TY - JOUR T1 - Effect of Blood Sample Storage on Sample Stability for CBC and Blood Cell Morphology Analysis AU - Keswani, Aditya Suresh AU - Swami, Dinesh AU - Gaikwad, Sheela AU - Jadhav, Dnyaneshwar AU - Bagate, Arvind JO - Research Journal of Medical Sciences VL - 19 IS - 2 SP - 349 EP - 353 PY - 2025 DA - 2001/08/19 SN - 1815-9346 DO - makrjms.2025.2.349.353 UR - https://makhillpublications.co/view-article.php?doi=makrjms.2025.2.349.353 KW - Blood sample storage KW - cell morphology KW - EDTA KW - hematological analysis KW - refrigeration AB -

Hematological analysis is fundamental in clinical practice, but delays in sample processing can compromise accuracy. This study aimed to evaluate the impact of storage time and temperature on complete blood count (CBC) parameters and blood cell morphology. Blood samples from 250 healthy adults were collected in K2EDTA tubes and stored at room temperature (18‐25°C) and refrigeration temperature (2‐8°C). Peripheral blood smears were prepared and analyzed at 0, 8,16, 24, 48, 72 and 96 hours post‐collection. Erythrocyte, leukocyte and platelet morphology were assessed using the Turgeon grading system and qualitative evaluation, respectively. Leukocyte differential counts were performed using an automated analyzer. Erythrocyte crenation was observed earlier and more frequently in samples stored at room temperature, starting at 8 hours, compared to refrigeration (starting at 24 hours). Loss of central pallor in erythrocytes occurred after 16 hours at room temperature and 48 hours under refrigeration. Leukocyte morphological changes, including cytoplasmic vacuolization, nuclear lobulation and pyknosis, were evident after 8 hours at room temperature and 24 hours under refrigeration. These changes impacted leukocyte differential counts, particularly at room temperature. Storage conditions significantly influence cellular morphology. Erythrocyte changes are attributed to membrane alterations, while leukocyte changes are linked to oxygen deprivation and metabolic stress. EDTA, the anticoagulant, also contributes to cellular damage over time. Immediate analysis of peripheral blood smears is recommended for optimal accuracy. If delays are unavoidable, refrigeration at 2‐8°C for up to 24 hours is preferable to room temperature storage. This study emphasizes the importance of standardized pre‐analytical procedures for reliable hematological analysis.

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