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Assignment
SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIRMENTS
FOR THE DEGREE IN
MEDICAL LABORATORY TECHNOLOGY (MLS)
SUBMITTED TO: SUBMITTED BY:
Name: Mam Rafia Name: Muhammad Hashim
Subject: Hematology Roll No: 35724
Riphah International University MLS(MLT) 2nd Semester
RIPHAH INTERNATIONAL
UNIVERSITY FAISALABAD
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Comparative Diagnostic Differences Between Different
Parts of Hematology Analyzer
Introduction
Automated hematology analyzers are used in clinical laboratories to monitor health conditions.
Although there are different parts of analyzers of different companies on the base of the
information they provide.
A complete blood count (CBC) is the first test requested by a physician to evaluate a patient’s
general health status. CBC is used to measure the oxygen-carrying red blood cells (RBC), the
platelets (PLT) that help clot the blood, and the white blood cells (WBC) of the immune system.
As part of the CBC, a WBC differential is conducted. Traditionally, a laboratory technician uses a
microscope to manually count 100 WBC and differentiate them into neutrophils (NEU),
lymphocytes (LYM), monocytes (MONO), eosinophils (EOS), and basophils (BASO). Each cell type
is reported as a percentage of total WBC, and a shift in the percentage indicates a condition.
1. 3 Part Analyzer
The 3-part analyzer is the most basic form of automated CBC analyzer, ideal for small to medium
laboratories due to its cost-effectiveness and ease of maintenance. Uses electrical impedance to
count and size blood cells, and colorimetric or cyanmethemoglobin methods to measure
hemoglobin concentration.
While sufficient for routine hematology and general screenings, 3-part analyzers lack detailed
leukocyte differentiation, which can lead to limitations in detecting early leukemic or
inflammatory changes.
WBC Differential (3 Parts):
1. Lymphocytes
2. Neutrophils
3. MID/Mix (Monocytes, Eosinophils, and Basophils combined)
Parameters Reported:
22 parameters WBC, LYM, MID, GRAN, LYM%, MID%, GRAN%, RBC, MCV, HCT, PLT, MPV, HGB,
MCH, MCHC, RDW%, RDW, PCT, PDW%, PDW, P-LCR, P-LCC
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Examples:
• Swelab™Alfa
3 parts CBC analyzer.
• Sysmex XP-100
2. 5 parts Analyzers
The 5-part analyzer is an advancement that have flow cytometry, optical detection, and reagent-
based RBC lysis to provide detailed WBC differentiation. It classifies leukocytes into five distinct
types.
Compared to 3-part analyzers, the 5-part models have higher diagnostic precision, particularly
in detecting leukemias, infections, and allergic or parasitic disorders where eosinophil and
basophil differentiation is critical. 5-part analyzers have superior sensitivity and specificity for
detecting abnormal white cell populations and differentiating immature from mature
granulocytes. The optical detection method allows morphological correlation and flagging of
abnormal scattergrams, aiding in disease detection. However, the instruments are more
expensive and require greater maintenance, making them better suited for hospital and
research laboratories where high diagnostic accuracy is essential.
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Principle:
includes reagent-based lysis to remove RBCs and isolate WBCs for optical analysis.
Fig: Working principle of 5-Part Analyzer
A 5-part hematology analyzer differentiates and counts five types of WBCs:
1. Neutrophils
2. Lymphocytes
3. Monocytes
4. Eosinophils
5. Basophils
Fig: 5 parts vs 3 Parts CBC Analyzer
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Example:
• Swelab Lumi
Clinical parameters:
RBC, MCV, HCT, RDW-CV, HGB, MCH,MCHC, PLT, MPV, , WBC, LYM#, LYM%, MON#, MON%,
NEU#, NEU%, EOS#, EOS%, BAS#, BAS% RDW-SD, PCT, PDW, P-LCC, P-LCR, AL#, AL%, IG#, IG%
• XS-800i
Clinical Parameters:
WBC, RBC, HGB, HCT, MCV, MCH, MCHC, PLT, RDW-SD, RDW-CV, PDW, MPV, P-LCR, PCT,
NEUT%, LYMPH%, MONO%, EO%, BASO%, NEUT#, LYMPH#, MONO#, EO#, BASO# IG%, IG#,
Other%, Other#
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4. 7 Parts Analyzers:
The 7-part hematology analyzer represents the most advanced generation, integrating electrical
impedance, flow cytometry, and fluorescent dye-based detection for comprehensive
hematologic evaluation. It provides all 5-part parameters plus counts for immature granulocytes
(IG), atypical lymphocytes (ALY), reticulocytes (RET), and nucleated RBCs (NRBC), giving a
complete profile of bone marrow activity and cell maturation. Examples include the Sysmex XN-
550 and Mindray BC-780, which deliver highly accurate quantitative and morphological
analyses.
