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Test Code CBCMDIFF Complete Blood Count (CBC) with Manual Differential

Container

Purple

Specimen Stability

2 days

Rejection Reasons

Clotted
Frozen

Reference Range

  0-2 Months 2 M to 1 year 1 year to 15 years   15 Y & older
WBC 5.0 - 38.0 x 10^3 / uL 5.0 - 18.0 4.5 - 12.0   4.8 - 10.8
RBC 3.90 - 7.10 x 10^6/uL 3.80 - 6.00 3.80 - 5.50   F: 4.20 - 5.40
M: 4.70 - 6.10
Hgb 12.0 - 27.0 g/dL 9.0 - 18.0  9.0 - 16.5    F: 12.0 - 16.0
M: 14.0 - 18.0 
Hct 43.0 - 61.0% 35.0 - 45.0% 35.0 - 40.0%   F: 37.0 - 47.0%
M: 42.0 - 52.0%
MCV 91 - 120 fL 77 - 93 fL 77 - 85 fL   F: 81 - 99 fL
M: 80 - 90 fL
MCH 35 - 38 pg 25 - 35 pg 27 - 31 pg
MCHC 33 - 37 g/dL 33 - 36 g/dL 33 - 37 g/dL
Platelet 140 - 350 x 10^3/uL
RDWSD 39 - 50 fL
RDWCV 11.5 - 14.5%
MPV 7.4 - 12.2 fL
           
  0-2 Months 2 M to 3 years 3 Y to 9 Y 9 Y to 15 Y 15 Y & Older
Neut % 40 - 75% 30 - 40% 35 - 60% 45 - 60% 50 - 80%
Lymph % 20 - 45% 40 - 60% 35 - 55% 20 - 35% 10 - 50%
Mono # 0.05 - 0.6 x 10^3/uL
Eos % 0 - 8%
Baso % 0 - 1%
IG % 0 - 5%
Metamyelocytes % 0
Myelocytes % 0
Promeylocytes % 0
Blastocytes % 0

Critical Value

Hgb: <7.0 g/dL

Hct: <21.0%

WBC: <1.5 or >30.0 x 10^3/uL

Platelets: <35 or >1,499 x 10^3/uL

Reflex Testing

Peripheral Smear will be sent for Pathologist review if one or more of the following criteria are met:

Based on CBC Results
  • WBC count greater than 30,000
  • RBC greater than 6.5 for male or greater than 6.0 for female
  • Hemoglobin less than 6.0 or greater than 18.0
  • Platelet count less than 35 or greater than 1000
  • MCV less than 60 or greater than 110 for adult

Based on Absolute Numbers
  • Neutrophils less than 0.5
  • Lymphocytes greater than 7 (over 14 years); greater than 10 (1-14 years)
  • Monocytes greater than 3
  • Eosinophils greater than 2
  • Basophils greater than 0.5

Based on Manual Differential
  • Blasts, unclassifiable – any
  • Promyelocytes greater than 3
  • Myelocytes greater than 5
  • Metamyelocytes greater than 10
  • NRBC (per 100 WBC) greater than 3
  • Any unusual or questionable hematological findings that one or more techs are not confident in classifying.

New Significant RBC Morphologic Abnormalities
  • 3+: anisocytosis, poikilocytosis, elliptocytes, hypochromia, polychromasia, basophilic stippling, stomatocytes
  • 2+: target cells, rouleaux
  • 1+: schistocytes, spherocytes, acanthocytes, tear drop cells
  • Any: sickle cells, Howell Jolly bodies, Pappenheimer bodies, agglutination, intraerythrocytic organisms

New Significant WBC Morphologic Abnormalities
  • 3+: Dohle bodies
  • 2+: hyposegmented PMNs
  • 1+: hypersegmented, hypogranular PMNs
  • Any: Auer Rods

Platelet Morphologic Abnormalities
  • 2+: giant, agranular platelets
  • 1+: bizarre platelets, satellitosis

When Ordered by a Provider
  • If the CBC has not been performed at MHCC, perform a CBC on the hematology analyzer.
  • If only slides have been sent from the ordering provider, contact testing location for copy of instrument print-out.

Newborn Criteria
  • Hemoglobin less than 14.0
  • MCV less than 85
  • Lymphocyte absolute count greater than 14
  • Nucleated RBC greater than 50 for patients less than 7 days old

Frequency of Path Review

Patients with chronic problems that have values that repeatedly fall within these criteria need only be reviewed by a pathologist one time in each 180-day period, unless a distinct change occurs.