Refrigerated storage improves the stability of the complete blood cell count and automated differential

A CBC count was performed on 113 random patient and 21 control specimens before and after 24-hour room temperature (RT) storage; 98 random patient and 20 control specimens also were analyzed before and after 24 hour 4 degrees C storage. The Cell-Dyn 3500 (Abbott Laboratories, Abbott Park, IL) was used for analysis. RT storage showed a decline in WBC count using the optical but not the impedance method, resulting in a large number of WBC flags. An increase in mean corpuscular volume also was seen for patient specimens. The automated WBC differential showed a decrease in the percentage of neutrophils and an increase in the percentage of lymphocytes, owing primarily to neutrophil degeneration. These changes also were seen in the manual differential to a similar degree. Storage of specimens at 4 degrees C largely prevented all of these changes. The implementation of refrigerated specimen storage is a simple, inexpensive method to improve the accuracy of CBC results for aged specimens on automated hematology analyzers.