Investigation of poikilocytic normochromic normocytic anemia. 1. Round and elongated forms

Occasional nonspecific poikilocytes are found in most normal blood smears, but dominance of one or more forms of poikilocytes usually is indicative of a specific anemia or disease in an organ or organ system. For example, stomatocytes are most commonly associated with acute alcoholism, while teardrop cells classically reflect "spent" polycythemia vera or myelofibrosis. The clinical significance of the various round poikilocytes (spherocytes, stomatocytes, target cells) and elongated poikilocytes (ovalocytes and elliptocytes, teardrop cells, sickle cells) is discussed.