Clinical Hematology Parameters

Our hematology analyzers quickly deliver precise, accurate results to help improve patient care. The Complete Blood Count with Differential (CBC-Diff) is one of the most ordered tests in health care. Our advanced hematology parameters provide clinical insights into red and white blood cell physiology to give health care providers information on blood components and blood disorders.

In vitro Diagnostic (IVD) Hematology Parameters*

In vitro Diagnostic (IVD) hematology parameters can be used to aid in monitoring disease progression and treatment. MPV, MRV and MDW are regulatory-cleared IVD tests that provide information to aid in patient management. From anemias to leukemias and multiple myeloma to sepsis, clinicians rely on these IVD parameters to provide the best possible treatment for their patients.

Hematology Clinical Parameter Mean Platelet Volume (MPV)
Mean Platelet Volume
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Hematology Clinical Parameters Monocyte Distribution Width (MDW)
Monocyte Distribution Width (MDW)
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Hematology Clinical Parameter Mean Reticulocyte Volume (MRV)
Mean Reticulocyte Volume
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“The development of the Coulter Principle revolutionized blood counting and allowed the accurate and automated enumeration of blood cells. We remain dedicated to innovation to improved workflow efficiency in the hematology laboratory and patient care.”
Elena Sukhacheva, Ph.D.

*In Vitro Diagnostic parameters. For use in In Vitro Diagnostic procedures.

Mean Platelet Volume (MPV)

What is the MPV Parameter?

  • MPV is the average volume of individual platelets and is derived from the PLT histogram
  • MPV parameter is measured in triplicate from the three apertures on the analyzer, and voting is performed comparing data for all three apertures. Results are produced by averaging the parameters obtained from the apertures that are within the established statistical range
  • PLT count and MPV measurement include the application of sweep flow to prevent the recirculation of cells behind the aperture. The sweep flow is a steady stream of diluent that flows behind the RBC aperture during the sensing period, which prevents cells from re-entering the sensing zone and being counted as platelets
  • Enhanced Beckman Coulter Principle allows a reportable MPV, even for thrombocytopenic patients
  • Expressed in fL

How is MPV used?

  • Direct volume measurement for MPV provides additional information, allowing for better thrombocytopenia management1–6
  • Extensive literature supports the clinical utility of MPV

Mean Platelet Volume: Unlike platelet counts, which measure the number of circulating platelets, MPV measures the average size of platelets. Platelet size may change in response to certain diseases such as lupus and thyroid disorders. Platelet size is also important in determining the underlying cause of abnormal platelet count. And because younger platelets tend to be larger than older platelets, MPV can be used to gauge platelet age, which can further aid in disease diagnosis.3

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Monocyte Distribution Width (MDW)

What is the MDW Parameter?

  • MDW is the quantitative measurement of the volume distribution of the monocyte population in the blood
  • MDW is elevated in early stages of bacterial, viral or fungal infections leading to sepsis
  • MDW is measured with VCS technology as part of the white blood cell (WBC) differential hematology analysis from K3EDTA or K2EDTA anticoagulated whole blood venous samples
  • Monocytes are key players of the innate immune response and activate the adaptive immune system. Functional plasticity and increased heterogeneity of monocytes in sepsis1 leads to increased morphological variability, which can be detected with MDW
  • MDW is the only proprietary, regulatory-cleared hematological biomarker exclusive to Beckman Coulter hematology analyzers

How is MDW used?

  • Results are automatically available as part of CBC-Diff with no impact to laboratory or emergency department workflow and with no additional tests to order
  • Helps reduce Dx uncertainty, aiding clinicians in escalating or de-escalating care in patients with suspected infectious etiology 

Monocyte Distribution Width: The MDW parameter reflects a change in the volume of circulating monocytes in response to pro-inflammatory signals from infectious organisms referred to as pathogen-associated molecular patterns (PAMPs). Importantly, the results of MDW are independent of monocytes subpopulation percentage. The MDW value can be assessed simultaneously with the WBC value to provide physicians additional information regarding a patient’s immune status in response to infection.8-19

*For COVID-19 use in the EU only.

For MDW specific performance claims, please refer to UniCel DxH 900 Coulter Cellular Analysis System Early Sepsis Indicator (ESId) Application Addendum PN C42014AC.

