The development of guidelines and recommendations for peripheral blood film review internationally

Speaker: Anna Merino (ES)
Moderator: Ciriaco Carru (IT)

Recorded at  7th November 2017 18:00 CET

With the advance of the technology of hematology analyzers, the indications for peripheral blood film (PBF) review by an expert have declined, but still remain essential. PBF review contributes to the following: 1) Complements/validates the findings of automated hematology analyzers, 2) Provides information on hematologic abnormalities that cannot be assessed by the current hematology analyzers, 3) Abnormal red cell morphology detection, 4) Identification of blasts, lymphoma or other abnormal cells, 4) Platelet clumping or abnormal platelet morphology inspection and 5) Dyshematopoiesis detection. Some examples are provided in the presentation. It also discusses on some issues related to who performs the PBF review.

 The PBF review by laboratory technologists validates hematology analyzer flags and identifies specific cells or qualitative abnormalities that cannot be identified by hematology analyzers. In addition, technologists triage blood films that require expert morphology review. The contribution of the pathologists is relevant since they are able to make a specific diagnosis, provide differential diagnosis, and/or recommend further testing based on all hematologic quantitative and qualitative values. In addition, they can summarize the findings in a narrative interpretation that becomes part of patient’s medical chart.

 The International Council of Standardization in Hematology (ICSH) is developing standards, guidelines and recommendations in peripheral blood film review internationally, which can provide the following benefits for pathologists: 1) Define the role and standardize the expectations of laboratory physicians, 2) Narrow the indications for PBF review by pathologists to those that contribute to patient care, 3) Provide a framework for reporting and 4) Opportunity for national and international collaboration & advancement of the field. Some of the ICSH recommendations are discussed in the presentation.

Teacher: Anna Merino