Contributions
Abstract: PB1815
Type: Publication Only
Session title: Thalassemias
Background
Anaemia is a global public health problem that affects almost one-third of the world population. Thalassaemia and iron deficiency anaemia are the most common causes of microcytic anaemia, with similar clinical and laboratory features, making their diagnostic often complicated. During the last decade, cell counter-based formulae and algorithms have been proposed in the differential diagnosis of microcytic anaemias. Unfortunately, only a few studies take into account certain not so rare clinical situations where microcytic anaemia may occur.
Aims
The aim of this study was to develop an algorithm as first tier screening tool in the differential diagnosis of microcytic anaemias.
Methods
We retrospectively analyzed results of complete red blood cells (RBCs) and reticulocyte (RET) counts obtained on the Sysmex XN-9000 of 280 adults, divided into 5 different groups : iron deficiency anaemia (n=56), β-thalassaemia minor (n=68), heterozygous haemoglobinopathies (n=24), hereditary spherocytosis (n=14) and other patients (n=118). A Classification and Regression Tree (CART) analysis was performed to obtain an algorithm in order to predict these groups.
Results
Four parameters were selected by the CART analysis: the percentage of microcytic RBCs (%MicroR), the %MicroR to percentage of hypochormic RBCs ratio (%MicroR/%Hypo-He), the reticulocyte haemoglobin content (RET-He) and the reticulocyte count to immature reticulocyte fraction ratio (RET/IRF). When applying the algorithm, 93/106 of the hereditary RBC disorder patients and 41/56 iron deficiency anaemia patients were corectly screened. The correct overall classification rate reached 83.6%. The best sensitivity and specificity were obtain for the screening of β-thalassaemia minor, with 92.6% and 94.8% respectively.
Conclusion
We proposed a costless, affordable, easy to use and effective algorithm that can be used routinely for the differential diagnosis of microcytic anaemias. The latter is based on erythrocyte and reticulocyte parameters offered by the most recent generation of the Sysmex analyzers, the XN-9000.
Keyword(s): Anemia, Hemolytic anemia, Iron deficiency anemia, Thalassemia
Abstract: PB1815
Type: Publication Only
Session title: Thalassemias
Background
Anaemia is a global public health problem that affects almost one-third of the world population. Thalassaemia and iron deficiency anaemia are the most common causes of microcytic anaemia, with similar clinical and laboratory features, making their diagnostic often complicated. During the last decade, cell counter-based formulae and algorithms have been proposed in the differential diagnosis of microcytic anaemias. Unfortunately, only a few studies take into account certain not so rare clinical situations where microcytic anaemia may occur.
Aims
The aim of this study was to develop an algorithm as first tier screening tool in the differential diagnosis of microcytic anaemias.
Methods
We retrospectively analyzed results of complete red blood cells (RBCs) and reticulocyte (RET) counts obtained on the Sysmex XN-9000 of 280 adults, divided into 5 different groups : iron deficiency anaemia (n=56), β-thalassaemia minor (n=68), heterozygous haemoglobinopathies (n=24), hereditary spherocytosis (n=14) and other patients (n=118). A Classification and Regression Tree (CART) analysis was performed to obtain an algorithm in order to predict these groups.
Results
Four parameters were selected by the CART analysis: the percentage of microcytic RBCs (%MicroR), the %MicroR to percentage of hypochormic RBCs ratio (%MicroR/%Hypo-He), the reticulocyte haemoglobin content (RET-He) and the reticulocyte count to immature reticulocyte fraction ratio (RET/IRF). When applying the algorithm, 93/106 of the hereditary RBC disorder patients and 41/56 iron deficiency anaemia patients were corectly screened. The correct overall classification rate reached 83.6%. The best sensitivity and specificity were obtain for the screening of β-thalassaemia minor, with 92.6% and 94.8% respectively.
Conclusion
We proposed a costless, affordable, easy to use and effective algorithm that can be used routinely for the differential diagnosis of microcytic anaemias. The latter is based on erythrocyte and reticulocyte parameters offered by the most recent generation of the Sysmex analyzers, the XN-9000.
Keyword(s): Anemia, Hemolytic anemia, Iron deficiency anemia, Thalassemia