Peripheral Blood Cell Analyses

The Clinical Cytometry Society (CCS) guidelines recommend using peripheral blood for flow cytometry.¹ The table below provides information for red blood cell (RBC) and white blood cell (WBC) sample preparation.¹

Erythrocyte Testing^2,3

• PNH populations are the easiest to analyze in RBCs, but the proportion of these cells relative to the proportion of other PNH cell types is often misleading because they are easily destroyed by terminal complement. Therefore, the PNH RBC proportion may not reflect the true PNH stem cell population or clone size
• Patients with PNH frequently receive packed RBC transfusions, which serve to dilute the PNH RBC clone, further contributing to a confounded result that may not reflect the true PNH clone size

Granulocyte Testing^2,3

• Granulocyte analysis provides the most accurate assessment of the true PNH stem cell population or clone size because these cells are not sensitive to complement-mediated destruction and are not subject to dilution during the frequent transfusions that many patients receive
• The number of granulocytes sufficient for flow cytometry can be difficult to obtain in some patients and the results from a single antibody staining can be suspect; thus, the CCS guidelines recommend using multiple antibodies

Monocyte Testing^2,3

• Like granulocytes, the numbers of monocytes sufficient for flow cytometry can be difficult to obtain in some patients and the results from a single antibody staining can be suspect; thus the CCS guidelines recommend using multiple antibodies

Next: Reagents for Flow Cytometry