ESTABLISHMENT OF QUANTITATIVE MEASUREMENT OF FRAGMENTED RED CELLS USING RETICULOCYTE ANALYZER

点击翻译按钮获取中文摘要

Purpose : The purposes were to establish a method of fragmented red cells (FRC) quantification using automated hematology analyzer, XE-2100 and to study about the clinical usefulness of this method.Research ptocess : Experimentary produced FRC by heating were used and new program which shows positive correlation with the results of manual counting has been established. As the patients having small red cells such as iron deficiency anemia shows false pocitive data, complementary gate to revise the results was also developed. Now, clinical study to evaluate its efficacy of the diagnosis of bone marrow transplantation-related thrombotic microangiopathy (BMT-TMA) in collaboration with three other hospitals in Hyogo.Results :1) Reticulocyte analyzer (RET channel) equipped to XE-2100 analyzes cells by flowcytometry after staining with fluorescent dye. In the RET channel, small red cells were considered as FRC, and gate 1 was set to positively refiect the manual counting data (r=0.986). Ninety clinical samples also showed significantly positive correlation between them (r=0.876, p<0.001). However, 17 samples obtained from patients with small MCV had falsely positive FRC data due to detection nomal small cells in gate 1. Then, we have developed complementary gate 2 and the following formula was obtained. Revised FRC=calculated FRC/e 0.43^<gate2/total>2) The usefulness of this method was evaluated in the 14 patients with hemolytic uremic syndrome or thrombotic thrombocytopenic purpura. FRC did not correlated with total LD on admission. As increase in LD isoenzyme 5 was observed, we have checked the relationship between them (r=0.732, p=0.008), indicating that FRC detected by our method reflects hemolysis.3) The increase in FRC % in the patients treated with bone marrow transplantation was detected in several conditions such as infection, VOD and so, on. Now, weare evaluating the efficacy of this method to detect BMT-TMA.