From the Guidelines
A CBC with differential is used to check for signs of cancer, particularly blood cancers, by examining white blood cell counts, the presence of immature or abnormal cells, and other parameters such as anemia or thrombocytopenia, as recommended in the latest guidelines for surveillance in individuals with predisposition to hematopoietic malignancy 1. When evaluating a CBC with diff for cancer, several key components are assessed, including:
- White blood cell count: Elevated (leukocytosis) or decreased (leukopenia) counts can suggest leukemia or lymphoma.
- Differential: The presence of blast cells or other immature cells, and abnormal distributions or morphologies of the five types of white blood cells (neutrophils, lymphocytes, monocytes, eosinophils, and basophils), can raise suspicion for malignancy.
- Red blood cell count and hemoglobin: Anemia may be present in various cancers.
- Platelet count: Thrombocytopenia may also be indicative of certain cancers. According to the most recent study on surveillance recommendations for children with predisposition to hematopoietic malignancy, a CBC with diff is recommended as part of the surveillance protocol for individuals with specific genetic predispositions, such as PAX5, TP53, and others 1. It is essential to note that while a CBC with diff can provide valuable information, it is not a definitive diagnostic tool for cancer. Abnormal results typically lead to additional testing, such as bone marrow biopsy, flow cytometry, or cytogenetic studies, to confirm a cancer diagnosis. The frequency of CBC with diff testing varies depending on the specific genetic predisposition and clinical indications, ranging from every 3-4 months to every 6-12 months 1.
From the Research
Labs Checked for Cancer in a CBC with Diff
- A Complete Blood Count (CBC) with differential is used to screen for various conditions, including certain cancers, such as chronic myeloid leukemia (CML) 2.
- The CBC parameters, including leukocyte count, and differentials, such as basophils and immature granulocytes (IGs), are used to diagnose and monitor CML 2.
- The absolute basophil count is effective for screening for CML, with a high area under the receiver operating characteristic (ROC) curve value of 0.982 2.
- A CBC with differential can also provide information about the immune system and help diagnose other conditions, such as anemia, infection, and immunodeficiencies 3.
- While a CBC with differential can be used to screen for certain cancers, other imaging modalities, such as MRI and PET/CT, are also used to diagnose and stage hematologic malignancies, including lymphoma, leukemia, and multiple myeloma 4, 5.
Specific Cancer Types
- Chronic myeloid leukemia (CML): CBC with differential, including absolute basophil count and immature granulocytes (IGs) 2.
- Lymphoma: whole-body MRI, CT, and PET/CT are used for staging and diagnosis 4, 5, 6.
- Leukemia: no specific imaging modality is currently recommended outside of clinical trials, but MRI and PET/MRI are being researched 5.
- Multiple myeloma: whole-body MRI is recognized as a highly sensitive test for assessment and staging 5.