Skip to main content
Log in

Reticulocyte counting in thalassemic and other conditions with the R-1000 Sysmex analyzer

  • Original Article
  • Published:
Annals of Hematology Aims and scope Submit manuscript

Summary

Precise reticulocyte counts are difficult to obtain by the manual method when their percentage in the blood is low or normal. In these instances, rapid reticulocyte counting by flow cytometry appears to offer more accuracy and precision. The purpose of this study was to establish reticulocyte counts in heterozygous β-thalassemia for reference purposes and to evaluate the performance of the recently introduced apparatus R-1000 (Sysmex) in the very heterogeneous thalassemic and sickle-cell syndromes. We studied a total of 364 samples; 102 heterozygous β-thalassemia carriers, 180 normal matched controls, 36 patients with thalassemia major or intermedia, and 46 patients with various sickle-cell syndromes. Reticulocyte counts (both as percentage and as total number) were higher in heterozygous β-thalassemia than in normal controls (p<0.001) and showed an inverse correlation with the respective hemoglobin values (p<0.001). These results confirm the proposed slightly increased erythropoietic activity in heterozygous β-thalassemia carriers. A drawback of the technique is that the reticulocyte-platelet discrimination error is signaled frequently in all conditions displaying a marked red cell heterogeneity, especially when these are associated with high reticulocyte numbers. This calls probably for readjustment of the corresponding algorithm. In addition, all these conditions show a significantly increased auramine-O mature red-cell nonspecific fluorescence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Alessi M, Longo G, Di Martino G, Cacciola JRE, Sortino G (1990) Serum erythropoietin levels in β-thalassemia. Ann NY Acad Sci 612: 534–535

    Google Scholar 

  2. Behrens G, von (1975) Mediterranean macrothrombocytopenia. Blood 46: 199–208

    Google Scholar 

  3. Corash L, Rheinschmidt M, Lieu S, Meers P, Brew E (1988) Enumeration of reticulocytes using fluorescence-activated flow cytometry. Pathol Immunopathol Res 7: 381–394

    Google Scholar 

  4. Davis B, Bigelow N (1989) Flow cytometric reticulocyte quantification using thiazole orange provides clinically useful reticulocyte maturity index. Arch Pathol Lab Med 113: 684–689

    Google Scholar 

  5. Ferguson D, Lee S, Gordon P (1990) Evaluation of reticulocyte counts by flow cytometry in a routine laboratory. Am J Hematol 33: 13–17

    Google Scholar 

  6. Kojima K, Niri M, Setoguchi K, Tsuda I, Tatsumi N (1989) An automated optoelectronic reticulocyte counter. Am J Clin Pathol 92: 57–61

    Google Scholar 

  7. Laharrague P, Corberand JX, Fillola G, Marcelino N (1990) Evaluation d'un analyseur automatique de reticulocytes: le Sysmex R-1000. Ann Biol Clin (Paris) 48: 253–258

    Google Scholar 

  8. Lee L, Chen C, Chiu L (1986) Thiazole orange: a new dye for reticulocyte analysis. Cytometry 7: 508–517

    Google Scholar 

  9. Makris P, Sclavunu S, Ballas A, Zurukzoglu W (1982) Le volume plaquettaire: etude comparative dans deux populations Grec et Francaise. Nouv Rev Fr Hematol 24: 301–306

    Google Scholar 

  10. Mazza U, Saglio G, Calligaris Cappio F, Camaschella C, Neretto G, Gallo E (1976) Clinical and haematological data in 254 cases of beta-thalassaemia trait in Italy. Br J Haematol 33: 91–99

    Google Scholar 

  11. Metzger DK, Charache S (1987) Flow cytometric reticulocyte counting with thioflavin T in a clinical hematology laboratory. Arch Pathol Lab Med 1: 540–544

    Google Scholar 

  12. Oyamatsu T, Shimizu N, Takeuchi K, Yamamoto M, Kawai Y, Watanabe K, Iri H (1898) Automated measurement of reticulocyte count by flow cytometry. II. Analysis of blood containing abnormal erythrocytes of giant platelets. Jpn J Clin Pathol 37: 807–812

    Google Scholar 

  13. Paterakis G, Papanikolaou A, Stathakis N, Terzoglou G (1987) Observed differences in computation of platelet parameters, by volume analysis, between beta-thalassemia heterozygotes and normal controls. Hellenic Armed Forces Med Rev 21: 283–286

    Google Scholar 

  14. Paterakis G, Terzoglou G, Vasiliou E (1989) The performance characteristics of an expert system for the “on-line” assessment of thalassemia trait and iron deficiency — Micro Hema Screen. Blood Cells 15: 541–561

    Google Scholar 

  15. Pootrakul P, Wasi P, Na-Nakorn S (1972) Haematological data in 312 cases of β-thalassemia trait in Thailand. Br J Haematol 24: 703–712

    Google Scholar 

  16. Salvatorelli G, Vedonato M (1989) EPO-EIA in β-thalassemic subjects. In: Proc 10th Congress of the ISH (European and African Div) Abstract 103

  17. Sklavunu S, Makris P, Athanasiadou F, Ballas A, Zurukzoglu W (1978) The platelet volume in adults with β-thalassemia trait. Arch Hellen Med Soc 5: 15–17

    Google Scholar 

  18. Tanke H, Rothbarth P, Vossen J, Koper G, Ploem J (1983) Flow cytometry of reticulocytes applied to clinical hematology. Blood 61: 1091–1097

    Google Scholar 

  19. Tichelli A, Gratwohl A, Driessen A, Mathys S, Pfefferkorn E, Regenass A, Schumacher P, Stebeler C, Wernli M, Nissen C, Speck B (1990) Evaluation of the Sysmex R-1000. An automated reticulocyte analyzer. Am J Clin Pathol 93: 70–78

    Google Scholar 

  20. Vaughan W, Hall J, Johnson K, Dougherty C, Peebles D (1985) Simultaneous reticulocyte and platelet counting on a clinical flow cytometer. Am J Hematol 18: 385–391

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Work supported by the Greek Ministry of Health (grant 1718/90)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Paterakis, G.S., Voskaridou, E., Loutradi, A. et al. Reticulocyte counting in thalassemic and other conditions with the R-1000 Sysmex analyzer. Ann Hematol 63, 218–222 (1991). https://doi.org/10.1007/BF01703447

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01703447

Key words

Navigation