Computing Your ANC
Your Absolute Neutrophil Count (ANC) is computed by multiplying your white blood cell count by the percentage of neutrophil cells among your white blood cells, specifically the mature neutrophils called segmented neutrophils and the almost mature neutrophils called bands.
The Marrowforums ANC Calculator will compute your ANC from the results shown on your differential lab report.
If you'd like to compute your ANC from your lab report yourself, this page explains how.
For more information about your ANC and what it means, see ANC: Absolute Neutrophil Count.
The formula for computing ANC has the form
ANC = WBC × Multiplier × Neutrophil percentagewhere:
- WBC is your White Blood Count.
- Multiplier is 1 if your lab report shows your WBC in cells per microliter (ÁL).
- Multiplier is 1000 if your lab report shows your WBC in thousands of cells per microliter (or 103/ÁL or K/ÁL).
- Percentages should be divided by 100 if they are shown as numbers between 0 and 100. For example, when 50 means 50% you should divide it by 100 to get 0.5, and use 0.5 in the ANC formula.
- Percentages should be used as is if they are decimal values between 0 and 1. For example, when 0.5 means 50% you should use 0.5 in the ANC formula.
The formula used to compute ANC depends in part on which combination of white cells blood types are included in your lab report. Use this chart to determine the case, then use the formula below the chart.
|Combination of Counts||Use||Comments|
|Neutrophils but not Band neutrophils||This assumes that NEUT means Total neutrophils. If you also have a value for SEGS, you can confirm this by checking that NEUT is the sum of SEGS + BANDS.|
|Neutrophils and Band neutrophils||It's not clear if NEUT means Total neutrophils (|
|Segmented neutrophils and Band neutrophils||We don't need to use the NEUT value in this case because Total neutrophil percentage = Segmented neutrophil percentage + Band neutrophil percentage = SEGS% + BANDS%|
|Polys but not Neutrophils or Band neutrophils||This assumes that POLY means Total neutrophils. If you also have a value for SEGS, you can confirm this by checking that NEUT is the sum of SEGS + BANDS.|
|Polys and Band neutrophils but not Neutrophils||It's not clear if POLY means Total neutrophils (|
ANC = WBC × Multiplier × NEUT% [Formula 1]
ANC = WBC × Multiplier × ( NEUT% + BANDS% )[Formula 2]
ANC = WBC × Multiplier × ( SEGS% + BANDS% )[Formula 3]
ANC = WBC × Multiplier × POLY% [Formula 4]
ANC = WBC × Multiplier × ( POLY% + BANDS% )[Formula 5]
Variations from One Lab to Another
Finding the right counts on your lab report and determining the Multiplier to compute your ANC are complicated by variations among the labs that do blood tests. Each lab that serves a doctor or treatment center may have its own conventions for the reports it issues.
A survey of other ANC calculators on the Internet shows that they don't account for these differences among lab reports. They assume that your lab report uses a particular set of counts, names, units, and notation. They usually assume that your differential results are shown as percentages, which is not always the case. In contrast, the Marrowforums ANC Calculator attempts to accommodate all of the variations among labs.
Here are factors that differ from one lab to another, which often make it tricky to interpret your lab report:
- Different names for your counts.
The label "neutrophils" is used inconsistently, sometimes referring to your total neutrophils (both segmented neutrophils and bands) and sometimes referring to only your segmented neutrophils. The same is true of the word "poly", short for polymorphonucleocytes or polymorphonuclear neutrophils (PMN). Lab reports may use either word with either meaning.
Bands are sometimes called stabs.
If your ANC is shown, it may be called AGC instead.
- Different units of volume.
Some lab reports show your WBC and other absolute blood counts in milliliters, some in microliters, some in liters, and some in cubic millimeters. Microliters and cubic millimeters are equivalent, but milliliters differ from microliters by a factor of 1000 and liters differ from milliliters by another factor of 1000.
- Different cell counting.
Some lab reports show counts as number of cells while others show number of thousands of cells.
- Different abbreviations.
Milliliters may appear as ml, mL, 10-3L, 10-3L, /103L, /10-3L, or in other ways.
Microliters may appear as Ál, ul, ÁL, uL, mcl, mcL, 10-6L, 10-6L, /106L, /10-6L, or in other ways.
"Thousands of cells" may appear as K, 103, 10-3, or in other ways, sometimes with a leading × symbol.
- Different scales for percentages.
Some labs report percentages on a scale of 0 to 100, so the percentages add up to 100. Other labs report percentages as decimals on a scale of 0.0 to 1.0, so the percentages add up to 1.0.
- Different reporting of your differential.
Some labs report your absolute number of cells (sometimes called the Absolute Cell Count or ACC) rather than your percentage of cells.
Accounting for Lab Variations When Computing Your ANC
To handle the variations among labs, we suggest that you use the ANC Calculator. It is specially designed to compute your ANC across all of these lab variations, and it shows you the formula it uses.
If you'd rather compute your own ANC, these guidelines may help:
- As a rule of thumb, if your WBC is a four- or five-digit whole number, e.g., 4500 or 10100, then the units are cells per microliter (or, equivalently, thousands of cells per milliliter) and the Multiplier is 1. If your WBC is a one- or two-digit number with a decimal, e.g., 4.5 or 10.1, then the units are thousands of cells per microliter (or millions of cells per milliliter) and the Multiplier is 1000.
- If your lab report shows your differential values as percentages that add up to 100 (or approximately 100), then each percentage should be divided by 100 when used in the formulas above. For example, divide 50 percent by 100 to get 50/100, or 0.50.
- If your lab report shows your differential values as decimal percentages that add up to 1.0 (or approximately 1.0), then each percentage should be used as is in the formulas above. For example, leave 0.15 as 0.15.
- If your lab report shows your differential values as absolute number of cells instead of percentages, you can convert your differential counts into percentages (by dividing them by the sum of them all) and then use the formulas above, but an easier method is to compute ANC directly from whichever counts are on your lab report:
- ANC = Absolute neutrophil count × Multiplier [Formula 6]
- ANC = ( Absolute segmented neutrophil count + Absolute band neutrophil count ) × Multiplier [Formula 7]
- ANC = ( Absolute neutrophil count + Absolute band neutrophil count ) × Multiplier [Formula 8]
- Use Formula 2, Formula 5, or Formula 8 only if you know that your Neutrophil count or your Poly count does not already include your Band neutrophil count. To be certain, ask your lab or doctor.