Reticulocyte parameters of delta beta thalassaemia trait, beta thalassaemia trait and iron deficiency anaemia.
OBJECTIVE
To analyse the differences in reticulocyte indices between delta beta thalassaemia trait (δβ-TT), beta thalassaemia trait (β-TT) and iron deficiency anaemia (IDA), and to correlate those differences with the physiopathological features of these three types of microcytoses.


METHODS
We performed a descriptive study of 428 samples (43 δβ-TT, 179 β-TT and 206 IDA) that were run on Advia 2120 analyser (Siemens). The following reticulocyte indices were assessed: absolute reticulocyte count (ARC), percentage of reticulocytes, mean corpuscular volume of reticulocytes (MCVr), haemoglobin content of reticulocytes (CHr), mean corpuscular haemoglobin concentration of reticulocytes, red blood cell distribution width of reticulocytes (RDWr), haemoglobin distribution width of reticulocytes (HDWr) and reticulocyte subpopulations based on their fluorescence according to mRNA (low (L-R), medium (M-R) and high (H-R)), MCV ratio and MCHC ratio. Correlation between fetal haemoglobin (HbF) and RDWr in patients with thalassaemia was evaluated.


RESULTS
RDWr was significantly higher in δβ-TT compared with β-TT (15.03% vs 13.82%, p<0.001), and so were HDWr (3.65% vs 3.27%, p<0.001), CHr (23.68 vs 22.66 pg, p<0.001) and MCVr (88.3 vs 85.5 fL, p<0.001). A good correlation was observed between HbF and RDWr (r=0.551, p<0.001). IDA subjects have more immature reticulocytes, but less ARC than β-TT, suggesting a certain degree of inefficient erythropoiesis in IDA in comparison with β-TT.


CONCLUSIONS
Previously described differences between δβ-TT, β-TT and IDA in the corpuscular indices of mature red blood cell can also be observed in reticulocytes. The degree of anisocytosis in reticulocytes from patients with thalassaemia is correlated with HbF.
Department of Haematology, Laboratorio Central de la Comunidad de Madrid, Madrid, Spain Programa de Doctorado de Investigación en Ciencias Médico-Quirúrgicas, Universidad Complutense de Madrid, Madrid, Spain Department of Haematology, Hospital Ramón y Cajal, Madrid, Spain.
Diego
D
Velasco-Rodríguez
Department of Haematology, Laboratorio Central de la Comunidad de Madrid, Madrid, Spain.
Juan-Manuel
JM
Alonso-Domínguez
Department of Haematology, Laboratorio Central de la Comunidad de Madrid, Madrid, Spain Department of Haematology, Hospital Clínico San Carlos, Madrid, Spain.
Fernando-Ataúlfo
FA
González-Fernández
Department of Haematology, Laboratorio Central de la Comunidad de Madrid, Madrid, Spain Department of Haematology, Hospital Ramón y Cajal, Madrid, Spain.
Jesús
J
Villarrubia
Department of Haematology, Laboratorio Central de la Comunidad de Madrid, Madrid, Spain.
María
M
Sopeña
Department of Haematology, Laboratorio Central de la Comunidad de Madrid, Madrid, Spain.
Lorena
L
Abalo
Department of Haematology, Hospital Clínico San Carlos, Madrid, Spain.
Paloma
P
Ropero
Department of Haematology, Hospital Clínico San Carlos, Madrid, Spain.
Jorge
J
Martínez-Nieto
Department of Haematology, Hospital Clínico San Carlos, Madrid, Spain.
Félix
F
de la Fuente Gonzalo
Department of Haematology, Laboratorio Central de la Comunidad de Madrid, Madrid, Spain.
Fernando
F
Cava
D018798:Anemia, Iron-Deficiency / Q000097:blood* / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D004906:Erythrocyte Count; D004909:Erythrocyte Indices; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D011237:Predictive Value of Tests; D012156:Reticulocytes / Q000378:metabolism / Q000473:pathology; D017086:beta-Thalassemia / Q000097:blood* / Q000175:diagnosis; D055538:delta-Thalassemia / Q000097:blood* / Q000175:diagnosis
D015415:Biomarkers; D006454:Hemoglobins
AUTOMATION; IRON; LABORATORY TESTS; RETICULOCYTE COUNTS; THALASSAEMIA