MDW values greater than 20.0 together with other laboratory findings and clinical information, aids in identifying patients with sepsis or at increased risk of developing sepsis within the first 12 hours of hospital admission.

MDW results greater than 20.0 should be interpreted in association with other clinical information and diagnostic testing as a proportion of patients without sepsis may have an elevated MDW value at baseline. MDW values less than or equal to 20.0 cannot rule out sepsis or the development of sepsis within 12 hours of hospital admission. The Early Sepsis Indicator should not be used as the sole basis to determine the absence of sepsis.

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Mean Reticulocyte Volume (MRV)

What is the MRV Parameter?

  • MRV is measured with VCS technology and represents the average volume of all retic events
  • The combination of low-frequency current, high-frequency current and light-scattering technology provides abundant cell-by-cell information and includes 29 morphometric data points per cell
  • While cells are prepared for reticulocyte analysis, they are spherified, cleared from hemoglobin, and stabilized in strictly controlled osmotic and temperature conditions, allowing for precise MRV measurement
  • A proprietary multidimensional analytical algorithm on reticulocytes helps avoid interference with reticulocyte count and MRV measurement in the presence of RBCs with inclusions

How is MRV used?

  • Anemia assessment and differential diagnosis20-30
  • Follow-up testing for anemia treatment30,31 

Mean Reticulocyte Volume: MRV represents the average volume of all reticulocytes. It is a reticulocyte characteristic that can be used to determine therapeutic effects on certain blood diseases. For example, MRV has been shown to increase in anemia patients with chronic kidney disease following intravenous iron therapy.32 However, following B12 treatment of patients with macrocytic anemia, MRV was shown to decrease.32 MRV is also used as a specific parameter to screen for hereditary spherocytosis, an inherited anemia that tends to result in lower MRV, and immune hemolytic anemia, an autoimmune disorder that tends to result in higher MRV.33

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Explore our Hematology Analyzers

1. Bowles, K., et al. (2005). Platelet size has diagnostic predictive value in patients with thrombocytopenia. Clinical and Laboratory Haematology, 27(6), 370–373.

2. Numbenjapon, T. et al. (2008). A prospective evaluation of normal mean platelet volume in discriminating hyperdestructive thrombocytopenia from hypoproductive thrombocytopenia. International Journal of Laboratory Hematology, 30(5), 408–414.

3. Lee, W. & Kim, T. (2010). Mean platelet volume and platelet distribution width are useful in the differential diagnosis of aplastic anemia and idiopathic thrombocytopenic purpura. Clinical Chemistry and Laboratory Medicine, 48(11).

4. Chandra, H. et al. (2010) Role of mean platelet volume as discriminating guide for bone marrow disease in patients with thrombocytopenia. International Journal of Laboratory Hematology, 32(5), 498–505.

5. Ntaios, G. et al. (2009). Evaluation of mean platelet volume in the differential diagnosis of thrombocytopenia. International Journal of Laboratory Hematology, 31(6), 688–689.

6. Latger-Cannard, V. et al. (2012). Mean platelet volume: comparison of three analysers towards standardization of platelet morphological phenotype. International Journal of Laboratory Hematology, 34(3), 300–310.

7. Shalova, I. et al. (2015). Human Monocytes Undergo Functional Re-programming during Sepsis Mediated by Hypoxia-Inducible Factor-1α. Immunity, 42(3), 484–498.

8. Riva, G. (2021). Monocyte Distribution Width (MDW) as novel inflammatory marker with prognostic significance in COVID-19 patients. Scientific Reports, 11(1).

9. Hossain, R. et al. (2021). Monocyte distribution width adds prognostic value in detection of COVID‐19 respiratory failure. International Journal of Laboratory Hematology, 44(2).

10. Malinovska, A et al., Monocyte distribution width as part of a broad pragmatic sepsis screen in the emergency department. JACEP Open. 2022; 3:e12679.

11. E. Piva et al., Monocyte Distribution Width (MDW) Parameter as a Sepsis Indicator in Intensive Care Units, Clin Chem Lab Med 2021.

12. P. Hausfater et al., Monocyte Distribution Width (MDW) Performance as an Early Sepsis Indicator in the Emergency Department: Comparison with CRP and Procalcitonin in a Multicenter International European Prospective Study, Crit Care 2021; 25, 227.

