The total number of white blood cells (WBC) in a blood smear is called a WBC count. When you conduct a WBC count, you actually receive a total that includes both WBCs and nucleated red blood cells. Nucleated red blood cells are the precursors to normal red blood cells and look very similar to WBCs. To obtain the real total of WBCs, you need to correct for the presence of nucleated red blood cells; and there is a simple formula you can use to accurately calculate the corrected WBC count.
- Diluting chamber
- Automated cell counter (optional)
Examine the blood smear meticulously in a pre-established pattern, so you don’t miss any sections. The corrected WBC count is expressed as cells per microliter (µL). When counting WBCs, you can also do a differential count of the different types of WBCs that you observe. WBCs are also known as leukocytes.
Count the total number of WBCs in your blood sample. This number is called the uncorrected WBC count. You can manually count the WBCs by diluting the blood in a diluting chamber, and then analyzing the smear in a hemocytometer. If you have access to an automated cell counter, such as an impedance counter or a flow cytometry counter, you can count the WBCs more quickly. In this example, the total number of WBCs is 15,000.
Record the number of nucleated red blood cells per 100 WBCs. You only need to note this number for the first time 100 WBCs you count. If the number of nucleated red blood cells (NRBCs) is greater than five, you need to calculate the corrected WBC count. For this example, the total number of nucleated red blood cells per 100 WBCs is 6.
Multiply the uncorrected WBC count by 100. For example:
15,000 × 100 = 1,500,000
Add 100 to the total number of NRBCs you observed per 100 WBCs. In this example:
6 + 100 = 106
Divide the second total from the first total.
1,500,000 ÷ 106 = 14,150.94
Therefore, in this example, the corrected WBC count can be rounded up to 14,151. The corrected WBC count equals the uncorrected WBC count multiplied by 100, and this total divided by the number of nucleated red blood cells added to 100.