Advanced Reticulocyte Parameters: Additional lab values to better understand red blood cell pathophysiology

Advanced Reticulocyte Parameters: Additional lab values to better understand red blood cell pathophysiology

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Variability in Band Reporting

 

  • RET%, RET# and Immature Reticulocyte Fraction (IRF) quantify mature and immature reticulocytes
  • IRF has been documented to be an indicator of erythropoiesis that correlates well with bone marrow recovery**
  • Reticulocyte Hemoglobin Equivalent (RET-He) represents hemoglobinization of the reticulocytes

 

Lab Workflow Benefits

  • Rapid determination of erythropoietic status is possible using hematological routine diagnostics
  • RET-He is analyzed from the same lavender top tube as the routine CBC
  • RET-He and IRF are reported with the reticulocyte count as a “comprehensive reticulocyte panel” and do not require any additional reagent or cost beyond a routine reticulocyte count

 

Clinical Benefits

  • When compared with the hemoglobin concentration or other RBC parameters, the advanced reticulocyte parameters can provide significantly faster insight into the erythropoietic status of patients with underlying red blood cell conditions.

 

Quantitative & Qualitative Information

The information provided by Sysmex’s advanced reticulocyte parameters paints a comprehensive picture of erythropoiesis.

  • Reticulocyte count: RET%, RET#
  • Reticulocyte maturity:
    • Nucleic acid in reticulocytes is stained using proprietary reagents
    • High fluorescing and moderately fluorescing reticulocytes are considered more immature and are included in the IRF result
  • Reticulocyte hemoglobin equivalent (RET-He)

 

Technology of RET Detection: Fluorescence Flow Cytometry

In the RET channel, the whole blood is diluted with CELLPACK™ DFL, then mixed with the fluorescent stain, Fluorocell™ RET. The stain enters the cells and attaches to the nucleic acids present. The fluorescence signal intensity measured in the flow cell corresponds to the nucleic acid content.

Reticulocytes emit a higher fluorescence signal than mature red blood cells (which do not contain nucleic acid) and a lower fluorescence signal compared to nucleated cells (WBCs, NRBCs). The reticulocyte population is divided into three populations based on their relative fluorescence: low, moderate and high fluorescing retics. The moderate and high fluorescing ratios are combined to calculate the Immature Reticulocyte Fraction (IRF). The stages of reticulocyte maturation can be determined because RNA content decreases as the reticulocyte matures.

Measurement Modes

In addition to the standard whole blood mode, the RET profile can also be analyzed in the pre-dilution mode offered by the XN and XN-L* analyzers.

*Available on XN-Series analyzers and optional on select XN-L Series analyzers *
*For references to independent publications, please contact your local Sysmex representative.

 


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