1. Overview of a CELL-DYN 3000 Series CBC Report

2. The Abbott CELL-DYN® System is distributed by Abbott Laboratories, USA, Abbott Park, IL 60064
Content or Pages
Revised, Added, or Deleted
Document Control Number
Revision Date
November, 2004
New Release
October, 2005
Pages 2 through 26 revised
©Copyright 2005 Abbott Laboratories
CELL-DYN is a registered trademark of Abbott Laboratories.
Any product information in this document should be used in conjunction with the latest version of the
Operation’s Manual and Service and Support Manual. If any discrepancies in information exist within
this document or any other, the latest version of the Operation’s Manual and/or Service and Support
Manual takes precedence.
All samples (printouts, graphics, displays or screens, etc.) are for information and illustration
purposes only and shall not be used for clinical or maintenance evaluations.

3. Objectives
Describe what the numbers and graphics on the CELL-DYN® 3000 Series display are relating to
Define common terminology used in hematology reports
Identify Blood Cell types
Describe Blood Cells by their appearance characteristics
Identify how indices are derived

4. Complete Blood Count
A Complete Blood Count (CBC) report includes information on three main types of blood cells:
White Blood Cells (WBC)
Red Blood Cells (RBC)
Platelets (PLT)
By measuring and visually examining the different cellular components of peripheral blood, it is possible to detect the existence of different disease states in the patient and to monitor treatments.
An anticoagulated whole blood specimen is used.

5. Cell Maturation
White cells, red cells and platelets are formed in the bone marrow by a process known as Hematopoiesis.
These essential blood cells fight infection, carry oxygen and help control bleeding.
As cells mature, their shape and contents change so that they can be most efficient at the work that they must do.
Immature forms of the cells are not normally found in a healthy individual’s blood.
In a normal blood sample, all of the white blood cells keep their nuclei so that they can alter their function to meet the challenges of protecting the body from invaders.
The red cells, however, lose their nuclei and fill up with the special oxygen-carrying molecule, hemoglobin. The red cell shape is flexible, and allows rapid transfer of oxygen into and out of the cell.
An increase in the number of immature neutrophils present in the blood is known as a “left shift”.

6. CELL-DYN 3000 Series Report Screen -MENU
Place the mouse over the parameters and histograms then click to access information.
Parameters
Scatterplots and Histograms
FLAG
Last Slide Viewed

7. Result Flags
Flags may appear next to results displayed on the Results screen and on a printed report.
Flagging is defined as “signaling or communicating a message with, or as if with, a flag”. In the hematology laboratory, a flag is the signal to the operator that the analyzed sample may have a significant abnormality.
To be useful, flagging should have a low false-positive rate coupled with a low false-negative rate with a resulting high efficiency for identifying potentially abnormal blood specimens.
The CELL-DYN 3000 Series analyzers monitor conditions and data criteria that may affect the displayed results and alert the operator through messages and flags.
Instructions for interpreting all flags, numeric, scatterplot and histogram data should be incorporated into the laboratory’s procedure and used to determine the need for further action and/or review of results.
For complete message and flagging information refer to the CELL-DYN System Operator’s Manual.
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8. WBC (Leukocytes) White Blood Cells (leukocytes) :
The CELL-DYN 3000 Series classifies five different cell types, Neutrophils, Lymphocytes. Monocytes, Eosinophils and Basophils based on the Absolute WBC Count.
White Blood Cells (leukocytes) :
help defend the body against infection,
are involved in inflammation,
and clean up cellular debris.
Types of white blood cells:
Granulocytes
Neutrophils
Eosinophils
Basophils
Lymphocytes
Monocytes
Neutrophils and lymphocytes are the most abundant WBCs in the blood.
The differentiation of WBCs is commonly referred to as a differential count.
Neutrophil
Eosinophil
Basophil
Lymphocyte
Monocyte
Multiplying the reported cell classification percentage by the total number of white blood cells will give the "absolute" number of these types of cells.
The CELL-DYN 3700 and 3500 report two WBC counts:
WOC (WBC Optical Count)
primary count is derived from the Optical Laser Assembly
WIC (WBC Impedance Count)
the secondary or Delta-check count is derived from the WBC Transducer Assembly
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9. Neutrophils Neutrophils: Other synonymous terms: Appearance:
comprise 34% to 75%* of the white cells in normal blood 
circulate in the blood for several hours before migrating out into the tissues
are the shortest-lived WBCs and probably only survive in the tissues for a few days.
Other synonymous terms:
polymorphonuclear leukocytes (PMNs, polys)
segmented leukocytes (segs).
Appearance:
purple granules in the cytoplasm
lobulated (multilobed) nucleus
pink abundant cytoplasm
Functions:
phagocytic cells which seek out bacteria or other infectious agents and phagocytize or engulf them
major cellular constituent of pus
numbers are increased in response to infection
The most common immature neutrophil seen in the blood is called a band neutrophil. This cell is similar to the mature neutrophil, but has a characteristic nucleus which is elongated and is not segmented.
Neutropenia = too few neutrophils
Neutrophilia = too many neutrophils
Band (Immature Neutrophil)
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*Note: reference ranges are from Williams Hematology 5th edition and Abbott Hematology Continuing Education Series WBC, 2001

