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Middleware and the Clinical Hematology Laboratory


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The Automated Differential Count

Slide 5

February 2009

In contrast, the automated differential count has different issues to be recognized.  It is clearly a more reproducible method than the manual differential and can be done quickly in an automated approach.  But, on the down side, it is geared towards “not missing” any morphologic changes and it must recognize a wide spectrum of white cell abnormalities including those from both lymphoid and myeloid cells, acute and chronic disorders, as well as reactive and malignant processes.  In addition, no single cell type in the peripheral blood perfectly represents each benign and malignant disease process.  And the automated differential count cannot consistently distinguish between reactive and malignant cell types.  Every instrument technology has its own inherent idiosyncrasies and, in my experience, will either over-capture or under-capture particular morphologic features.  But from a management perspective, the automated differential count, since it is a technology based, is relatively inexpensive to perform.  Bottomline: the laboratory must find how to maximize the use of automated differential counts while minimizing the number of manual differential counts performed.

The Automated Differential Count


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