Red blood cell size differential method for time-series detailed monitoring of anemic disorders with RBC size abnormalities in mean corpuscular volume (MCV) and/or red blood cell distribution width (RDW)

AbstractBackground: Size heterogeneity in red blood cells (RBCs), as indicated by elevated RBC distribution width (RDW), is increasingly considered a prognostic factor in various diseases. However, the semi-quantitative nature of the RDW value appears limited when evaluating quantitative changes in time-series RBC size distributions over a clinical course. Methods: We developed a time-series anemia monitoring program by displaying progressive differences between six size fractions in an RBC size distribution. To standardize each variation precisely, our program includes an angular transformation that is applied to all measured count ratio data. Results: By representing microcytic and/or macrocytic changes in time series independently, this method appears to improve evaluations of anisocytosis, reflecting the responsiveness of treatments and effects, such as deficiencies in iron or vitamin B12. Time-series displays of RBC size changes also appear to enable verification of latent clinical developments at ea...