Version: June 22, 2012

G Gu ui id da an nc ce e o on n D De et te er rm mi in ni in ng g t th he e A Ab bs so ol lu ut te e N Ne eu ut tr ro op ph hi il l C Co ou un nt t ( (A AN NC C) )

T Th he e p pu ur rp po os se e o of f t th hi is s d do oc cu um me en nt t i is s t to o p pr ro ov vi id de e O Ov ve er ra al ll l P Pr ri in nc ci ip pa al l I In nv ve es st ti ig ga at to or rs s a an nd d t th he ei ir r r re es se ea ar rc ch h t te ea am ms s g gu ui id da an nc ce e
o on n c ca al lc cu ul la at ti in ng g t th he e A AN NC C. .

G Ge en ne er ra al l I In nf fo or rm ma at ti io on n: :

A A C CB BC C w wi it th h d di if ff fe er re en nt ti ia al l b bl lo oo od d t te es st t m me ea as su ur re es s t th he e d di if ff fe er re en nt t t ty yp pe es s o of f w wh hi it te e b bl lo oo od d c ce el ll ls s a an nd d
i it te em mi iz ze es s t th he em m o on n t th he e l la ab b r re ep po or rt t. . W Wh hi il le e a a m ma an nu ua al l d di if ff fe er re en nt ti ia al l i is s t th he e g go ol ld d- -s st ta an nd da ar rd d f fo or r
d de et te er rm mi in ni in ng g t th he e A AN NC C, , t th hi is s i is s o of ft te en n i im mp pr ra ac ct ti ic ca al l f fo or r m ma an ny y c ca an nc ce er r p pa at ti ie en nt ts s. . A Al lt te er rn na at ti iv ve el ly y t th he e A AN NC C
i is s m mo os st t o of ft te en n d de et te er rm mi in ne ed d f fr ro om m a an n a au ut to om ma at te ed d d di if ff fe er re en nt ti ia al l. .

T Th he e A AN NC C i is s n no ot t m me ea as su ur re ed d d di ir re ec ct tl ly y; ; i it t m mu us st t b be e c co om mp pu ut te ed d f fr ro om m t th he e W Wh hi it te e B Bl lo oo od d C Co ou un nt t a an nd d t th he e
n ne eu ut tr ro op ph hi il ls s i in n t th he e d di if ff fe er re en nt ti ia al l, , u us si in ng g a a f fo or rm mu ul la a. .

N Ne eu ut tr ro op ph hi il ls s c co om me e i in n t tw wo o t ty yp pe es s: : p po ol ly ys s ( (a al ls so o k kn no ow wn n a as s s se eg gs s, , s se eg gm me en nt te ed d n ne eu ut tr ro op ph hi il ls s, , n ne eu ut tr ro op ph hi il ls s, ,
o or r g gr ra an nu ul lo oc cy yt te es s) ) a an nd d b ba an nd ds s ( (a al ls so o k kn no ow wn n a as s s st ta ab bs s, , s se eg gs s o or r s se eg gm me en nt te ed d b ba an nd ds s) ). .

A Au ut to om ma at te ed d d di if ff fe er re en nt ti ia al ls s u us se e o on nl ly y t th he e p pe er rc ce en nt ta ag ge e o of f p po ol ly ys s t to o c ca al lc cu ul la at te e t th he e A AN NC C. . B By y n no ot t i in nc cl lu ud di in ng g
t th he e b ba an nd ds s, , t th hi is s u un nd de er re es st ti im ma at te es s t th he e A AN NC C i in n i in nd di iv vi id du ua al ls s w wi it th h a a s si ig gn ni if fi ic ca an nt t n nu um mb be er r o of f b ba an nd ds s. .

T Th he e m me et th ho od d o of f c ca al lc cu ul la at ti in ng g t th he e A AN NC C s sh ho ou ul ld d b be e s sp pe ec ci if fi ie ed d i in n t th he e r re es se ea ar rc ch h p pr ro ot to oc co ol l. . W Wh he en n t th he e
m me et th ho od d o of f c ca al lc cu ul la at ti in ng g t th he e A AN NC C i is s n no ot t i in nc cl lu ud de ed d, , i it t i is s a ap pp pr ro op pr ri ia at te e t to o r re ec ca al lc cu ul la at te e t th he e A AN NC C b ba as se ed d o on n
t th he e p pe er rc ce en nt ta ag ge e o of f b bo ot th h p po ol ly ys s a an nd d b ba an nd ds s. . T Th hi is s w wo ou ul ld d a al ls so o b be e a ac cc ce ep pt ta ab bl le e f fo or r d de et te er rm mi in ni in ng g t th he e
m ma ax xi im ma al l t to ox xi ic ci it ty y o of f t th he er ra ap py y. . R Re em me em mb be er r: : i if f a a r re ec ca al lc cu ul la at ti io on n p pr ra ac ct ti ic ce e i is s u us se ed d, , i it t s sh ho ou ul ld d b be e a ap pp pl li ie ed d
i in n a a c co on ns si is st te en nt t m ma an nn ne er r a ac cr ro os ss s a al ll l i in nd di iv vi id du ua al ls s b be ei in ng g t tr re ea at te ed d o on n t th he e r re es se ea ar rc ch h p pr ro ot to oc co ol l. .


