A new red cell index and portable RBC analyzer for screening of iron deficiency and Thalassemia minor in a Chinese population

Abstract

Anemia is a widespread public health problem with 1/4 ~1/3 of the world’s population being affected. In Southeast Asia, Thalassemia trait (TT) and iron deficiency anemia (IDA) are the two most common anemia types and can have a serious impact on quality of life. IDA patients can be treated with iron supplementation, yet TT patients have diminished capacity to process iron. Therefore, distinguishing between types of anemia is essential for effective diagnosis and treatment. Here, we present two advances towards low-cost screening for anemia. First: a new red-cell-based index, Joint Indicator A, to discriminate between IDA, TT, and healthy children in a Chinese population. We collected retrospective data from 384 Chinese children and used discriminant function analysis to determine the best analytic function to separate healthy and diseased groups, achieving 94% sensitivity and 90% specificity, significantly higher than reported indices. This result is achieved using only three red cell parameters: mean cell volume (MCV), red cell distribution width (RDW) and mean cell hemoglobin concentration (MCHC). Our second advance: the development of a low cost, portable red cell analyzer to measure these parameters. Taken together, these two results may help pave the way for widespread screening for nutritional and genetic anemias.

Prognostic value of baseline hemoglobin‐to‐red blood cell distribution width ratio in small cell lung cancer: A retrospective analysis

“…Red blood cell distribution width (RDW) is another important CBC parameter. RDW has been used for the diagnosis and differential diagnosis of various types of anemia . In recent years, changes in RDW have been found to be related to the inflammatory state of the body, which has been shown to affect the development of tumors .…”

“…RDW has been used for the diagnosis and differential diagnosis of various types of anemia. 15 In recent years, changes in RDW have been found to be related to the inflammatory state of the body, 16,17 which has been shown to affect the development of tumors. 18,19 Therefore, researchers explored the relationship between RDW and the prognosis of some malignant tumors and confirmed that a high RDW is associated with a poor prognosis, such as in breast cancer, 20 esophageal cancer, 21 non-small cell lung cancer (NSCLC), 22 SCLC, 23 and other tumors.…”

Screening of nutritional and genetic anemias using elastic light scattering

“…The zero degree scattering is defined by the propagation direction of the incident beam, while our optical system collects the forward-directed portion of the 4π-steradian sphere of scattering angles. Compared to our prior-reported system, 35 the utilized wavelengths have been changed, and the optical system has been redesigned to eliminate a dichroic mirror, reducing cost while minimizing wavefront aberrations that can interfere with the generation of a clean scattering pattern.…”

“…33,34 We previously reported that quadratic discriminant analysis (QDA) applied to the three red cell parameters MCV, RDW, and MCHC outperformed established indices in discriminating healthy from anemic patients, and IDA from TT patients in Chinese children. 35 However, these parameters are currently measured in the hospital by a complex flow cytometry system that requires regular maintenance and operation by a highly trained user. This makes their measurement by standard methods unsuitable for wide-spread population-level screening.…”

“…[36][37][38] We previously demonstrated the proofof-concept of a cost-effective red cell analyzer for measuring light scattering from whole blood, without sample flow or any moving parts, to quickly determine red cell morphology. 35,37 However, as our prior work was primarily focused on establishing, through historical review, that cell morphology could accurately separate anemia types, the validation of our instrument was strictly limited to a 10-patient proof of concept study of healthy adult subjects.…”