanimation Médicale, Pôle de Médecines Spécialisées, F-35033 Rennes, France
    2. INSERM, CIC 02-03, EHESP, F-35043 Rennes, France
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  • Nolwenn Le Meur,

    1. Université Rennes 1, F-35043, Rennes, France
    2. EHESP, Département d'Informatique Médicale et de Biostatistiques, F-35043, Rennes, France
    3. INSERM, U936, F-35043 Rennes, France
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  • Yves Le Tulzo,

    1. CHU Rennes, Maladies Infectieuses et Réanimation Médicale, Pôle de Médecines Spécialisées, F-35033 Rennes, France
    2. INSERM, CIC 02-03, EHESP, F-35043 Rennes, France
    3. Université Rennes 1, F-35043, Rennes, France
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  • Thierry Fest

    1. CHU Rennes, Laboratoire d'Hématologie, Pôle de Biologie, F-35033 Rennes, France
    2. Université Rennes 1, F-35043, Rennes, France
    3. INSERM, U917, F-35043 Rennes, France
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  • How to cite this article: Roussel M, Gros A, Gacouin A, Le Meur N, Le Tulzo Y, Fest T. Toward new insights on the white blood cell differential by flow cytometry: A proof of concept study on the sepsis model Cytometry Part B 2012; 82B: 345–352.

Abstract

Background:

We sought to evaluate, on a model of sepsis, the clinical relevance of new parameters obtained on a white blood cell (WBC) differential by flow cytometry, implemented in the routine workflow of our hematology laboratory.

Methods:

A WBC with differential by flow cytometry was done on 459 patients at admission in intensive care unit. They were retrospectively categorized in having (i) infection or not or (ii) a high gravity score (severe sepsis or septic shock) or not. We analyzed by hierarchical clustering, in a multidimensional manner, 50 parameters provided by the flow cytometric platform in place of the standard seven parameters for a standard differential.

Results:

Our approach allows to discriminate on the basis of a WBC differential (i) infected patients at admission based on a 16 parameter signature, with a concordance rate of 72.7% and a specificity of 79.9% and (ii) patients with high gravity score (septic shock or severe sepsis) at admission with a signature of eight parameters, with a concordance rate of 74.7% and a specificity of 75.9%.

Conclusions:

This study shows the clinical relevance of an extended WBC differential to obtain by a flow cytometer integrated into a routine hematology laboratory workflow. Development of such approach implicates the redefinition of the WBC differential by integrating new parameters. © 2012 International Clinical Cytometry Society

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