Microscope fluorometric investigations on the reticulocytic maturation distribution as diagnostic criterion of disordered erythropoiesis.

A microscope fluorometric technique is described which permits not only the visual identification of reticulocytes under the fluorescence microscope but also the determination of their relative stage of maturation to normocytes. The technique is based on a specific staining procedure which results in a fluorescent complex between the reticulocytic RNA and acridine orange. Thus, the relative mass of RNA in the individual reticulocytes can be measured by means of mciroscope fluorometry. As the reticulocytic RNA content decreases and finally disappears during the final maturation process of reticulocytes after their release into the peripheral blood stream, the fluorescence signal indicates the relative degree of this maturation. A characteristic frequency distribution of this parameter can be obtained for a given blood sample by microscope fluorometry measuring 200 to 300 reticulocytes. The preliminary use of this technique for following up the course of two cases of hemolytic anemia and one of pernicious megaloblastic anemia during their treatment demonstrates the potential diagnostic value of this technique of identifying the change of the reticulocyte maturation distribution in addition to the reticulocyte count. Satisfactory agreement between the microscope fluorometric results and those obtained by counting separately the four reticulocytic maturation stages according to Heilmeyer and Wesbäuser has been achieved. The possibility of obtaining quantitative and comparable results by use of this method may be considered a general advantage and a promising basis for the development of an automated technique.