Blood Cell Analysis: The Importance For Biopsy Interpretation [o Hemograma: Importância Para A Interpretação Da Biópsia]

Examination of blood cells is an essential part of the hematological investigation. The introduction of new physical principles for cell analysis incorporated into automated cell counters has provided new information about blood cells. Data related to both quantification and cell morphology features observed in peripheral blood examinations may be helpful during bone marrow analysis. In this brief review some of these new parameters are presented, such as the red blood cell distribution width (RDW) and indices related to volume, immaturity and hemoglobin content of reticulocytes. The interpretation of graphic displays (histograms of red cells, white cells and platelets) can provide further information that is not available from the assessment of numeric data. Other parameters and platelet indices, such as the mean platelet volume (MPV) and immature platelet fraction (IPF) are introduced, although they are still not standardized and must be used with caution. The quantification of various white blood cell populations present in peripheral blood and the advantages and limitations of automated counts are considered. Although the development of sophisticated automated blood cell analyzers has reduced the number of blood smear examinations, this type of procedure should be encouraged as the smear is an important tool in the diagnosis of several pathologic conditions.313178182(2008) Interpretação Clínica Do Hemograma, , Grotto HZW (ed), São Paulo: Editora AtheneuSandhaus, L.M., Meyer, P., How useful are CBC and reticulocyte reports to clinicians? (2002) Am J Clin Pathol, 118 (5), pp. 787-793Dixon, L.R., The complete blood count: Physiologic basis and clinical usage (1997) J Perinat Neonatal Nurs, 11 (3), pp. 1-18(2001) Practical Haematology, , Lewis SM, Bain BJ, Bates I (eds)., 9th ed. London: Churchill LivingstoneGreen, R., King, R., A new red cell discriminant incorporating volume dispersion for differentiating iron deficiency anemia from thalassemia minor (1989) Blood Cells, 15 (3), pp. 481-491Lima, C.S., Reis, A.R., Grotto, H.Z., Saad, S.T., Costa, F.F., Comparison of red cell distribution width and a red cell discriminant function incorporating volume dispersion for distinguishing iron deficiency from beta thalassemia trait in patients with microcytosis (1996) Sao Paulo Med J, 114 (5), pp. 1265-1269Noronha, J.F., Lorand-Metze, I.G., Grotto, H.Z., Hematopoietic progenitor cells (HPC) and immature reticulocytes evaluations in mobilization process: New parameters measured by conventional blood cell counter (2006) J Clin Lab Anal, 20 (4), pp. 149-153Cortellazzi, L.C., Teixeira, S.M., Borba, R., Gervásio, S., Cintra, C.S., Grotto, H.Z.W., Reticulocyte parameters in hemoglobinopathies and iron deficiency anemia (2003) Rev Bras Hematol Hemoter, 25 (2), pp. 97-102Lambert, J.-F., Beris, P., Pathophysiology and differential diagnosis of anemia (2006) Disorders of Iron Homeostasis, Erythrocytes, Erythropoiesis, pp. 73-101. , In: Beaumont C, Beris P, Beuzard Y, Brugnara C., Genoa, Italy: Forum Service Editore, cap 3Brugnara, C., Schiller, B., Moran, J., Reticulocyte hemoglobin equivalent (Ret He) and assessment of iron-deficient states (2006) Clin Lab Haematol, 28 (5), pp. 303-308Mast, A.E., Blinder, M.A., Dietzen, D.J., Reticulocyte hemoglobin content (2008) Am J Hematol, 83 (4), pp. 307-310Kim, J.M., Ihm, C.H., Kim, H.J., Evaluation of reticulocyte haemoglobin content as marker of iron deficiency and predictor of response to intravenous iron in haemodialysis patients (2008) Int J Lab Hematol, 30 (1), pp. 46-52Schaefer, M., Rowan, R.M., The clinical relevance of nucleated red blood celll counts (2000) Sysmex J Intern, 10, pp. 59-63Cornet, E., Perol, J.P., Troussard, X., Performance evaluation and relevance of the CellaVision DM96 system in routine analysis and in patients with malignant hematological diseases (2008) Int J Lab Hematol, 30 (6), pp. 536-542Felle, P., McMahon, C., Rooney, S., Donnelly, P., Ni Chonchubhair, F., Platelets in the paediatric population: The influence of age and the limitations of automation (2005) Clin Lab Haematol, 27 (4), pp. 250-257Abe, Y., Wada, H., Tomatsu, H., Sakaguchi, A., Nishioka, J., Yabu, Y., A simple technique to determine thrombopoiesis level using immature platelet fraction (IPF) (2006) Thromb Res, 118 (4), pp. 463-469Takami, A., Shibayama, M., Orito, M., Omote, M., Okumura, H., Yamashita, T., Immature platelet fraction for prediction of platelet engraftment after allogeneic stem cell transplantation (2007) Bone Marrow Transplant, 39 (8), pp. 501-507Threatte, G.A., Usefulness of the mean platelet volume (1993) Clin Lab Med, 13 (4), pp. 937-950Buttarello, M., Plebani, M., Automated blood cell counts: State of the art. State of the art (2008) Am J Clin Pathol, 130 (1), pp. 104-116Sugimori, N., Kondo, Y., Shibayama, M., Omote, M., Takami, A., Sugimori, C., Aberrant increase in the immature platelet fraction in patients with myelodysplastic syndrome: A marker of karyotypic abnormalities associated with poor prognosis (2009) Eur J Haematol, 82 (1), pp. 54-6