Shedding New Light on Cell Morphology

With hematology labs facing heavier workloads and smaller staff sizes, any information that can help direct the slide-review process is a welcome advantage. After all, if laboratorians know which slides to review, they can focus time and energy on the samples that truly need attention.

The COULTER® LH 700 Series* hematology analyzers offer just such an advantage, in the form of a little-known feature that provides further detail about the main white blood cell populations as well as reticulocytes.

Here’s how it works: as part of the analysis process, the analyzers capture
six different values for specific cell populations:

• white blood cells­neutrophils, lymphocytes, monocytes and eosinophils
• red blood cells­reticulocytes and non-reticulocytes

The numbers are displayed as part of the Diff Data and Retic Data tabs—no special training is required to access the information.

The numerical data is not intended for diagnostic use, but it can be used to flag potential abnormalities and help technologists determine which smears to review.

Putting the Data to Work
Originally, the WBC data (referred to as Research Population Data**) was used only by Beckman Coulter service engineers, as a way to verify the optimal setup of white blood cell subpopulations. Later, Dr. Ramon Simon, European scientific manager for Beckman Coulter, began exploring research applications for the data.

"I wanted to see if the data could help indicate when a peripheral blood smear would be needed," says Dr. Simon. "Today, several labs worldwide are using the WBC Research Population Data in various ways and they are collaborating with each other to continue discovering new applications for the information."

Indeed, a number of published case studies have shown that changes in the WBC Research Population Data appear to correlate with the presence of abnormal cells. The data have been studied with cellular abnormalities including:

• Lymphocytes: Abnormal lymphs, variant lymphs, increased numbers of lymphs
• Granulocytes: Immature granulocytes, dysplastic granulocytes
• Hemoparasitic infections: Macrophages, variant lymphs

Dr. Simon notes that a compelling benefit of using the LH 700 Series hematology systems is that cells are analyzed in their native state. "There is no staining, which means you can analyze the cell properties with higher accuracy."

Getting Started
The analysis of those WBC data is free, since it occurs as part of the advanced VCS technology measurements on LH instruments. On the LH 780 and LH 750, the Research Population Data can be used as part of the Decision Rule screen.

Laboratories should consult with a Beckman Coulter service engineer to ensure their system¹s data plots have been optimized before establishing their own hospital population normal ranges.

For example, laboratories that are currently using the WBC Research Population Data for flagging have spent months gathering and analyzing information from patient samples. As they began to see patterns emerge, these labs have been able to use the information to direct slide review.

"This is an exciting time," says Dr. Simon. "We are in new territory and we are learning so much about what the morphology of white blood cells can tell us."

Where to Look
The LH analyzers present numerical WBC data as a three-dimensional cube, displayed as part of the Diff Data and Retic Data tabs.

Here's a look at how the WBC data can be compared to more familiar parameters on the RBC side.

*The LH 700 Series is comprised of the COULTER LH 750 and LH 780 hematology analyzers.
**For research use only. Not for use in diagnostic procedures.

Research Population Data as it appears on the LH 780 screen.