Identification and Enumeration of Nucleated Red Blood Cells in Peripheral Blood

• Identification and Enumeration of Nucleated Red Blood Cells in Peripheral Blood

AUTHOR(S)

Bernard J FERNANDES

Department of Laboratory Medicine, Mount Sinai Hospital and University of Toronto

SUMMARY

Erythropoiesis is an exquisitely regulated process that results in the production of red blood cells. In humans, nucleated red blood cells ( NRBC ) do not appear in the peripheral blood except in the fetal and neonatal periods. The presence of NRBC in the peripheral blood in adults and children and elevated counts in neonates is encountered in many disease states and associated with a poor prognosis. Traditional methods for identification and enumeration of NRBC in the peripheral blood by manual morphology is time consuming and has low precision. The Sysmex XE-2100 automated hematology analyzer generates an automated NRBC count using a combination of technologies. The automated NRBC count has a high degree of precision, a wide range of linearity and compares favorably with the manual morphology method and with a proposed flow cytometric reference method. When the instrument is run in a discreet complete blood count ( CBC )/ differential mode, the " NRBC? " suspect flag is efficient for screening for the presence of NRBC in peripheral blood. The XE-2100 NRBC count is robust, precise and accurate and represents an important advance in the analytic capabilities of the clinical hematology laboratory.

KEY WORDS

Nucleated Red Blood Cell, Identification, Enumeration, Automated Hematology Analyzer, XE-2100, Complete Blood Count