C Ca al lc cu ul la at ti in ng g t th he e A AN NC C w wi it th h b bo ot th h p po ol ly ys s a an nd d b ba an nd ds s: :

Y Yo ou u c ca an n c ca al lc cu ul la at te e t th he e A AN NC C f fr ro om m t th he e p pe er rc ce en nt ta ag ge e o of f n ne eu ut tr ro op ph hi il ls s o or r f fr ro om m t th he e a ab bs so ol lu ut te e n nu um mb be er r o of f
c ce el ll ls s. .

o o T Th he e f fo or rm mu ul la a t to o c ca al lc cu ul la at te e t th he e A AN NC C f fr ro om m t th he e p pe er rc ce en nt ta ag ge e o of f n ne eu ut tr ro op ph hi il ls s: :
W Wh hi it te e b bl lo oo od d c co ou un nt t ( (W WB BC C) ) x x t to ot ta al l n ne eu ut tr ro op ph hi il ls s ( (p po ol ly ys s % % + + b ba an nd ds s % %) ) m mu ul lt ti ip pl li ie ed d b by y 1 10 0 = = A AN NC C

o o T Th he e f fo or rm mu ul la a t to o c ca al lc cu ul la at te e t th he e A AN NC C f fr ro om m a ab bs so ol lu ut te e n nu um mb be er rs s: :
A Ab bs so ol lu ut te e p po ol ly ys s + + A Ab bs so ol lu ut te e b ba an nd ds s m mu ul lt ti ip pl li ie ed d b by y 1 10 00 00 0 = = A AN NC C


Version: June 22, 2012


S Sa am mp pl le e C Ca al lc cu ul la at ti io on n o of f t th he e A AN NC C u us si in ng g b bo ot th h p po ol ly ys s a an nd d b ba an nd ds s




T Te es st t D De es sc cr ri ip pt ti io on n R Re es su ul lt t F Fl la ag gs s R Re ef f. . R Ra an ng ge e U Un ni it ts s
C CB BC C w wi it th h d di if ff fe er re en nt ti ia al l
W WB BC C 2 2. .1 1 L L ( (4 4. .5 5 1 11 1. .0 0) ) ( (t th h/ /c cm mm m) )
H HC CT T 3 31 1. .5 5 L L ( (4 41 1. .0 0 5 53 3. .0 0) ) ( (% %) )
H HG GB B 1 11 1. .0 0 L L ( (1 13 3. .5 5 1 17 7. .5 5) ) ( (g gm m/ /d dl l) )
R RB BC C 3 3. .3 37 7 L L ( (4 4. .5 50 0 5 5. .9 90 0) ) ( (m mi il l/ /c cm mm m) )
P PL LT T 1 16 67 7 ( (1 15 50 0 4 40 00 0) ) ( (t th h/ /c cm mm m) )
P Po ol ly ys s 2 22 2 L L ( (4 40 0- -7 70 0) ) ( (% %) )
B Ba an nd ds s 4 4 ( (0 0 1 10 0) ) ( (% %) )
L Ly ym mp ph hs s 1 15 5 L L ( (2 22 2- -4 44 4) ) ( (% %) )
M Mo on no os s 5 55 5 H H ( (4 4- -1 11 1) ) ( (% %) )
E EO OS S 3 3 ( (0 0- -8 8) ) ( (% %) )
B Ba as so os s 0 0 ( (0 0- -3 3) ) ( (% %) )
M My ye el lo os s 1 1 H H ( (0 0) ) ( (% %) )
A Ab bs s N Ne eu ut ts s 0 0. .4 46 6 L L ( (1 1. .8 8- -7 7. .7 7) ) ( (t th h/ /c cm mm m) )
A Ab bs s B Ba an nd ds s 0 0. .0 08 8 ( (t th h/ /c cm mm m) )
A Ab bs s L Ly ym mp ph hs s 0 0. .3 32 2 L L ( (1 1. .0 0- -4 4. .8 8) ) ( (t th h/ /c cm mm m) )
A Ab bs s M Mo on no os s 1 1. .1 16 6 ( (0 0. .2 2- -1 1. .2 2) ) ( (t th h/ /m mm m3 3) )
A Ab bs s E EO OS S 0 0. .0 06 6 L L ( (0 0. .1 1- -0 0. .3 3) ) ( (t th h/ /c cm mm m) )
A Ab bs s B Ba as so os s 0 0. .0 00 0 ( (0 0. .0 0- -0 0. .3 3) ) ( (t th h/ /c cm mm m) )

To determine the ANC from %
of neutrophils:

1. Find the WBC, the polys and
bands.
WBC 2.1
Polys 22 %
Bands 4 %
2. Multiply the WBC by the sum
of the polys and bands.
2.1 x (22 + 4) = 54.6
3. Multiply the product by 10.
54.6 x 10 = 546

The ANC for research purposes and
for grading adverse events is 546.
To calculate the ANC from
absolute numbers:

1. Find the Absolute polys and
Absolute bands.
Absolute polys 0.46
Absolute bands 0.08
2. Add the Absolute polys and
Absolute bands.
(0.46 + 0.08) = 0.54
3. Multiply the product by 1000.
0.54 x 1000 = 540

The ANC for research purposes and
for grading adverse events is 540.