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WBCs Differentiation

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nRBC Location

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Platelet Scattergram

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Linearity

WBC 0.02400 x 103/L

RBC 0.007.0 x 106/L

Hemoglobin 0.0022.5 g / dL Platelet 5.0 3500 x103/L

Reticulocyte 0.2 24.5 %

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Within Run Precision

Mean SD CV

WBC (x103/L) 7.5 0.2 2.7

RBC (x106/L) 5.0 .006 1.2

Hb (g/dL)

15.0

0.14

0.93

MCV (fL) 90 0.7 0.78

Plt(x103/L) 300 8.8 2.93

Retic (%) 2.0 0.25 12.5

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Limitation of the nRBC count

Sample : uncorrected WBC count 3.00x103/L

: 2% nRBCs orabsolute 0.20x109 / L

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Normal

WBCB

(x103

cells/mL)

Correct

ecdWB

CB

(x103

cells/m

L)

RBC

(x106

cells/mL)

Hb

(g/d

L)

HCT

(%)

MCV

(fL)

MCH

(pg)

MCHC

(g/dL)

RDW

(%)

Retic

(x109

cells/L)

AbsNRBC

(x109

cell/mL)

mean 7.43 4.53 12 36.08 86.0 26.38 33.09 15.66 15.55 0.00

SD 0.17 0.08 0.07 0.38 1.05 0.39 0.24 0.08 3.00 0.00

%CV 2.35 1.81 0.60 1.05 1.32 1.48 0.73 0.52 19.27 0.00

-Thalssemia/Hb E disease with splenegtomy

mean 70.60 11.95 3.36 7.75 27.11 80.61 23.03 28.59 26.40 579.63 58.65

SD 0.83 0.39 0.05 0.07 0.33 0.54 0.26 0.26 0.14 48.51 0.89

%CV 1.17 3.29 1.56 0.96 1.23 0.67 1.11 0.92 0.54 8.37 1.53

Test Precision

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-Thalassemia 1 trait

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-thalassemia/Hb E with splenectomy

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-thalassemia/Hb E with splenectomy

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Corrected WBC

0

20

40

60

80

100

120

WBC(x103c

ell/ulL

Uncorrect WBC

0

20

40

60

80

100

120

WBC(x103c

ell/ul)

-Th

alassemia/HbEwith

splenectomy

-Thala

ssemia/HbE

HbH

HbH-CS

-Thalassemia2trait

-Thalassemia1trait

-Th

alassemia/HbEwith

splenectomy

-Thala

ssemia/HbE

HbH

HbH-CS

-Thalassemia2trait

-Thalassemia1trait

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r = 0.87

The correlation of different technique

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The Importance of NRBC measurement

- To monitor bone marrow activity(the same as reticulocyte)

- To accurately count the number of

white blood cell which is importantin the monitor of drug toxicity in

splenectomized thalassemia subjects

(such as deferriprone, hydroxyurea)

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RBC

0

2

4

6

8

10

RBC(

x109

cell/uL)

-Th

alassemia/HbEwith

splenectomy

-Thala

ssemia/HbE

HbH

HbH-CS

-Thala

ssemia2trait

-Thala

ssemia1trait

Hb

0

2

4

6

8

10

12

14

16

Hb

(g/dL)

-Th

alassemia/HbEwith

splenectomy

-Thala

ssemia/HbE

HbH

HbH-CS

-Thala

ssemia2trait

-Thala

ssemia1trait