These analyzers are crucial for oncology, hematology, and transplant monitoring, where detailed
differentiation helps track chemotherapy response, anemia classification, and bone marrow
regeneration.
Despite higher costs, the diagnostic value and comprehensive parameter range make 7-part
analyzers the gold standard for tertiary care centers and research facilities, where in-depth
hematological profiling is required.
Working Principle:
A 7-part differential hematology analyzer works using a combination of electrical impedance,
flow cytometry, and fluorescence-based detection to count and classify blood cells.
Fig: Flow Cytometry Method for Cell Detection Using Fluorescent Dyes.
Parameters Measure:
RBC count, Hb, HCT, MCV, MCH, MCHC, RDW, Neutrophils, Lymphocytes, Monocytes,
Eosinophils, Basophils, Immature Granulocytes (IGs), A typical Lymphocytes, PLT count, MPV,
PDW, P-LCR, and RET count.
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Example:
• XN-550 (6-Part)
Parameters:
WBC, RBC, HGB, HCT, MCV, MCH, MCHC, PLT, RDW-SD, RDW-CV, PDW, MPV, P-LCR, PCT, NEUT#,
LYMPH#, MONO#, EO#, BASO#, NEUT%, LYMPH%, MONO%, EO%, BASO%, IG#, IG%, MicroR,
MacroR.
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• BC-760 & BC-780
Parameters:
WBC Bas# Bas% Neu# Neu% Eos# Eos% Lym# Lym% Mon# Mon% IMG# IMG% RET% RET# IRF
RBC HGB MCV MCH MCHC RDW-CV RDW-SD HCT NRBC# NRBC% PLT MPV PDW PCT P-LCR P-LCC
IPF.
Parameter-wise Difference
1. White Blood Cells (WBC)
In 3-part analyzers, WBCs are categorized into three groups: lymphocytes, neutrophils, and a
mixed population (MID), which includes monocytes, eosinophils, and basophils. This basic
classification limits the ability to detect specific abnormalities, such as eosinophilia or
basophilia.
In contrast, 5-part analyzers differentiate WBCs into five subtypes neutrophils, lymphocytes,
monocytes, eosinophils, and basophils using optical and impedance methods, significantly
improving diagnostic precision in infectious, allergic, and leukemic conditions.
7-part analyzers go further by identifying immature granulocytes (IMG# and IMG%), atypical
lymphocytes, and blast cells, offering valuable insights for hematologic malignancies and bone
marrow monitoring.
2. Red Blood Cells (RBC)
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All analyzers measure RBC count through electrical impedance, but their accuracy and
morphological interpretation differ.
3-part analyzers provide RBC count and basic red cell indices (MCV, MCH, MCHC), suitable for
screening anemias. However, 5-part analyzers include refined measurement of RDW-CV and
RDW-SD, improving the ability to distinguish microcytic, normocytic, and macrocytic anemia.
7-part analyzers add further classification with parameters like MicroR and MacroR, quantifying
microcytic and macrocytic red cells separately. This supports more accurate diagnosis of mixed
anemia types and bone marrow dysplasia.
3. Hemoglobin (HGB)
In all analyzer types, hemoglobin concentration is measured photometrically after RBC lysis.
3-part analyzers use the cyanmethemoglobin or colorimetric method, while 5- and 7-part
analyzers often use non-cyanide optical systems, ensuring faster and more environmentally
safe readings.
4. Hematocrit (HCT)
Hematocrit represents the proportion of RBCs in whole blood.
3-part analyzers calculate HCT indirectly using RBC and MCV values, which can introduce errors
in cases of anisocytosis.
In 5-part analyzers, HCT is derived from optical and impedance-based measurements, reducing
variability.
7-part analyzers further improve HCT estimation by incorporating reticulocyte and nucleated
RBC correction, ensuring better accuracy in critical patients and neonates.
