White Blood Cell and Peripheral Blast Counts in Leukemia Patients with Non-Graying WBC-Diff Scattergram

Graying scattergram of White Blood Cell differential (WBC-diff) is often accompanied by blasts in the blood and/or leukocytosis in leukemia patients. Therefore, monitoring White Blood Cell (WBC) and peripheral blast count is crucial for patient management. In contrast, patients with non-graying WBC-diff scattergrams may have varying WBC counts and peripheral blasts. This study aimed to establish the cut-off values of WBC and peripheral blast counts that could predict a non-graying scattergram in leukemia patients. A retrospective descriptive study with a cross-sectional design analyzed secondary data from 21 leukemia patients. The acute and chronic leukemia diagnosis were based on bone marrow aspirates, which simultaneously showed a graying WBC-diff scattergram on Complete Blood Count (CBC). Receiver Operating Characteristic (ROC) curve analysis was conducted when the patient’s CBC displayed a non-graying scattergram. The cut-off value for WBC count was 16,380 x 109/L with an Area Under Curve (AUC) of 0.932, a sensitivity of 85.7%, p = 0.001, and the cut-off for peripheral blast count was 35.5% with an AUC of 0.872, the sensitivity of 76.2%, p=0.001. The results suggest that a non-graying scattergram of the WDF channel in leukemia is more likely associated with WBC counts below 16,380 x 109/L and peripheral blast counts below 35.5%, which have excellent and good predictive value.