Within-subject biological variation of reticulocytes and reticulocyte-derived parameters

Automation of reticulocyte counting has decreased the analytical imprecision of this parameter. This has made it possible to use the number of reticulocytes and its derived parameters (reticulocyte maturity and reticulocyte cell indices) in new diagnostic and monitoring situations. For rational use of these parameters, it is important to have knowledge of their biological variability. The biological variability of reticulocytes and its derived parameters was studied in 13 healthy people during a period of 7 wk on 2 different instruments. The within-subject coefficient of variation for the reticulocyte count was about 11%, for the mean reticulocyte volume, mean reticulocyte haemoglobin content and mean reticulocyte haemoglobin concentration it was between 1 and 2%, whereas the coefficient of variations for the subpopulations of reticulocytes with different maturity varied depending on the method used for the measurements. The critical difference, that is the change in a result making it significantly different from the previous result, was about 35% for the reticulocyte count and 5-8% for the reticulocyte cell indices, making these indices excellent to follow changes in erythropoiesis. With a possible exception for the mean reticulocyte volume, the within-subject variation was small compared to the between-subject variation.