The reticulocyte hemoglobin equivalent (Ret He) represents an indirect measure of the functional iron available for erythropoiesis over the previous 2-3 days. Only the analyzers of a single manufacturer, Sysmex (Sysmex Corporation, Kobe, Japan), include Ret He. Red blood cell size factor (RSf) is a new parameter provided by Beckman Coulter, which joins together the volume of the erythrocytes and the volume of reticulocytes. The aims of the study were to investigate the clinical usefulness of RSf in the study of erythropoiesis status and to assess its concordance with Ret He values. Samples from 417 patients were run on both LH 78 (Beckman Coulter) and Sysmex XE 5 analyzers. Independent samples t-test, Pearson correlation, receiver operating characteristic (ROC) analysis and inter-rater reliability ([kappa] index) were applied. Good correlation between RSf and Ret He was observed, r = .8184. Significant differences (P < .1) were detected when groups with inefficient erythropoiesis were compared with patients undergoing therapy and healthy subjects. ROC analysis for RSf in the diagnosis of inefficient erythropoiesis, cutoff 91.1 fl, area under curve .963, sensitivity 91.7%, specificity 88.5%. Concordance between RSf and Ret He [kappa] = .68. RSf and Ret He are suitable parameters for the assessment of erythropoiesis status.
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