13. A. Woo et al., Monocyte Distribution Width Compared with C-Reactive Protein and Procalcitonin for Early Sepsis Detection in the Emergency Department, PLoS ONE 2021; 16(4): e0250101.

14. H. Lin et al., Clinical Impact of Monocyte Distribution Width and Neutrophil-to-Lymphocyte Ratio for Distinguishing COVID-19 and Influenza from Other Upper Respiratory Tract Infections: A Pilot Study, PLoS ONE 2020 15(11): e0241262.

15. L. Agnello et al., Monocyte Distribution Width (MDW) as a Screening Tool for Sepsis in the Emergency Department, Clin Chem Lab Med 2020; 58(11):1951-1957. https://doi:10.1515/cclm-2020-0417

16. Marcos-Morales, A et al., Elevated monocyte distribution width in trauma: An early cellular biomarker of organ dysfunction, Injury 2021; S0020-1383(21):00933-00935.

17. E. Crouser et al., Monocyte Distribution Width: A Novel Indicator of Sepsis-2 and Sepsis-3 in High-Risk Emergency Department Patients, Critical Care Med 2019; 47:1018-1025.

18. E. Crouser et al., Improved Early Detection of Sepsis in the ED with a Novel Monocyte Distribution Width Biomarker, CHEST 2017; 152(3):518-526.

19. A. Ognibene et al., Elevated Monocyte Distribution Width in COVID-19 Patients: The Contribution of the Novel Sepsis Indicator, Clinica Chimica Acta 2020; 509: 22-24.

20. Lazarova E. et al. (2014). Automated reticulocyte parameters for hereditary spherocytosis screening. Annals of Hematology, 93(11), 1809–1818.

21. Nair, S. (2015). Mean reticulocyte volume enhances the utility of red cell mean sphered cell volume in differentiating peripheral blood spherocytes of hereditary spherocytosis from other causes. Indian Journal of Pathology and Microbiology, 58(3), 307.

22. Xu, Y. et al. (2015). Mean reticulocyte volume: a specific parameter to screen for hereditary spherocytosis. European Journal of Haematology, 96(2), 170–174.

23. Liao, L. et al. (2019). Blood cell parameters for screening and diagnosis of hereditary spherocytosis. Journal of Clinical Laboratory Analysis, 33(4), e22844.

24. Wu, Y. et al. (2021). The diagnostic protocol for hereditary spherocytosis‐2021 update. Journal of Clinical Laboratory Analysis, 35(12).

25. Arora, R. et al. (2018). Utility of mean sphered cell volume and mean reticulocyte volume for the diagnosis of hereditary spherocytosis. Hematology, 23(7), 413–416.

26. Crispin, P. et al. (2019). Red Cell and Reticulocyte Parameters for the Detection of Iron Deficiency in Pregnancy. Clinical Laboratory, 65(11/2019).

27. Banfi, G. et al. (2006). Reticulocyte count, mean reticulocyte volume, immature reticulocyte fraction, and mean sphered cell volume in elite athletes: reference values and comparison with the general population. Clinical Chemistry and Laboratory Medicine (CCLM), 44(5).

28. Rodrigues, al. (2007). Clinical Utility of Beckman-Coulter Gen’s Reticulocyte Analysis in the Study of Anemia of Chronic Disease (ACD). Laboratory Hematology, 13(3), 85–92.

29. Buttarello M. (2016). Laboratory diagnosis of anemia: are the old and new red cell parameters useful in classification and treatment, how? International Journal of Laboratory Hematology, 38, 123–132.

30. Piva, E. et al. (2015). Clinical Utility of Reticulocyte Parameters. Clinics in Laboratory Medicine, 35(1), 133–163.

31. Agarwal, M., & Pai, S. (2017). Reticulocyte Hemoglobin Content (CHr): The Gold Standard for Diagnosing Iron Deficiency. Journal of The Association of Physicians of India, 65.

32. Noronha J. et al. (2003) Immature reticulocytes as an early predictor of engraftment in autologous and allogeneic bone marrow transplantation. Clin Lab Haematoly 25:47–54.

33. Arora, R. et al. (2018). Utility of mean sphered cell volume and mean reticulocyte volume for the diagnosis of hereditary spherocytosis. Hematology, 23(7), 413–416.