Innovative haematological parameters in clinical practice

Abstract

Anaemia is a global public health problem affecting populations in both developing and developed countries. According to the World Health Organisation (WHO) anaemia affects 1.62 billion people, which corresponds to 25% of the world population. In case of anaemia microcytic erythropoiesis is frequently due to iron deficiency and α- or β-thalassaemia. It is important to discriminate between iron-deficiency anaemia and thalassaemia in order to avoid unnecessary iron therapy and to prevent the development of haemosiderosis which may result in serious complications like cardiomyopathy, liver fibrosis or endocrine dysfunctions.A variety of laboratory parameters is available for anaemia screening and assessment of iron status. However, no single marker or combination of tests is optimal for discrimination between iron deficiency, functional iron deficiency and thalassaemia.In this thesis, the additional value of innovative haemocytometric parameters reflecting haemoglobin content of red blood cells and reticulocytes is investigated in subjects with microcytic anaemia, patients undergoing haemodialysis treatment, subjects with community acquired pneumonia, and women during pregnancy. Clinical studies revealed the usefulness of innovative haemocytometric parameters for haemoglobinisation of red blood cells (RBC) and reticulocytes, RBC-He and Ret-He. The applicability of newly derived discriminating algorithms for the screening and diagnosis of haematological abnormalities is evaluated. Subsequently, the laboratory screening for anaemia is improved by the development of advanced discriminating algorithms for the diagnosis of iron-deficient erythropoiesis and thalassemia.This thesis provides a basis for improved diagnostics of anaemia using specific parameters or advanced algorithms, depending on the patient group involved