Gene Gulati1, Vandi Ly1, Guldeep Uppal1, Jerald Gong1.
Abstract
BACKGROUND: Lymphocytosis and smudge cells are commonly observed on the blood smears of patients with an established or suspected diagnosis of chronic lymphocytic leukemia/small lymphocytic lymphoma. Excluding smudge cells from the manual differential count (MDIFF), a common laboratory practice, yields unreliable results and consequently necessitates performing the MDIFF testing on an albuminized blood smear.
OBJECTIVE: To assess the reliability of counting smudge cells as lymphocytes in the MDIFFs on nonalbuminized smears and automated differentials (ADIFFs) as a substitute for MDIFFs.
METHODS: We compared corresponding results of MDIFFs on nonalbuminized smears vs MDIFFs on albuminized smears (group A, n = 82), ADIFFs vs MDIFFs on nonalbuminized smears (group B, n = 68), and ADIFF vs MDIFFs on albuminized smears (group C, n = 50). Smudge cells on the nonalbuminized smears were counted as lymphocytes. We focused on 2 white blood cell types: neutrophils and lymphocytes.
RESULTS: Respective means for % lymphocytes and % neutrophils were 83.2 vs 83.2 and 14.0 vs 13.6 for Group A, 75.0 vs 77.0 and 20.2 vs 19.8 for Group B, and 76.1 vs 79.3 and 18.7 vs 17.4 for Group C. Respective correlation coefficients for % lymphocytes and % neutrophils were 0.92 and 0.94 for group A, 0.94 and 0.97 for group B, and 0.88 and 0.92 for group C.
CONCLUSION: Counting smudge cells as lymphocytes on nonalbuminized blood smears yielded reliable MDIFF results. Reportable ADIFF results were generated by the analyzer on 73% of the specimens, of which 93% were reliable. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
BACKGROUND: Lymphocytosis and smudge cells are commonly observed on the blood smears of patients with an established or suspected diagnosis of chronic lymphocytic leukemia/small lymphocytic lymphoma. Excluding smudge cells from the manual differential count (MDIFF), a common laboratory practice, yields unreliable results and consequently necessitates performing the MDIFF testing on an albuminized blood smear.
OBJECTIVE: To assess the reliability of counting smudge cells as lymphocytes in the MDIFFs on nonalbuminized smears and automated differentials (ADIFFs) as a substitute for MDIFFs.
METHODS: We compared corresponding results of MDIFFs on nonalbuminized smears vs MDIFFs on albuminized smears (group A, n = 82), ADIFFs vs MDIFFs on nonalbuminized smears (group B, n = 68), and ADIFF vs MDIFFs on albuminized smears (group C, n = 50). Smudge cells on the nonalbuminized smears were counted as lymphocytes. We focused on 2 white blood cell types: neutrophils and lymphocytes.
RESULTS: Respective means for % lymphocytes and % neutrophils were 83.2 vs 83.2 and 14.0 vs 13.6 for Group A, 75.0 vs 77.0 and 20.2 vs 19.8 for Group B, and 76.1 vs 79.3 and 18.7 vs 17.4 for Group C. Respective correlation coefficients for % lymphocytes and % neutrophils were 0.92 and 0.94 for group A, 0.94 and 0.97 for group B, and 0.88 and 0.92 for group C.
CONCLUSION: Counting smudge cells as lymphocytes on nonalbuminized blood smears yielded reliable MDIFF results. Reportable ADIFF results were generated by the analyzer on 73% of the specimens, of which 93% were reliable. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
Entities:
Keywords:
blood smears; chronic lymphocytic leukemia; differential leukocyte counts; lymphocytes; small lymphocytic lymphoma; smudge cells
Mesh：
Year: 2017
PMID： 28371883 DOI： 10.1093/labmed/lmx002
Source DB: PubMed Journal: Lab Med ISSN： 0007-5027