A Complete Blood Count (CBC) Panel is used as a screening test for various disease states including anemia, leukemia, and inflammatory processes.
A CBC blood test includes the following biomarkers: WBC, RBC, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet count, Neutrophils, Lymphs, Monocytes, Eos, Basos, Neutrophils (Absolute), Lymphs (Absolute), Monocytes(Absolute), Eos (Absolute), Basos (Absolute), Immature Granulocytes, Immature Grans (Abs)
NOTE: Only measurable biomarkers will be reported.
Reflex Parameters for Manual Slide Review
|
|
Less than |
Greater Than |
WBC |
1.5 x 10^3 |
30.0 x 10^3 |
Hemoglobin |
7.0 g/dL |
19.0 g/dL |
Hematocrit |
None |
75% |
Platelet |
100 x 10^3 |
800 x 10^3 |
MCV |
70 fL |
115 fL |
MCH |
22 pg |
37 pg |
MCHC |
29 g/dL |
36.5 g/dL |
RBC |
None |
8.00 x 10^6 |
RDW |
None |
21.5 |
Relative Neutrophil % |
1% or ABNC <500 |
None |
Relative Lymphocyte % |
1% |
70% |
Relative Monocyte % |
None |
25% |
Eosinophil |
None |
35% |
Basophil |
None |
3.50% |
|
|
|
Platelet |
<75 with no flags,
>100 and <130 with platelet clump flag present,
>1000 |
Instrument Flags |
Variant lymphs, blasts,
immature neutrophils, nRBC’s, abnormal platelets,
giant platelets, potential interference |
|
|
|
The automated differential averages 6000 cells. If none of the above parameters are met, the results are released without manual review. |
CBC Reflex Pathway
Step 1 - The slide review is performed by qualified Laboratory staff and includes:
- Confirmation of differential percentages
- WBC and platelet estimates, when needed
- Full review of RBC morphology
- Comments for toxic changes, RBC inclusions, abnormal lymphs, and other
- significant findings
- If the differential percentages agree with the automated counts and no abnormal cells are seen, the automated differential is reported with appropriate comments
Step 2 - The slide review is performed by qualified Laboratory staff and includes: If any of the following are seen on the slide review, Laboratory staff will perform a manual differential:
- Immature, abnormal, or toxic cells
- nRBC’s
- Disagreement with automated differential
- Atypical/abnormal RBC morphology
- Any RBC inclusions
Step 3 - If any of the following are seen on the manual differential, a Pathologist will review the slide:
- WBC<1,500 with abnormal cells noted
- Blasts/immature cells, hairy cell lymphs, or megakaryocytes
- New abnormal lymphocytes or monocytes
- Variant or atypical lymphs >15%
- Blood parasites
- RBC morphology with 3 spherocytes, RBC inclusions, suspect Hgb-C,
- crystals, Pappenheimer bodies or bizarre morphology
- nRBC’s