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Peripheral blood monocyte counting: towards a new reference method

W Hübl1, S Andert, A Erath

  • 1Institut für Klinische Chemie, Wilhelminenspital, Wien, Austria.

European Journal of Clinical Chemistry and Clinical Biochemistry : Journal of the Forum of European Clinical Chemistry Societies
|November 1, 1995
PubMed
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Flow cytometry offers a precise and accurate method for counting monocytes, outperforming manual differentials. This advanced technique is ideal for evaluating hematology analyzers and establishing a new reference standard for monocyte enumeration.

Area of Science:

  • Hematology
  • Immunology
  • Clinical Chemistry

Background:

  • Monocyte counting is crucial for diagnosing and monitoring various medical conditions.
  • Traditional manual differential counts can be labor-intensive and prone to variability.
  • Flow cytometry using fluorescence-labeled monoclonal antibodies is emerging as a potential reference method.

Purpose of the Study:

  • To compare the precision and accuracy of monocyte counting using automated hematology analyzers and flow cytometry against manual differentials.
  • To evaluate flow cytometry as a potential reference method for monocyte enumeration.

Main Methods:

  • Compared monocyte counts from Coulter STKS, Cobas Argos 5 Diff, manual differential, and Coulter Epics Profile II flow cytometer.
  • Utilized double-staining with CD45-FITC and CD14-PE fluorescence-labeled monoclonal antibodies for flow cytometry.

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  • Assessed precision and accuracy using normal and abnormal samples, and analyzed sex-based differences in monocyte counts.

    • Main Results:

    • Automated methods (STKS, Argos, Profile II) demonstrated superior precision compared to manual differentials.
    • Good correlation was observed between automated methods and manual counts (STKS: r=0.934, Argos: r=0.808, Profile II: r=0.924).
    • Flow cytometry (Profile II) showed minimal bias and identified higher monocyte counts and wider normal ranges in males compared to females.

    Conclusions:

    • Flow cytometry provides an efficient and accurate tool for evaluating monocyte counting performance of hematology analyzers.
    • Flow cytometry is a suitable successor to the manual differential for establishing a reference method for monocyte counting.
    • Sex-specific reference ranges for monocyte counts should be considered.