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Optimization of the automated, CS-2000i™ method for measuring low levels of von Willebrand factor ristocetin cofactor activity (VWF:RCo)

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Abstract

Measurements of von Willebrand factor ristocetin cofactor activity (VWF:RCo) are necessary for the diagnosis of von Willebrand disease (VWD). However, the conventional manual glass-plate method is technically demanding, and exhibits high intra-/inter-laboratory variation. An automated technique has been recently described utilizing the CS-2000i™ with specific VWF:RCo reagents, but measurements at lower levels (<10 IU/dL) lack reliability. We have optimized this automated system for measuring low levels of VWF:RCo. Using a sample volume (72 μL) and initial stirring speed (400 rpm), the lowest level of VWF:RCo detected with a CV < 20 % was 2.5 IU/dL. Greater variability was evident at this stirring speed with smaller sample volumes. Decreasing the stirring speed (200 rpm) with a sample volume (72 μL), however, significantly improved the CV, and enabled measurements at the lowest levels (≤2.5 IU/dL). The optimized assay demonstrated a high correlation (R 2 = 0.841) with the glass-plate method at <10 IU/dL VWF:RCo, suggesting that the different VWF:RCo reagents did not affect the results. In addition, changes in VWF:RCo post-DDAVP infusions were parallel in both assays, indicating that the automated method is suitable for the clinical monitoring of treatment in VWD. The optimized automated measurement of VWF:RCo offers a promising method for evaluating VWF at low levels of hemostatic activity.

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Conflict of interest

Okuda M is a chief scientist of Sysmex Corp. The other authors declare that they have no conflict to declare. This work was partly supported by grants for MEXT KAKENHI 24591558 (KN) and 25461605 (TM) in Japan.

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Authors and Affiliations

  1. Department of Pediatrics, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan

    Tomoko Matsumoto, Keiji Nogami & Midori Shima

  2. Production Division, Sysmex Corporation, Kobe, Japan

    Masahiro Okuda

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  1. Tomoko Matsumoto
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  2. Keiji Nogami
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  3. Masahiro Okuda
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  4. Midori Shima
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Correspondence to Keiji Nogami.

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Matsumoto, T., Nogami, K., Okuda, M. et al. Optimization of the automated, CS-2000i™ method for measuring low levels of von Willebrand factor ristocetin cofactor activity (VWF:RCo). Int J Hematol 101, 126–132 (2015). https://doi.org/10.1007/s12185-014-1720-x

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  • DOI: https://doi.org/10.1007/s12185-014-1720-x

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