General Information, Hematology

Hematology Instrumentation Update

Spectrum Health Regional Laboratories will be upgrading the hematology instrumentation to the advanced technology of the Sysmex XN analyzers. This will occur on May 29, 2019, and will lead to a standardized approach to hematology results. Due to this upgrade, the following changes will occur:

The Retic Count, Automated [LAB296] will be eliminated and replaced with the Reticulocyte count with Reticulocyte Hemoglobin [LAB3500].
- This test includes: RBC count, Retic Absolute, Retic He, Retic Percent and the IRF. The IRF (Immature Reticulocyte Fraction) is an early and sensitive index of erythropoiesis, thus useful in the classification of anemias based on the marrow production (increased in regenerating anemias such as acquired hemolytic anemia or blood loss, and decreased in hyporegenerating anemias such as anemia of chronic disease), the therapeutic management of anemia and in monitoring erythropoietic stimulating agents, and in monitoring for bone marrow and stem cell transplants and response.
All laboratory sites will now be reflexing and reporting the IPF % and IPF absolute when a platelet count is below 75 x 10^3/uL.
- The Immature Platelet Fraction (IPF) is an indicator of the thrombopoietic activity, providing valuable information in assessing the mechanism of thrombocytopenias. An elevated IPF is observed in thrombocytopenia of peripheral origin caused by excessive consumption of platelets (such as ITP), while thrombocytopenia caused by inadequate platelet production is characterized by a reduced number of immature platelets entering into the circulation.
All laboratory sites will now be reporting the Nucleated Red Blood Cell (NRBC) count with the CBC (Complete Blood Count, [LAB293], [LAB294], [LAB2111032]) results.
The Red Blood Cell (RBC) morphology grading will align with the International Society for Laboratory Hematology recommendations.
CSF cell counts ([LAB2111025], [LAB212]) will be reported as WBC and RBC instead of TNC and RBC.