Hematology Primer
Slang and
Short forms
The CBC (Complete Blood Count)—used for screening and diagnosis.
Sample Collection
Venipuncture, fingerstick or heel stick
Purple (lavender) top tube containing EDTA (anticoagulant)
Processing
Check for appropriate sample (clots, sufficient quantity)
Slide (blood smear) using Wright Stain, a combination of eosin & methylene blue
dyes
Analysis
Spun hematocrit (cap crit, microhematocrit) __________
Hemogram
White cell count (5-10,000/mm3) _______
Red cell count (4.8-5.6 x106/mm3, slightly lower in females) ________
Hemoglobin (12-16 g/dL) __________
Hematocrit (hgb x 3 = hct) 36%-48%--the percentage of whole blood composed
of red cells _________
Red cell indices, measure of red cell size (MCV), size variation (RDW) and
hemoglobin content (MCH, MCHC)
Platelet count—extruded fragments of megakaryocytes (150,000-400,000) _____
aniso
basos
cap crit
crit
diff
eos
H/H
hct
hgb
lymphs
monos
nucs
plt
PMNs
poik
polys
RBC
retics
schistos
segs
WBC
poly
Differential—reports the percentage of each white cell type (leukocytes) __________
Automated—may be reported in decimals and may add up to 100 +/- 1
Manual—always reported in whole numbers and should always total 100
Cell types
Granulocytes
Polymorphonuclear leukocytes ________
Segmented neutrophil normal 40%-70% __________
Bands (stabs) 4%-8%
Neutrophilic metamyelocyte (youngs, juveniles) (abnormal)
Basophils—large, dark blue granules 0-1% ________
Eosinophils—large dark red granules 0%-5% ________
Lymphocytes 25%-40% )________
Monocytes 5%-8% ________
Blasts—usually indicative of a myeloproliferative/myelodysplastic disorder
(e.g. leukemia, polycythemia vera)
Characteristics seen on visual examination of Wright-stained smears:
Combing Forms:
an- without
chrom- color
crit (Gr. Krinos) to
separate
cyt- cell
globin- a protein
hemo- blood
hypo- decreased
leuko- white
macro- large
micro- small
myelo- marrow
normo- normal
poikilo- varying
shapes
poly- many
thrombo- clot
White cells
-penia deficiency
-emia blood
-cytosis increased
number of cells
-osis abnormal or
disease state
Toxic granulation (heavy granulation seen in neutrophils)
Vacuoles (especially in monocytes)
Atypical lymphocytes (often seen in infectious mononucleosis)
© Laura Bryan MT (ASCP), CMT
1
February 2007
Hematology Primer
Nucleoli (an indication of an immature nucleus)
Auer rods (pathognomonic for acute myelogenous leukemia)
Drugs for
anemia:
Red cells, graded 1+ (<10% of cells affected) to 4+ (>75% cells affected)
Polychromasia—purplish-red to bluish-red cells, correlates with reticulocyte
count. ________
Macrocytes—large (correlates with MCV greater than 98)
Microcytes—small (correlates with MCV less than 82)
Hypochromic—pale centers due to decreased hemoglobin, correlates with
MCHC of less than 32 g/dL
nRBC (normoblast)—immature red cell with nucleus _______
Poikilocytosis—variation in the shape of the red cells _______
Anisocytosis—variation in the size of red cells (correlates with RDW
greater than 15%) _____
Schistocytes—remnants, shreds of red cell membranes ________
Target cells—indicative of hemoglobinopathy
Spherocytes—spherical cells (instead of normal biconcave)
Sickle cells—sickle-shaped cells seen in sickle cell patients
Platelets—may be abnormal size (giant platelets) or clumped ________
Reticulocyte Count—percent of immature red cells (using methylene blue stain) _______
Hematologic Diseases
Myelodysplastic/myeloproliferative diseases including monocytic and myelocytic
leukemias (AML, CML)
Lymphocytic diseases including lymphomas (ALL, CLL, Hodgkin and non-Hodgkin
lymphoma)
FAB (French-American-British) classification system for leukemias
Anemia
Hemoglobinopathies
Sickle cell
Thalassemia
Nutrition/malabsorption
Iron deficiency anemia—either poor intake/absorption or insufficient intake to
compensate for chronic blood loss
Pernicious anemia—deficiency of B12 due to poor diet or lack of intrinsic
factor
Hereditary spherocytosis—cell membrane defect causing fragility and decreased
cell lifespan
Polycythemia vera—increase in red cell count to as much as 70%, treated with
therapeutic phlebotomy
© Laura Bryan MT (ASCP), CMT
2
February 2007
Folate, folacin
Apo-Folic
cyanocobalamin
(B12)
Epoetin alpha
EPO
RHEUPO-α
Epogen
Procrit
Fergon
Ferro-Sequels
ferrous sulfate
Slow FE
For
Polycythemia:
Mustargen
Busulfex
Myleran