When to do diffs: how often should differential counts be repeated? 1980

G Brecher, and R E Anderson, and P D McMullen

Large numbers of differential counts are generated in hospital laboratories by physician requesting repeat counts, often daily. Their purpose is to detect trends in polymorphonuclear neutrophils (PMN) to monitor infections or therapy with marrow-depressant drugs. Recently, a number of automated differential counters have come on the market to handle the still increasing load of differentials. We proposed that a strategy of performing differential counts only after a significant change in total WBCs had taken place would result in little or no loss of information. Since WBC counts are routinely performed by automated instruments already available in most laboratories, the purchase of expensive differential counters might thus be avoided. To test this thesis, we analyzed 415 successive sequences of WBC and differential counts, each sequence consisting of four determinations within a 10-day period. Criteria for significant trends in WBC and PMN were based on clinical judgment or on recently determined day-to-day physiologic variations. Among 415 sequences examined, only four could be found in which PMN had changed without a concomitant change of equal significance in WBC. It was concluded that the proposed strategy of using WBC as an indicator of developing neutropenia or neutrophilia was sound. It would have resulted in loss of information in about 1% of instances only, at a considerable saving in differential counts.

UI MeSH Term Description Entries
D007958 Leukocyte Count The number of WHITE BLOOD CELLS per unit volume in venous BLOOD. A differential leukocyte count measures the relative numbers of the different types of white cells. Blood Cell Count, White,Differential Leukocyte Count,Leukocyte Count, Differential,Leukocyte Number,White Blood Cell Count,Count, Differential Leukocyte,Count, Leukocyte,Counts, Differential Leukocyte,Counts, Leukocyte,Differential Leukocyte Counts,Leukocyte Counts,Leukocyte Counts, Differential,Leukocyte Numbers,Number, Leukocyte,Numbers, Leukocyte
D007962 Leukocytes White blood cells. These include granular leukocytes (BASOPHILS; EOSINOPHILS; and NEUTROPHILS) as well as non-granular leukocytes (LYMPHOCYTES and MONOCYTES). Blood Cells, White,Blood Corpuscles, White,White Blood Cells,White Blood Corpuscles,Blood Cell, White,Blood Corpuscle, White,Corpuscle, White Blood,Corpuscles, White Blood,Leukocyte,White Blood Cell,White Blood Corpuscle
D009504 Neutrophils Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes. LE Cells,Leukocytes, Polymorphonuclear,Polymorphonuclear Leukocytes,Polymorphonuclear Neutrophils,Neutrophil Band Cells,Band Cell, Neutrophil,Cell, LE,LE Cell,Leukocyte, Polymorphonuclear,Neutrophil,Neutrophil Band Cell,Neutrophil, Polymorphonuclear,Polymorphonuclear Leukocyte,Polymorphonuclear Neutrophil
D003201 Computers Programmable electronic devices designed to accept data, perform prescribed mathematical and logical operations at high speed, and display the results of these operations. Calculators, Programmable,Computer Hardware,Computers, Digital,Hardware, Computer,Calculator, Programmable,Computer,Computer, Digital,Digital Computer,Digital Computers,Programmable Calculator,Programmable Calculators
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor

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