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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter

IMPACT FACTOR 2018: 3.638

CiteScore 2018: 2.44

SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

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Volume 56, Issue 8


Analytical performance of an automated volumetric flow cytometer for quantitation of T, B and natural killer lymphocytes

Simon Degandt / Bart Peeters / Stijn Jughmans / Nancy Boeckx / Xavier Bossuyt
Published Online: 2018-02-21 | DOI: https://doi.org/10.1515/cclm-2017-0638



Quantitation of lymphocyte subsets (B cells, T cells, CD4 and CD8 T cells and NK cells) classically relies on quantitation of lymphocytes and immunophenotyping by flow cytometry. AQUIOS CL (Beckman Coulter) is a fully automated system that performs an onboard volumetric cell count, automatically processes the sample (staining, lysing and fixation) and analyzes the results. We compared AQUIOS CL to a dual-platform analysis and evaluated analytical performance.


We evaluated precision, sample stability, inter-sample carryover, linearity and interpanel consistency. AQUIOS CL was compared to a dual-platform method (Sysmex XE-5000 and BD FACSCanto-II). A total of 113 patient samples were included: 45 from posttransplant patients, 44 from children and 24 random routine samples. The degree of automation was scored through the need of manual revisions triggered by AQUIOS CL run notifications and run flags.


Intrarun and interrun variability was <9.1% with dedicated control material and <32.1% with patient samples. Relative values of lymphocyte subsets could be determined up to 48 h after venipuncture when the sample was kept at room temperature. There was no carryover and good linearity. Interpanel consistency was 3.3% for relative values and 9.4% for absolute values. Method comparison showed good analytical correlation between AQUIOS CL and a dual-platform method. Thirty-five percent of the samples triggered a run notification. In 74% of these samples, the results could be accepted without intervention, so in 26% of all samples, an unnecessary notification was generated.


AQUIOS CL allows for reliable fully automated immunophenotyping of lymphocyte subset quantitation. Gating algorithms could be further improved.

This article offers supplementary material which is provided at the end of the article.

Keywords: AQUIOS; flow cytometry; lymphocyte subsets


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About the article

Corresponding author: Prof. Dr. Xavier Bossuyt, PhD, MD, Department of Laboratory Medicine, UZ Leuven, Herestraat 49, 3000 Leuven, Belgium

aSimon Degandt and Bart Peeters share first authorship.

bNancy Boeckx and Xavier Bossuyt share senior authorship.

Received: 2017-07-20

Accepted: 2018-01-19

Published Online: 2018-02-21

Published in Print: 2018-07-26

Author contributions: BP, NB, XB: study design. SD: drafted the manuscript. BP, SJ: patient recruitment. SD, BP, SJ: data acquisition. SD, BP: statistical analysis. NB,XB checked and improved content and English grammar and style of the manuscript. NB, XB commented on and edited the manuscript, which was read and approved by all authors. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 56, Issue 8, Pages 1277–1288, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2017-0638.

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