Hematology

MCV

rbc size

range: 80-100 fL

MCV (fL) = hct (%) / RBC(10^12/L) x 10

increased MCV

>100 fL = macrocytic

megaloblastic anemia

hemolytic anemia w/ reticulocytosis

liver disease

newborn

decreased MCV

<80 fL = microcytic

IDA

thalassemia

sideroblastic anemia

lead poisoning

MCH

weight of hgb in one RBC

26 - 34 pg

MCH (pg) = hgb (g/dL) / RBC (10^12/L) x 10

increased MCH

> 34 pg
macrocytic anemia

decreased MCH

< 26 pg

microcytic, hypochromic anemia

MCHC

color of RBC

32-37 g/dL

MCHC (g/dL) = hgb (g/dL) / hct (%) x 100

increased MCHC

>37 g/dL = hyperchromic

possible error in RBC or hgb measurement

spherocytes

decreased MCHC

<32 g/dL = hypochromic

IDA

thalassemia

RBC

total # of cells

M: 4.5 - 6.0 x 10^12/L
F: 4.0 - 5.5 x 10^12/L

increased RBC count

M: >6.0 ×10^12/L

F: >5.5 ×10^12/L

polycythemia vera (PV)

decreased RBC count

M: <4.5 ×10^12/L

F: <4.0 ×10^12/L

anemia

hgb

oxygen carrier from lungs to tissues

M: 13.5 - 17.5 g/dL

F: 12.0 - 16.0 g/dL

increased hgb

M: >17.5 g/dL

F: >16.0 g/dL

polycythemia

decreased hgb

M: <13.5 g/dL

F: <12.0 g/dL

anemia

hct

ratio of RBCs to total blood; blood viscosity
M: 41 - 53%

F: 36 - 46%

hct purpose

check for anemia

estimate risk of blood viscosity

RDW

variation in RBC size

11.5 - 14.5%

increased RDW

>14.5%

post-txn

post treatment (iron, B12, or folic acid therapy)

presence of two concurrent deficiencies (iron & folic acid deficiencies)

idiopathic sideroblastic anemia

ANC

absolute neutrophil count

1.5 - 8.0 x 10^9/L

ANC = (WBC) x [(% segmented + % bands) / 100] 

increased ANC

>8.0 x 10^9/L = neutrophilia = left shift

> or = 50.0 x 10^9/L = chronic disease (CML) or severe immediate danger (leukemoid reaction)

decreased ANC

<1.5 x 10^9/L = neutropenia

< or = 0.5 x 10^9/L = high risk life-threatening sepsis

plt

initiates hemostasis

150 - 450 x 10^9/L

increased plt count

>450 x 10^9/L = thrombocytosis => clotting risk

decreased plt count

<150 x 10^9/L = thrombocytopenia => bleeding risk

MPV

volume of plt  = gauge BM function

7.8 - 10.2 fL

increased MPV

>10.2 fL = BM making new, large plts

WBC

immune defense

4.0 - 11.0 × 10^9/L

WBC count (cells/mm³) = (# cells counted x DF) / (# squares x 0.1 mm³)

increased WBC count

>11.0 × 10^9/L = immunosuppression, BM failure

decreased WBC count

<4.0 × 10^9/L = infection, inflammation

myeloblast

≥20% myeloblasts is diagnostic of Acute Leukemia (AML)

no cytoplasmic granules

promyelocyte

≥20% myeloblasts is diagnostic of Acute Leukemia (AML)

primary granules containing myeloperoxidase

myelocyte

severe marrow release or chronic leukemia (CML)

first stage where granulocyte types can be differentiated (neut, baso, eos)

secondary granules containing alkaline phosphatase & lysozyme

metamyelocyte

kidney bean shape

indicates a significant marrow response (infection/inflammation)

secondary granules

band neutrophil

0 - 0.7 × 10^9/L

no segmentation

secondary granules

segmented neutrophil (PMN)

2.5 - 7.0 × 10^9/L

bacterial

increased = neutrophilia => acute bacterial infection, physical stress, or inflammation

decreased = neutropenia => chemotherapy, severe sepsis, BM failure

eosinophil

0 - 0.4 × 10^9/L

parasitic & allergic

increased = eosinophilia => NAACPP

decreased = eosinopenia => acute stress/high corticosteroids

basophil

0 - 0.2 × 10^9/L

hypersensitivity reaction or allergy

increased = basophilia => CML or hypersensitivity reactions (release histamine)

decreased = basopenia => acute allergic reactions or acute stress

lymphocyte

1.0 - 4.0 × 10^9/L

increased = lymphocytosis => viral infections, whooping cough

decreased = lymphopenia => immunosuppresssion

monocyte

0.2 - 1.0 × 10^9/L

increased = chronic infections, recovery phase of acute infections, or malignancy

decreased = BM suppression