Table 2.
Sets of screening criteria.
| Parameter | Group 1 Narrow limits |
Group 2 Intermediary limits |
Group 3 Wide limits |
Group 4 Adapted ISLH screening criteria16 |
|---|---|---|---|---|
| Quantitative screening criteria | ||||
| Hemoglobin | <9.5 g/dL or >18.0 g/dL | <8.0 g/dL or >19.0 g/dL | <7.5 g/dL or >20.0 g/dL | <7.0 g/dL or >18.5 g/dL |
| MCV | <77 fL (adults) and <74 fL (children aged ≤12 years) or >100 fL | <75 fL or >105 fL | <74 fL or >105 fL | <75 fL or >105 fL |
| MCHC | <31.5 g/dL | <31.0 g/dL | <30.0 g/dL | <30 g/dL |
| MCHC | >36.5 g/dL | >36.5 g/dL | >36.5 g/dL | >36.5 g/dL |
| RDW-CV | >17.0% | >18.0% | >19.0% | >22.0% |
| RDW-SD | >60 fL | >65 fL | >70 fL | – |
| Reticulocytes | >0.150 × 106/μL or >2.5% | >0.150 × 106/μL or >2.5% | >0.150 × 106/μL or >2.5% | >0.100 × 106/μL |
| WBC | <4.0 × 103/μL or >12.0 × 103/μL | <3.5 × 103/μL or >15.0 × 103/μL | <3.2 × 103/μL or >20.0 × 103/μL | <4.0 × 103/μL or >30.0 × 103/μL |
| Neutrophils # | <1.8 × 103/μL or >7.0 × 103/μL | <1.5 × 103/μL or >11.0 × 103/μL | <1.0 × 103/μL or >15.0 × 103/μL | <1.0 × 103/μL or >20.0 × 103/μL |
| Neutrophils % | <38% or >70% | <35% or >80% | <25% or >85% | – |
| Lymphocytes # | <0.8 × 103/μL or >5.0 × 103/μL (adults) and <0.8 × 103/μL or >7.0 × 103/μL (children aged ≤12 years) | <0.8 × 103/μL or >5.0 × 103/μL (adults) and <0.8 × 103/μL or >7.0 × 103/μL (children aged ≤12 years) | <0.5 × 103/μL or >5.0 × 103/μL (adults) and <0.5 × 103/μL or >7.0 × 103/μL (children aged ≤12 years) | >5.0 × 103/μL (adults) and >7.0 × 103/μL (children aged ≤12 years) |
| Lymphocytes % | <20% or >50% | <12% or >60% | <8% or >70% | – |
| Monocytes # | <0.1 × 103/μL or >1.3 × 103/μL (adults) and <0.1 × 103/μL or >2.0 × 103/μL (children aged ≤12 years) | <0.1 × 103/μL or >1.3 × 103/μL (adults) and <0.1 × 103/μL or >2.0 × 103/μL (children aged ≤12 years) | <0.1 × 103/μL or >1.5 × 103/μL (adults) and <0.1 × 103/μL >2.0 × 103/μL (children aged ≤12 years) |
>1.5 × 103/μL (adults) and >3.0 × 103/μL (children aged ≤12 years) |
| Monocytes % | <1% or >12% | <1% or >16% | <1% or >20% | – |
| Eosinophils # | >2.0 × 103/μL | >2.5 × 103/μL | >2.5 × 103/μL | >2.0 × 103/μL |
| Eosinophils % | >20% | >25% | >30% | – |
| Basophils # | >0.3 × 103/μL | >0.3 × 103/μL | >0.5 × 103/μL | >0.5 × 103/μL |
| Basophils % | >2% | >2% | ≥3% | – |
| Platelets | <100 × 103/μL or >600 × 103/μL | <100 × 103/μL or >800 × 103/μL | <90 × 103/μL or >1000 × 103/μL | <100 × 103/μL or >1000 × 103/μL |
| MPV | >12.0 fL | >12.5 fL | ≥13.0 fL | ≥12.5 fL |
| Qualitative screening criteria | ||||
| Suspect flags | Immature granulocytes? | |||
| Left shift? | ||||
| Atypical lymphocytes? | ||||
| Abnormal lymphocytes/blasts? | ||||
| Blasts? | ||||
| Nucleated red blood cells? | ||||
| Fragments? (schistocytes) | ||||
| Dimorphic RBC population (erythrocyte population heterogeneous in size) | ||||
| Lyse resistant RBC | ||||
| Platelet clumps? (generated by scatter gram) Platelet clumps (S)? (generated by the impedance channel) | ||||
| Turbidity/hemoglobin interference? Hemoglobin defect? Spurious hemoglobin measurement | ||||
| ALL | MBSR if newborn | |||
| (*) and (----) | These symbols beside the counts on the readout indicate that automated counts are not reliable or not available for the sample in question, respectively | |||
ISLH: International Society for Laboratory Hematology; MCV: mean corpuscular volume; MCHC: mean corpuscular hemoglobin concentration; RDW-CV: red blood cell distribution width coefficient of variation; RDW-SD: red blood cell distribution width standard deviation; RBC: red blood cells; WBC: white blood cells; MPV: mean platelet volume; MBSR: manual blood smear review.
Note: The terms narrow, intermediary and wide limits refer to their relative and absolute overall amplitudes in relation to the lower and upper limits of the complete blood count reference values.