The absolute neutrophil count includes which cells?

• A. All neutrophils, except segmented forms
• B. All neutrophils, including mature and immature forms
• C. All neutrophils, except band neutrophils
• D. All neutrophils, only mature forms

Answer: (B)

The absolute neutrophil count measures the total circulating pool of neutrophils, including both mature and immature forms. It is derived from the white blood cell count and the differential, specifically by adding the percentage of neutrophils (m mature segmented cells) to the percentage of bands (immature neutrophils) and multiplying by the WBC. This means the ANC captures both mature neutrophils and the immature band forms in circulation. Clinically, a rise in bands (a left shift) accompanies infection or inflammation, increasing the ANC. Therefore, the correct concept is that the ANC includes all neutrophils, including mature and immature forms.