EXAMPLES OF COMMON BLOOD CELL COUNT
ANALYSES, MADE IN DIFFERENT LABORATORIES
AND REFERENCE VALUES.
PAY ATTENTION: reference values of normal parameters can differ depending from age,
sex, race, laboratory equipment etc. Results of laboratory investigations are interpreted in
consideration of other clinical/laboratory examinations.
For example, some age/sex differences in adults are shown in the following research:
Full blood count normal reference values for adults in France
J Clin Pathol 2014;67:341-344 doi:10.1136/jclinpath-2013-201687
Table 3 (http://jcp.bmj.com/content/67/4/341/T3.expansion.html)
Full blood count normal reference values defined by values comprised between the 2.5 and
97.5 percentiles
Men (years) Min–max
Haematocrit (%)
Haemoglobin (g/L)
16–69
16–69
16–29
30–59
12
Red blood cells (10 /L) 60–69
16–19
20–39
40–49
50–59
MCV (fL)
60–69
16–19
MCH (pg/cell)
20–69
MCHC (g/L)
16–69
16–49
50–59
60–69
9
Leucocytes (10 /L)
16–49
50–59
9
Neutrophils (10 /L)
60–69
39.2–48.6
134–167
4.53–5.79
4.38–5.65
4.28–5.57
78.0–91.9
79.6–94.0
81.0–94.9
82.2–96.3
82.1–97.0
26.3–32.1
27.3–32.8
324–363
4.09–11.00
4.06–10.46
4.05–9.92
Women (years)
16–44
45–54
55–69
16–49
50–54
55–69
16–29
30–49
50–69
16–19
20–29
30–39
40–69
16–29
30–69
16–69
16–44
45–49
50–54
55–69
1.780–6.946 16–44
1.915–6.634 45–49
1.847–6.138 50–54
Min–max
34.4–43.9
34.7–44.6
35.9–44.6
115–149
118–151
121–150
4.01–5.19
3.93–5.09
3.99–5.12
75.7–92.7
74.7–94.2
77.9–95.3
79.9–95.6
24.4–32.1
26.4–32.6
319–358
4.02–11.42
4.01–11.02
3.78–9.70
3.78–9.42
1.750–7.500
1.812–7.154
1.720–6.299
Men (years) Min–max
Eosinophils (109/L)
9
Basophils (10 /L)
Lymphocytes (109/L)
16–19
20–29
30–59
60–69
16–39
40–69
16–39
40–69
Women (years)
55–69
0.046–0.630 16–19
0.048–0.593 20–49
0.046–0.547 50–69
0.052–0.576
0.000–0.097 16–19
0.000–0.091 20–69
1.340–3.919 16–29
1.241–3.617 30–69
16–39
0.228–0.773 16–29
0.201–0.714
40–69
0.233–0.725 30–49
0.205–0.663
16–59
60–69
16–69
50–69
16–54
55–69
16–69
0.192–0.608
185–445
187–420
7.5–10.9
Monocytes (109/L)
9
Platelets (10 /L)
MPV (fL)
172–398
161–393
7.4–10.8
Min–max
1.692–5.839
0.040–0.576
0.041–0.549
0.044–0.474
0.000–0.081
0.000–0.085
1.370–3.966
1.240–3.561

Min, minimum, 2.5 percentiles; Max, maximum, 97.5 percentiles.

MCH, mean corpuscular haemoglobin; MCHC, mean cell haemoglobin concentration;
MCV, mean cell volume; MPV, mean platelet volume.
If you wish to understand in detail the process of explanation of laboratory tests to patients,
we recommend the following article:
Explaining laboratory test results to patients: what the clinician needs to know
BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h5552 (Published 03 December 2015)
http://www.bmj.com/content/351/bmj.h5552?etoc
We recommend students to train themselves in diagnostics of hematologic conditions in
laboratory reports. Please see some examples on the following pages.
Example of blood analysis of patient with acute myeloid leukemia
http://pfyziollfup.upol.cz/castwiki2/?p=13090
Examples of CBC from different laboratories:
http://www.leukos.us/archives/entry_91.asp
http://jmmultiplemyeloma.blogspot.cz/2012/08/2nd-asct-day-82-august-8-2012.html
http://knowyourblood.com/understanding-your-cbc-complete-blood-count-test-results/
Changes of neutrophils and WBC
Premature release of the immature white cells is responsible for the phenomenon known as a
shift-to-the-left
Neutrophils
Myeloblasts
Promyelocytes
Myelocytes
Metamyelocytes
Bands
Polysegmented
Normal
values
0
0
0
0-1
1-5
45-70
Acute
bacterial
inflammation
(moderate)
0
0
0
↑
↑
N or ↑,
sometimes ↓
Acute
/chronic
bacterial
inflammation
(severe)
Acute
/chronic
bacterial
inflammation
(severe)
= regenerative shift-to-the-left, release of increased quantity of metamyelocytes and bands from
bone marrow
0
↑ or 0
↑
↑
↑
N or ↑,
sometimes ↓
= hyperregenerative shift-to-the-left, hyperactivation of bone marrow in case of insufficiency of
protective mechanisms against the infection
0
0
0
0
↑,
↓ or N,
degenerative
degenerative
changes
changes
= degenerative shift-to-the-left, can be the sign of toxic injury/depletion of bone marrow
Acute
myeloid
leukemia
↑↑
0 or 1-2
0 or 1-2
N or ↑
N or ↑
N or ↓
Chronic
myeloid
leukemia
↑
↑
↑
↑
↑
N, ↑ or ↓
Leukemoid
reaction
0 or ↑
0 or ↑
0 or ↑
↑
↑
N, ↑ or ↓
Right shift
0
WBC is usually >50 *10^9, the reason for ↑ in WBC is usually known and prominent
0
0
0
0
N, ↑ or ↓
(=depletion of bone marrow)
In inflammation, caused by bacteria (for example in patients with appendicitis/bacterial
tonsillitis) number of young forms of neutrophils (metamyelocytes and band forms) increases
(= left shift in leukocyte formula)
Studies consistently show that 80-85% of adults with appendicitis have a white blood cell
(WBC) count greater than 10,500 cells/µL. Neutrophilia greater than 75% occurs in 78% of
patients. Less than 4% of patients with appendicitis have a WBC count less than 10,500
cells/µL and neutrophilia less than 75%. http://emedicine.medscape.com/article/773895workup#c8