In the event of pseudoleukopenia in leukemia patients, what is the recommended action to ensure accurate WBC counts?

In cases of pseudoleukopenia among leukemia patients, it is essential to obtain an accurate white blood cell (WBC) count. Pseudoleukopenia refers to an apparent low white blood cell count that can occur in certain conditions, including leukemia, due to the clumping of leukocytes or their sequestration.

Preparing a manual WBC count using a hemacytometer is the recommended action in this scenario because it allows for direct visualization and counting of cells, which can help avoid the inaccuracies that may arise from automated analyzers. Manual counting provides a more precise assessment of the WBC population, as it allows the technologist to observe any abnormalities in the cell morphology or clumping that could affect the automated readings.

In contrast, while administering a WBC growth factor may be beneficial for some patients to increase WBC levels, it does not address the immediate need for accurate counting. Repeating the automated count or using a different analyzer may also yield the same erroneous results if the underlying issues causing pseudoleukopenia are not addressed, such as cell clumping or other artifacts that automated systems may not detect. Thus, a manual count effectively circumvents these issues and ensures reliable data for clinical decision-making.