The most classical studies of blood cell counting and morphologic observation were
used to chamber count and microscopy, so they are tedious and time consuming. But in
this century, the continuous investigations had shown many useful indices such as
MCV, MCH and MCHC to diagnose about several red cell disorders.
Then MCV reveals only the average value of many cells, does not indicate
heterogeneity of red cell populations. Recently, the changes from chamber counter to
flow cytometry or electronic impedance method for routine blood count have brought not
only improved speed and precision but also routinely provide RDW values by analysis of
large number of variable sifted red cells.
Some authors reported that RDW was clinically informative and precious indicator for
the morphologic classification of various etiologic anemias, as terms of heterogenous or
homogenous anemia.
Therefore we obrained RDW and other red cell indices in 348 patients of various
hematologic conditions and 100 healthy control group to evaluation of clinical significance
in the classification of anemic disorders.
We observed the following results :
1. In the most of cases, the increment or decrement of MCV were always combined
the perarell changes of MCH and MCHC. But the values of MCV and RDW were rarely
correlated in any cases.
2. So the terms of "heterogenous" or "homogenous anemia" were clinically more
meaningful morphologic classification than "hypochromic" or "normochromic anemia. "
3. The heterogenous microcytic anemia contained I.D.A., anemia due to splenomegaly
and the state after major surgery. In heterogenous normocytic anemia, the secondary
anemia of solid tumor, acute blood loss and A.M.L. were parted. The perncious anemia,
ALL and immune hemolytic anemia were belonged to heterogenous macrocytic anemia.
4. The homogenous microcytic anemia was observed in anemia of chronic disorders. In
homogenous normocytic anemia, the anemia in rheumatoid disorders and chronic
leukemia were parted. The aplastic anemia and MDS were belonged to homogenous
macrocytic anemia.
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