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Reticulocyte parameters of delta beta thalassaemia trait, beta thalassaemia trait and iron deficiency anaemia
  1. Diego Velasco-Rodríguez1,2,3,
  2. Juan-Manuel Alonso-Domínguez1,
  3. Fernando-Ataúlfo González-Fernández1,4,
  4. Jesús Villarrubia1,3,
  5. María Sopeña1,
  6. Lorena Abalo1,
  7. Paloma Ropero4,
  8. Jorge Martínez-Nieto4,
  9. Félix de la Fuente Gonzalo4,
  10. Fernando Cava1
  1. 1Department of Haematology, Laboratorio Central de la Comunidad de Madrid, Madrid, Spain
  2. 2Programa de Doctorado de Investigación en Ciencias Médico-Quirúrgicas, Universidad Complutense de Madrid, Madrid, Spain
  3. 3Department of Haematology, Hospital Ramón y Cajal, Madrid, Spain
  4. 4Department of Haematology, Hospital Clínico San Carlos, Madrid, Spain
  1. Correspondence to Diego Velasco-Rodríguez, Department of Haematology, Central Laboratory of Madrid, Hospital Infanta Sofía, Paseo de Europa 34, 28702 San Sebastián de los Reyes, Madrid, Spain; diegovelascorodriguez{at}


Aims 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.

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