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IJSTR >> Volume 9 - Issue 4, April 2020 Edition

International Journal of Scientific & Technology Research  
International Journal of Scientific & Technology Research

Website: http://www.ijstr.org

ISSN 2277-8616

Absolute Mature Reticulocyte Count As An Indicator Of Red Blood Cell Production

[Full Text]



Byung Ryul Jeon



Reticulocyte production index, AMRC, anemia, LFR, XE-2100



The reticulocyte production index (RPI), a standard metric used in the diagnosis of anemia, is calculated using two formulas. The first formula adjusts for anemia using the patient’s hemoglobin or hematocrit level to generate an expected hemoglobin/hematocrit ratio. The second formula adjusts for prematurely released reticulocytes based on the reticulocyte maturation time, as determined from the patient’s hematocrit level. However, modern automated hematology analyzers provide a wide array of data in addition to reticulocyte count (calculated as a percentage), including both the absolute reticulocyte count and the immature reticulocyte fraction. Using these parameters, we developed a new indicator, the absolute mature reticulocyte count (AMRC) which we evaluated relative to RPI values. A total of 1,349 samples were tested in terms of complete blood count (CBC) and reticulocyte count using a fully automated hematology analyzer (XE-2100; Sysmex Corporation, Kobe, Japan). The AMRC, calculated as AMRC = reticulocyte count × LFR (low fluorescence ratio), was compared with the RPI, calculated based on the “continuous maturation time” (RPI-C) and “stepwise maturation time” (RPI-S). The AMRC and RPI-C, and the AMRC and RPI-S, showed strong positive correlations (r2 = 0.87 and 0.76, respectively). Although the RPI is widely used for estimating red blood cell (RBC) production in the clinical setting, AMRC was shown to correlate well with RPI. Moreover, because AMRC does not require hematocrit correction, it can be readily automated and practically applied.



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