5. Red Cell Indices (MCV, MCH, MCHC, RDW-CV, RDW-SD)
All analyzers calculate MCV, MCH, and MCHC, but only 5-part and 7-part analyzers include
RDW-CV and RDW-SD, providing information about red cell size variability.
The 7-part analyzer’s dual RDW metrics (CV and SD), combined with MicroR and MacroR
counts.
6. Platelet Parameters (PLT, MPV, PDW, PCT, P-LCR, P-LCC, IPF)
3-part analyzers report platelet count (PLT) and mean platelet volume (MPV). However, platelet
clumps or small RBC fragments can interfere with readings.
5-part analyzers improve accuracy using optical platelet separation, adding parameters such as
PDW (platelet distribution width) and PCT (plateletcrit) to assess platelet morphology and
concentration.
7-part analyzers expand platelet evaluation with P-LCR (large platelet ratio), P-LCC (large
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platelet count), and IPF (immature platelet fraction), allowing clinicians to differentiate
destructive thrombocytopenia from bone marrow suppression.
7. Reticulocyte and Nucleated RBC Parameters (RET%, RET#, IRF, NRBC#, NRBC%)
These parameters are absent in 3-part analyzers.
Some 5-part analyzers may estimate reticulocytes, but full quantification requires 7-part
analyzers, which use fluorescence flow cytometry to detect reticulocytes (RET%) and immature
reticulocyte fraction (IRF), offering detailed insights into erythropoietic activity.
The 7-part system also provides NRBC counts, essential in newborn screening, hemolysis, and
bone marrow recovery. These analyzers achieve near-manual precision in reticulocyte and
NRBC detection, improving anemia classification.
8. Advanced Parameters (IG#, IG%, MicroR, MacroR, ALY#, ALY%)
These are exclusive to 7-part analyzers.
Immature granulocytes (IG) indicate early myeloid proliferation, aiding in detecting sepsis and
bone marrow stimulation.
MicroR and MacroR quantify abnormal RBC sizes, while Atypical lymphocytes (ALY) and blasts
assist in diagnosing viral infections and hematologic malignancies.
Such precision is achieved using fluorescent labeling and multi-angle light scatter detection,
making 7-part systems indispensable for advanced diagnostic centers.
Summary:
Table: Comparative Diagnostic Differences Between Different Parts of Hematology Analyzer
Feature 3-Part Analyzer 5-Part Analyzer 7-Part Analyzer
Combination of
Electrical impedance for cell
electrical impedance Electrical impedance, flow
counting and sizing;
and optical (laser/flow cytometry & fluorescence-
Working Principle colorimetric
cytometry) methods based detection for high-
(cyanmethemoglobin) for
with reagent-based precision analysis.
hemoglobin measurement.
RBC lysis.
3 groups: 5 groups: 7 groups:
• Lymphocytes • Neutrophils • Neutrophils
• Neutrophils • Lymphocytes • Lymphocytes
• MID (Monocytes, • Monocytes • Monocytes
WBC Eosinophils, Basophils • Eosinophils • Eosinophils
Differential combined) • Basophils • Basophils
• Immature Granulocytes
(IGs)
• Atypical Lymphocytes /
NRBCs
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Accurate WBC High precision, detects
Low cost, easy maintenance,
differentiation, immature cells, used in
Advantages suitable for small labs and
suitable for diagnostic advanced diagnostic and
basic screening.
labs and hospitals. research settings.
Cannot distinguish individual Higher cost; requires Expensive; requires trained
Limitations WBC types beyond 3 groups; reagents and personnel and complex
limited diagnostic depth. maintenance. maintenance.
Examples Swelab Lumi, Sysmex Sysmex XN-550, Mindray BC-
Swelab™ Alfa, Sysmex XP-100
(Instruments) XS-800i 760/780
References
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▪ Goswami, Krishnajyoti, and Subrata Mookherjee. "COMPARISON BETWEEN HAEMATOLOGICAL PARAMETERS BY
THE MERILYZER CELQUANT 360 AUTOMATED HAEMATOLOGY ANALYSER AND SYSMEX XP-100 HAEMATOLOGY
ANALYSER WITH THE MANUAL METHODS." European Journal of Biomedical 5.1 (2018): 675-679.
▪ Tailor, H., et al. "Evaluation of the Sysmex XN-550, a Novel Compact Haematology analyser from the XN-L® series,
compared to the XN-20 system." International journal of laboratory hematology 39.6 (2017): 585-589.
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