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Simultaneous measurement of reticulocyte and red blood cell indices in
healthy subjects and patients with microcytic and macrocytic anemia
G d'Onofrio, R Chirillo, G Zini, G Caenaro, M Tommasi and G Micciulli
Research Center for the Development and Clinical Evaluation of Automated
Methods in Hematology, Universita Cattolica del Sacro Cuore, Rome, Italy.
Using the new Bayer H*3 hematology analyzer (Leverkusen, Germany), we have
determined red blood cell and reticulocyte indices in 64 healthy subjects,
in patients with microcytosis due to iron deficiency (58 patients) and
heterozygous beta-thalassemia (40 patients), and in patients with
macrocytosis (28 patients). We found in all cases that reticulocytes were
larger than mature red cells by 24% to 35%, with a hemoglobin concentration
16% to 25% lower and a similar hemoglobin content. The correlation between
red cell and reticulocyte indices was strikingly tight (r = .928 for
volume, r = .929 for hemoglobin concentration, r = .972 for hemoglobin
content) in all four groups, regardless of red blood cell size. The ratio
of reticulocyte to red blood cell mean corpuscolar volume (MCV ratio) was
constantly above 1. Inversion of the MCV ratio was observed only in four
patients. It was always abrupt and transitory and was associated with
erythropoietic changes leading to the production of red blood cells of a
different volume (treatment of megaloblastic anemia, functional iron
deficiency, bone marrow transplantation). In two cases of marrow
transplantation, reticulocyte volume fell during the aplastic phase after
conditioning chemotherapy and then rapidly increased up to values higher
than before; this production of macroreticulocytes was the earliest sign of
engraftment.
Volume 85,
Issue 3,
pp. 818-823,
02/01/1995
Copyright © 1995 by The American Society of Hematology
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