What can be done to prevent discrepancies between automated WBC counts and estimates caused by smudge cells?

To address discrepancies between automated white blood cell (WBC) counts and manual estimates due to smudge cells, using 22% bovine albumin can be highly effective. Smudge cells are often seen in conditions like chronic lymphocytic leukemia and are fragile lymphocytes that can become damaged during the process of cell counting. When these cells rupture, they can cause inaccuracies in automated counts, as the analyzer may misinterpret them or fail to count them entirely.

Adding bovine albumin to the sample helps stabilize the smudge cells, reducing their fragility and preventing further damage during processing. This stabilization allows for a more accurate representation of the true WBC count, as the albumin provides a protective effect and helps maintain cell integrity, enabling the automated analyzer to detect and count the cells more effectively.

In contrast, diluting samples further with saline could potentially dilute the true concentration of cells, making the problem worse rather than better. Using a lower speed on the analyzer might not be effective because the mechanical processes involved in counting might still lead to the same discrepancies. Increasing the incubation time for the sample does not directly address the issue of smudge cells and could lead to more deterioration rather than stabilization.

Overall, incorporating 22% bovine albumin