Intra-and inter-analyzer imprecision of cell population data on Sysmex XN-10

Introduction: Cell population data (CPD) derived from modern hematology analyzers provide morphological and functional insights into leukocytes beyond traditional cell counts. Nevertheless, their introduction into clinical practice requires proven analytical precision and consistency across instrumentation. Method: Two K2EDTA blood samples (one from a healthy blood donor and one from an intensive care unit patient) were analyzed in ten replicates on two Sysmex XN-10 analyzers. Intra- and inter-analyzer imprecision were calculated as coefficients of variation (CV%). Results: Intra-analyzer CV% ranged from 0.2–7.9% and inter-analyzer CV% from 0.6–9.8%. For neutrophil, lymphocyte, and monocyte CPD parameters, intra-/inter-analyzer CV% were 0.2–2.5%/0.6–7.0%, 0.5–6.6%/0.7–7.2%, and 0.2–7.9%/0.8–9.8%, respectively. The mostly used CPD parameters NE-SFL (neutrophil fluorescence intensity) and MO-X (monocyte complexity) displayed very low imprecision, with intra-analyzer CV% of 0.7–0.9% and 0.2–0.5%, and inter-analyzer CV% of 0.9–1.1% and 0.8–1.7%, respectively. Discussion: Our results confirm excellent reproducibility of Sysmex XN-10 CPD, consistent with or even improving upon earlier data obtained with the previous Sysmex XN-9000. The very low intra- and inter-analyzer variability of NE-SFL and MO-X supports their use as reliable clinical parameters, especially for infection and sepsis diagnostics.