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The complete blood count ( CBC ) or Hemogram is a test that evaluates the cells that circulate in blood. Blood consists of three types of cells suspended in fluid called plasma: white blood cells (WBCs), red blood cells (RBCs), and platelets (PLTs). They are produced and mature primarily in the bone marrow and, under normal circumstances, are released into the bloodstream as needed.
A CBC test or Hemogram test is typically performed using an automated instrument that measures various parameters, including counts of the cells that are present in a person's sample of blood. The results of a CBC or Hemogram can provide information about not only the number of cell types but also can give an indication of the physical characteristics of some of the cells. A standard CBC or Hemogram includes the following:
Evaluation of white blood cells: WBC count; may or may not include a WBC differential.
Evaluation of red blood cells: RBC count, hemoglobin (Hb), hematocrit (Hct) and RBC indices, which includes mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red cell distribution width (RDW). The RBC evaluation may or may not include reticulocyte count.
Evaluation of platelets: platelet count; may or may not include mean platelet volume (MPV) and/or platelet distribution width (PDW).
Significant abnormalities in one or more of the blood cell populations can indicate the presence of one or more conditions. Typically other tests are performed to help determine the cause of abnormal results. Often, this requires visual confirmation by examining a blood smear under a microscope. A trained laboratorian can evaluate the appearance and physical characteristics of the blood cells, such as size, shape and color, noting any abnormalities that may be present. Any additional information is noted and reported to the healthcare provider. This information gives the health practitioner additional clues as to the cause of abnormal CBC or Hemogram results.
The three types of cells evaluated by the CBC test or Hemogram test include:
White Blood Cells There are five different types of WBCs, also called leukocytes that the body uses to maintain a healthy state and to fight infections or other causes of injury. They are neutrophils, lymphocytes, basophils, eosinophils, and monocytes. They are present in the blood at relatively stable numbers. These numbers may temporarily shift higher or lower depending on what is going on in the body. For instance, an infection can stimulate the body to produce a higher number of neutrophils to fight off bacterial infection. With allergies, there may be an increased number of eosinophils. An increased number of lymphocytes may be produced with a viral infection. In certain disease states, such as leukemia, abnormal (immature or mature) white cells rapidly multiply, increasing the WBC count.
Red Blood Cells Red blood cells, also called erythrocytes, are produced in the bone marrow and released into the bloodstream as they mature. They contain hemoglobin, a protein that transports oxygen throughout the body. The typical lifespan of an RBC is 120 days; thus the bone marrow must continually produce new RBCs to replace those that age and disintegrate or are lost through bleeding. A number of conditions can affect the production of new RBCs and/or their lifespan, in addition to those conditions that may result in significant bleeding.
The CBC determines the number of RBCs and amount of hemoglobin present, the proportion of blood made up of RBCs (hematocrit), and whether the population of RBCs appears to be normal. RBCs normally are uniform with minimal variations in size and shape; however, significant variations can occur with conditions such as vitamin B12 and folate deficiencies, iron deficiency, and with a variety of other conditions. If the concentration of red blood cells and/or the amount of hemoglobin in the blood drops below normal, a person is said to have anemia and may have symptoms such as fatigue and weakness. Much less frequently, there may be too many RBCs in the blood (erythrocytosis or polycythemia). In extreme cases, this can interfere with the flow of blood through the small veins and arteries.
Platelets Platelets, also called thrombocytes, are special cell fragments that play an important role in normal blood clotting. A person who does not have enough platelets may be at an increased risk of excessive bleeding and bruising. An excess of platelets can cause excessive clotting or, if the platelets are not functioning properly, excessive bleeding. The CBC test or Hemogram test measures the number and size of platelets present.
CBC, Hemogram, CBC with Differential and Complete Blood Count.
Routine test, Infection, Anemia and Cancer.
CBC test or Hemogram test is peformed to determine your general health status; to screen for, diagnose, or monitor any one of a variety of diseases and conditions that affect blood cells, such as anemia, infection, inflammation, bleeding disorder or cancer.
The CBC test or Hemogram test is a very common test. Many people have a CBC test or Hemogram test performed when they have a routine health examination. If a person is healthy and has results that are within normal limits, then that person may not require another CBC or Hemogram until their health status changes or until their healthcare provider feels that it is necessary.
A CBC test or Hemogram test may be recommended when a person has any number of signs and symptoms that may be related to disorders that affect blood cells. When an individual has fatigue or weakness or has an infection, inflammation, bruising, or bleeding, a health practitioner may prescribe a CBC to help diagnose the cause and/or determine its severity.
When a person has been diagnosed with a disease known to affect blood cells, a CBC will often be tested on a regular basis to monitor their condition. Likewise, if someone is receiving treatment for a blood-related disorder, then a CBC may be performed frequently to determine if the treatment is effective.
Some therapies, such as chemotherapy, can affect bone marrow production of cells. Some medications can decrease WBC counts overall. A CBC test or Hemogram test may be done on a regular basis to monitor these drug treatments.