The cellular and morphological analysis is an integral part of any hematology laboratory. The hematology analyzers are being used predominantly for cell counts and differential leukocyte analysis, but in addition, these analyzers are capable of reporting many additional parameters and can provide much more information than what they are intended to provide, but unfortunately, due to lack of knowledge and propagation, they are not being optimally utilized to their full potential. The new information available with these additional parameters may help the laboratory physician in the screening and diagnosis of many disease states.
At the highest level of hematology laboratory automation are scalable, configurable automation systems that are useful in following analytic determinations like CBC, 6-part white blood count (WBC) differential, nucleated red blood cell (NRBC), reticulocyte count (RET) and immature retic fraction (IRF), automated immature platelet fraction (IPF), and automated smear preparation and staining. These on-demand tests are standardized assays that meet performance goals, decrease the technologist’s hands-on time, eliminate batch testing, and provide results faster to physicians.
The modern-day analyzers are providing 5- to 7-parts differential white-cell analysis, based on different technologies, such as, electrical impedance, radiofrequency conductivity, light scatter, fluorescent scatter, cytochemistry, etc. In addition to these, they also provide additional information in the form cell population data (CPD) and lymph index, large unstained cell population, and hemoparasites, which can be utilized in the screening of benign and malignant hematological conditions. Majority of hematology analyzers are now available with an integrated reticulocyte count analysis with the routine complete blood count analysis, which not only provides the reticulocyte percent and absolute reticulocyte counts but also provides additional data in the form of reticulocyte hemoglobin content (CHr), percent hypochromic cells, percent microcytic cell or microcytic anemia factor, immature reticulocyte fraction, etc. Laboratories that have incorporated HbA1c testing on high-speed hematology lines are performing >90 percent of assays from lavender-top tubes with minimal technologist intervention.
From the point of view of analysis, the ability to analyze and report immature forms of three cell lines (WBC, RBC, and PLT) enables the hematology laboratory to fully automate parameters that can aid physicians in their therapeutic decision-making processes.
The user must identify the abilities and the limitations of these analyzers for better optimization in the laboratory; hence, it is the need of the hour to propagate this useful information acquired from hematology analyzers, both to the clinician and the laboratory physician as it may help the patients by reducing the cost to the diagnosis by avoiding other unnecessary tests and may also help in timely management of the disease states.