A critical evaluation of the manual/visual differential leukocyte counting method

The performance of differential leukocyte counting by 73 technologists and technicians working in 5 different laboratories in a large medical center was evaluated. Good correlation with the reference method was found for neutrophils, normal lymphocytes, and eosinophils. More variability was noted in the estimation of stab neutrophils and variant (atypical) lymphocytes and monocytes. The sensitivity of this method for clinically important conditions ranged from 100% to 34%, depending upon the abnormality.