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Does the band cell survive the 21st century?

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van der Meer W, van Gelder W, de Keijzer R, Willems H. Does the band cell survive the 21st century?

Eur J Haematol 2006. © Blackwell Munksgaard 2006. Abstract: 

Objectives: The differentiation of white blood cells is a worldwide-accepted method to obtain medical information. The conventional microscopic differential, however, is a laborious and expensive test with a low statistical value. Especially for band cell identification there is a wide range of variance. In this report we describe the intervariability of band cell enumeration. Methods: From a septic patient, an EDTA anti-coagulated blood sample was obtained and a smear was made and stained (May-Grünwald Giemsa). A PowerPoint presentation was made twice of 100 random cells and sent to 157 different hospital laboratories in the Netherlands for a leukocyte differential. In the first survey neutrophils were differentiated in segmented and band neutrophils whereas in the second survey no discrimination was made between segmented and band neutrophils. Results: The first survey was responded by 68% of the laboratories (756 individuals) and the second survey by 73% of the laboratories (637 individuals). The laboratory mean values of the segmented neutrophils were 42.9% (SD: 7.8, range 22–64%) and 69.9% (SD: 1.4, range 62–72%) for the first and second survey respectively. For the individual technicians the values of the segmented neutrophils were 43.9% (SD: 11.2, range 15–72%) and 70.0% (SD: 2.0, range 59–77%) for the first and second survey respectively. Conclusions: Because of the enormous variation of band cell counting we recommend to cease quantitative reporting of band cells, especially since the results only have a clinical relevance in a limited number of pathological circumstances.
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Keywords: band cells; differentials; intervariation; left shift

Document Type: Research Article

Affiliations: 1: Department of Clinical Chemistry, Radboud University Nijmegen Medical Center, The Netherlands 2: Department of Clinical Chemistry, Albert Schweitzer Hospital Dordrecht, The Netherlands 3: Department of Clinical Chemistry, Hospital Rivierenland Tiel, The Netherlands

Publication date: March 1, 2006

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