Reticulocyte hemoglobin equivalent (Ret-he) as measurement of bone marrow iron storage

Prussian blue staining examination is the current gold standard for evaluation of bone marrow iron storage. This procedure re-quires bone marrow aspiration examination, which is physically uncomfortable, expensive, and burdensome for patients. Reticulocyte hemoglobin equivalent (RET-He) determination is a method used to detect hemoglobin in reticulocytes, an indicator of potential iron deficiency and erythropoietic disorders. The purpose of this study is to assess RET-He as a method of measuring bone marrow iron storage. From August–December 2017, secondary data were collected from 50 patients (24 females and 26 males) without history of blood transfusion four days prior to RET-He. Data was analyzed using chi-squared and unpaired t-test. Between positive and negative bone marrow iron storage groups, there were significant differences in mean age (44 vs. 53 y, respectively, p= 0.024) and RET-He (29.7 vs. 26.9, respectively, p= 0.041). Based on ROC analyses, the AUC score was 0.672 (p= 0.030), which indicates that RET-He > 28.8 represents positive bone marrow iron storage with 72.0% sensitivity and 68.0% specificity. RET-He can be used as a method of measuring bone marrow iron storage.