[JordanN]

Hi, Everyone!

My father has a CBC and white cell differential done twice a week. These are standing orders that I don't think the doctor alters from week to week. The particular laboratory he uses reports the percentages of white cells, the morphology of the platelets, and the morphology of the red cells all under the heading of "white cell differential."

We have noticed that each time we get the results there are a large number of differences in what is included in the report. For example, on Monday the report will show myelocytes, dacrocytes, ovalocytes, but on Thursday these items are absent. I am wondering if these cells aren't seen on one day but are on another or if the doctor is specifically ordering a check for certain items at certain times. There doesn't appear to be any pattern for when certain items show up or disappear.

Does a differential report anything that the pathologist sees even if not specifically ordered by the doctor or are certain tests such as red cell morphology, blast counts, etc only reported if ordered by the doctor? Do the variable counts really reflect that one day he as a huge variety of abnormal cell shapes (6 or 7 types) in large quantities (1+ to 3+) and two days later he only has one or two abnormal cell types? The recent appearance of some items such as blasts in the peripheral blood is concerning, and I'm wondering if blasts were not there before but are now (only 1% now), or if they have been there all along and the doctor is only now asking to report it.

Thank you as always for all the wisdom and support everyone on this forum gives to all of its members! You are all an amazing group of people!