10. Lymphocytes Lymphocytes (lymphs): Other synonymous terms: Appearance:
comprise about 20% to 47%* of WBCs in normal blood 
circulate in the blood and populate the lymph nodes, spleen, and thymus
may also be found in organs of the body such as the skin, lungs, and gastrointestinal tract.
major types of lymphocytes are T cells, B cells, and Natural Killer (NK) cells
Other synonymous terms:
T cells, B cells, and NK cells
Appearance:
cells vary in size, but are usually round
smallest of the WBC types; they are just slightly larger than RBC's
have slightly indented dark-staining nucleus (the nuclear material is not clumped)
do not have granules in cytoplasm
contain a small amount of cytoplasm which stains basophilic (a bluish color derived from basic stain)
Note: some lymphocytes, especially those formed in reaction to certain viral infections, are much larger and have more abundant cytoplasm
Functions:
major cellular component of the immune system and antibody production
viral infections can either increase or decrease the total percentage of lymphocytes
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*Note: reference ranges are from Williams Hematology 5th edition and Abbott Hematology Continuing Education Series WBC, 2001

11. Monocytes Monocytes (monos): Other synonymous terms: Appearance:
comprise 3% to 10%* of the white cells in normal blood 
circulate in the blood before migrating out into the tissues, where they differentiate into macrophages
Other synonymous terms:
Macrophage
Appearance:
a little larger than the granulocytes
have pale blue/gray cytoplasm with no granules
bean shaped, oval, horseshoe, or kidney shaped nucleus
nuclear material is less dense than in lymphocytes
Functions:
play an important role in the body’s defense against intracellular bacteria and fungi
mature into macrophages (important germ-eating cells)
phagocytosis of cellular debris that results from normal wear-and-tear on the body
degrade foreign materials into small fragments that lymphocytes can recognize and initiate an immune response to
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*Note: reference ranges are from Williams Hematology 5th edition and Abbott Hematology Continuing Education Series WBC, 2001

12. Eosinophils Eosinophils (eos): Appearance: Functions:
comprise about 0% to 5%* of the white cells in normal blood 
type of phagocyte that produces the anti-inflammatory protein histamine, can be seen in people with allergies or parasitic infections
Appearance:
prominent, coarse granules that stain intensely orange with Wright’s stain
Bi-lobed nucleus
abundant cytoplasm
Functions:
important in the host’s defense against parasites and in allergic reactions
numbers can dramatically increase during parasitic infestations
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*Note: reference ranges are from Williams Hematology 5th edition and Abbott Hematology Continuing Education Series WBC, 2001

13. Basophils Basophils (basos): Appearance: Functions: least common WBC
comprise about 0% to 3%* of the white cells in normal blood 
role of blood basophils is not known with certainty, but they are closely related to tissue mast cells
Mast cells release mediators, such as histamine, important in the host’s defense against parasites and in allergic reactions
Appearance:
smallest circulating granulocytes
prominent, coarse granules that stain deep blue to violet
multilobed nucleus
abundant cytoplasm
Functions:
play a central role in inflammatory and immediate allergic reactions
numbers are increased in allergic or inflammatory states, iron deficiency, some infections, hematopoietic malignancy, or premalignant states
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*Note: reference ranges are from Williams Hematology 5th edition and Abbott Hematology Continuing Education Series WBC, 2001

