In the Sysmex DI-60 digital morphology system, a platelet estimate factor (PEF) is used to calculate the estimated platelet count (PLT).


To determine the most accurate PEF by analyzing various specimens, including those with abnormal flag alerts, using both impedance (PLT-I) and optical fluorescent (PLT-F) PLT methods. A validation study was then conducted using random specimens to evaluate the accuracy of the PEF.


This study included 120 blood specimens without flag alerts, and 120 blood specimens with flag alerts related to platelet abnormalities to determine the PEF. Each group was equally divided into thrombocytopenia, normal count, and thrombocytosis specimens. The PEF values obtained from the PLT-I and PLT-F methods were analyzed. An additional 120 specimens were used to compare the estimated PLT from PEF with the PLT-F count. Unadjusted PEF disregarded platelet ranges and flag alerts, whereas adjusted PEF incorporated them.


The mean PEF values ranged within 9.95 to 12.99 for PLT-I–obtained values (PEF-I) and within 10.32 to 11.69 for PLT-F–obtained values (PEF-F) across different PLT ranges. The mean PEF values were significantly higher in specimens with flags compared with those without flags. The values were 12.43 compared with 10.19 for PEF-I and 11.45 compared with 10.4 for PEF-F. A significant difference was found between PEF-I and PEF-F in flagged specimens, with respective values of 12.43 and 11.45. There was excellent agreement between estimated PLTs using adjusted PEF and PLT-F. However, proportional biases were observed between estimated PLT using unadjusted PEF and PLT-F.


Adjustment of PEF values according to specific platelet ranges and flag alert presence was shown to enhance the accuracy of PLT estimation using the Sysmex DI-60 system.

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Competing Interests

The author has no relevant financial interest in the products or companies described in this article.