Biochemical markers and haematologic indices in the diagnosis of iron-restricted erythropoiesis and monitoring of r-HuEPO therapy

Summary: Classical iron deficiency (ID) is not a challenge for the laboratory and physicians. The diagnosis is associated with microcytic hypochromic anemia and low serum ferritin. Anemia that accompanies infection, inflammation, and cancer, commonly termed anemia of chronic disorders (ACD) has apparently normal or increased iron stores. However, 20% of these patients have iron-restricted erythropoiesis (functional ID), an imbalance between iron requirements of the erythroid marrow and the actual iron supply. Functional ID leads to a reduction of red cell hemoglobinization, which causes hypochromic microcytic anemia. The early diagnosis of functional ID is based on the measurement of heamoglobin content of reticulocytes. This index can be estimated measuring the CHr with the Bayer Advia analyzer or the Ret-Y, using the Sysmex XE analyzer series. A CHr 1 pg, of sTfR > 20% or an upward movement of the patient data point in the diagnostic plot indicates response to iron or r-HuEPO.