14. RBC (Erythrocytes) Red Blood Cells (RBC): Normal RBCs
limited life span of around 100 to 120 days
contain hemoglobin
Red Blood Cell Indices:
calculations or measures that allow the characteristics of size and content of an average red cell to be determined. They include:
Mean Cell Volume (MCV), Mean Cell Hemoglobin (MCH), and Mean Cell Hemoglobin Concentration (MCHC)
Appearance:
usually appear round or oval and are reddish color from the protein hemoglobin
stain darker at the edges than in the middle reflecting their biconcave shape
Functions:
red blood cells carry oxygen to organs and tissues
Clinical Utility:
Anemia - one of the more common blood disorders, occurs when the number of healthy red blood cells decreases
Polycythemia – excess number of red blood cells
Hereditary Disorders
Normal RBCs
Abnormal RBCs
RBC with inclusions
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Nucleated RBC
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15. Hemoglobin (HGB) Hemoglobin (Hgb): Functions: Clinical Utility:
Hemoglobin molecule
Hemoglobin (Hgb):
is a red colored protein pigment found within RBC's
consists of two basic parts:
the iron containing pigment heme
the protein globin
Functions:
main function of hemoglobin is oxygen uptake in the lungs, carriage in the RBC's and release in other tissues.
also carries CO2
powerful buffering agent in the maintenance of blood pH levels
Clinical Utility:
Anemia is defined as a reduction in the number of circulating Red Blood Cells or in the quantity of hemoglobin
Most anemia’s are characterized by a decrease in the concentration of Red Blood Cellular hemoglobin
Most common type of anemia overall is iron deficiency
Thalassemia is a hereditary condition that results in abnormal hemoglobin formation
Sickle Cell Anemia – hereditary condition, Hemoglobin S
Sickle Cell Anemia
Thalassemia Major
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16. Hematocrit (HCT) (RBC x MCV)/10 = HCT
proportion of the whole blood that consists of packed Red Blood Cells
expressed as a percentage by volume
Other synonymous terms:
“crit”
Calculation:
The Hematocrit is calculated on the CELL-DYN 3700 using the following formula:
(RBC x MCV)/10 = HCT
Clinical Utility:
A low Hematocrit percentage can be a indicator of anemia
A high Hematocrit percentage can be associated with dehydration and smoking
Volume of packed
Red Blood Cells
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17. RBC Index: Mean Cell Volume (MCV)
indicates the volume of the "average" red cell in a sample
is expressed in femtoliters (fL; liters)
Other synonymous terms:
Mean Corpuscular Volume
Direct Measurement:
MCV on the CELL-DYN Systems is a direct measurement
Traditionally, MCV was a calculated parameter, derived by using the following formula: MCV = (HCT ÷ RBC) x 10
Clinical Utility:
MCV is of considerable importance in the differential diagnosis of anemia
A high MCV may indicate anemia due to vitamin B12 or folic acid deficiency
A low MCV may indicate anemia due to iron deficiency
Abnormal RBCs
Macrocytosis: larger than normal RBCs
Microcytosis: smaller than normal RBCs
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18. RBC Index: Mean Cell Hemoglobin (MCH)
the hemoglobin content of an "average" red cell in a sample
expressed in picograms (pg) per cell
Other synonymous terms:
Mean Corpuscular Hemoglobin
Calculation:
The MCH is calculated on the CD3700 using the following formula:
HGB / RBC x 10 = MCH.
Clinical Utility:
MCH has a close relationship with the MCV, either increasing or decreasing with the MCV
A high MCH is commonly due to macrocytic anemia.
Macrocytic anemia is a blood disorder in which not enough red blood cells are produced, but the ones that are present are large (thus containing more hemoglobin)
A low MCH can be due to loss of blood over time, too little iron in the body, or microcytic anemia
Normal RBCs
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19. RBC Index: Mean Cell Hemoglobin Concentration (MCHC)
indicates the hemoglobin concentration in the RBC mass
expressed in grams per deciliter (g/dL)
Other synonymous terms:
Mean Corpuscular Hemoglobin Concentration
Calculation:
The MCHC is calculated on the CD3700 using the following formula:
(HGB / (MCV x RBC)) x 100 = MCHC
Clinical Utility:
Used in conjunction with other RBC indices
Normal RBCs
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20. Red Cell Distribution Width (RDW)
the width of the RBC histogram is called the Red Cell Distribution Width or RDW
a measure of the differences in cell sizes of the RBC population, the more variation in size the higher the RDW value
expressed in percent
Histogram:
a graphic representation of cell frequencies versus size
in a homogeneous cell population, the curve assumes a symmetrical bell-shape
a wide or more flattened curve is seen when the standard deviation from the mean is increased
shifts in one direction or another can be of diagnostic importance
Clinical Utility:
If anemia is suspected, based on other blood counts, RDW test results are often used together with MCV results to figure out what the cause of the anemia might be
May differentiate Thalassemia from iron deficiency
Histogram
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21. Platelets (PLT) Platelets: Other synonymous terms: Appearance:
the smallest blood cell
normally between 150, ,000* platelets in each microliter of blood  
involved in the process of blood clotting
Other synonymous terms:
thrombocytes
Appearance:
central granules which stain red-purple surrounded by light blue
Functions:
aggregate (clump together) to plug small holes in damaged blood vessels
release phospholipids necessary for coagulation
Clinical Utility:
Low platelet counts or abnormally shaped platelets are associated with bleeding disorders
High platelet counts sometimes indicate disorders of the bone marrow
Giant Platelet
thrombocytopenia = too few platelets
thrombocytosis= too many platelets
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*Note: Reference range from Abbott Hematology Continuing Education Series RBC Indices, 1996

