Aim of this research was to analyze application of comprehensive automated reticulocyte parameters in diagnosis and differentiation of anemias based on VUH SK experience. We analyzed all reticulocyte parameter orders sent to VUH SK Laboratory Medicine Center during October and December of 2012.
Material and methods. We selected 512 adult patients' test results of automated blood counts with reticulocyte parameters. All hematology assays were performed by automated hematology analyzer Sysmex XE-5000, employing principles of hydrodynamic focusing and fluorescent flow cytometry.
Results. It was found that reduced hemoglobin (HGB) concentration, consistent with anemia diagnosis was present in 63% of anatysed patients. These patients were analyzed further for reticulo-cyte production index (RPI). After applying of anemia differentiation algorithm based on HGB-MCV-RPI data, we revealed that most prominent part of pa -tients (62%) had normocytic anemia with hyporegenerative bone marrow response, 25% had macrocytosis with hyporegenerative response, while microcytosis with hyporegenerative and normocytosis with hyperregenerative BM response had 11% and 2% of patients respectively. We es -tablished range of diagnosis in each group of aforementioned patients and evaluated their patterns. Anemia differentiation algorithm also revealed less frequent patient groups: microcytosis, normocytosis and macrocytosis with normal BM re gener a tive re sponse along with macrocytosis with hyperregenerative BM response. We establish correlation of new reticulocyte parameters (IRF and RET-He) with other hematology assay parameters in each group of aforementioned patients. It was found that IRF parameter might prove to be useful in estimation of severity of BM supression by pathological process and RET-He parameter might be of value for detection of early iron deficiency and evaluation of early response to iron treatment.
Keywords: anemia differentiation algorithm, reticulocyte production index, fraction of immature reticulocytes, reticulocyte hemoglobin equivalent.