22. Mean Platelet Volume (MPV)
average volume of a Platelet
expressed in femtoliters
Calculation:
Mean Platelet Volume (MPV) is derived from the PLT histogram after the PLT count has been determined
MPV is a calculated value derived from the Plateletcrit and Platelet count
The Plateletcrit (PCT) is the product of PLT and MPV and is analogous to the hematocrit. It is calculated as follows:
PCT = (PLT x MPV)/10
Histogram:
a graphic representation of cell frequencies versus size
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23. WIC Count Time
An absolute cell count cannot be obtained unless the precise volume of diluted whole blood that passes through the aperture during the count cycle is known. The CELL-DYN3000 Series utilizes a volumetric metering process to regulate the count cycle and ensure that a precise volume of sample is used.
WIC Count time is used to regulate the WBC count cycle in the WIC Transducer Assembly.
WIC count time (WCT) is the time it takes for the meniscus in the WBC metering tube to go from the first sensor to the second sensor.
It can be reviewed in the Diagnostic – Raw Data Summary screen along with the Upper Count time. This data is only available for the last sample run.
Upper Detector
Count Initiated
Meniscus
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Count
Volume
Lower Detector
Count Completed

24. RBC Count Time
An absolute cell count cannot be obtained unless the precise volume of diluted whole blood that passes through the aperture during the count cycle is known. The CELL-DYN3000 Series utilizes a volumetric metering process to regulate the count cycle and ensure that a precise volume of sample is used.
RBC count time (RCT) is the time it takes for the meniscus in the RBC metering tube to go from the first sensor to the second sensor.
It can be reviewed in the Diagnostic – Raw Data Summary screen along with the Upper Count time. This data is only available for the last sample run.
Upper Detector
Count Initiated
Meniscus
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Count
Volume
Lower Detector
Count Completed

25. 90 – 10 Degree Scatterplot
As cells enter the flow cell laser intercept area they scatter the laser light at different angles, yielding information about cell size, internal structure, granularity and surface morphology.
The optical signals the cells generate are detected and converted to electrical impulses which are then stored and analyzed by the computer.
The first step is the the 90 degree and 10 degree scatterplot used to determine whether the WBC’s are either Mono or Polynuclear cell types.
The customer can select up to 9 different angles of scatter to display.
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26. 0-10 Degree Scatterplot
As cells enter the flow cell laser intercept area they scatter the laser light at different angles, yielding information about cell size, internal structure, granularity and surface morphology.
The optical signals the cells generate are detected and converted to electrical impulses which are then stored and analyzed by the computer.
The 0 degree and 10 degree scatterplot is the final step used to determine the five different WBC types.
The mononuclear cells are plotted on this scatterplot. The algorithm also uses the orientation of the neutrophil cluster to aid in classifying the mononuclears.
Basophils are included in the mononuclear cluster because their granules dissolve in the Sheath Reagent.
The customer can select up to 9 different
angles of scatter to display.
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27. RBC Histogram This is a graphical representation of the RBC count.
On the Y axis is total number of events or cells that passed through the aperture during the count cycle in the RBC Transducer.
The X-axis is the size or channels each event fell in based on the amplitude of the signal generated during the count cycle.
The channel size used for RBC calculation is equal to fL.
The data derived is used in the absolute RBC count and the MCV value.
Histogram
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28. Platelet Histogram
This is a graphical representation of the Platelet count.
On the Y axis is total number of events or cells that passed through the aperture during the count cycle in the RBC Transducer.
The X-axis is the size or channels each event fell in based on the amplitude of the signal generated during the count cycle.
The channel size used for PLT calculation is equal to fL.
The data derived is used in the absolute PLT count and the MPV value.
Histogram
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29. In this training program you were familiarized with:
Summary
In this training program you were familiarized with:
what the numbers and graphics on the CELL-DYN 3000 Series display are relating to
common terminology used in hematology reports
Blood Cell types
Blood Cell appearance characteristics
how indices are derived
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