Immature reticulocyte fraction is an early predictor of bone marrow recovery post chemotherapy in patients with acute leukemia

A. Raja Zahratul Raja-Sabudin, Ainoon Othman, Khalid Awad E. Ahmed-Mohamed, Azlin Ithnin, Hafiza Alauddin, Hamidah Alias, Zarina Abdul-Latif, Srijit Das, Fadilah S. Abdul-Wahid, Noor H. Hussin

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Objectives: To establish the benefits of immature reticulocyte fraction (IRF) measurement using an automated hematology cells analyzer over absolute neutrophil count (ANC) in predicting bone marrow recovery post induction chemotherapy. Methods: A prospective observational study was carried out in the Departments of Pathology, Medicine, and Pediatrics, Universiti Kebangsaan Malaysia, Medical Center (UKMMC), Kuala Lumpur, Malaysia during a period of 19 months from April 2009 to December 2010 to assess the bone marrow recovery in patients with acute leukemia. A total of 22 patients in remission induction phases were enrolled in this study. The blood specimens were collected from day zero after chemotherapy, and every 3 days until patients recovered hematologically. All blood samples were measured for ANC and IRF using an automated hematology analyzer (Beckman-Coulter LH750). Results: The percentage of patients showing IRF recovery earlier than ANC recovery was 63.6% (14 out of 22 patients). There was a significant difference in the mean number of days for IRF recovery as compared with ANC recovery (14.05 and 17.18 days), p=0.005. Conclusion: This study proved that IRF was more useful in predicting bone marrow recovery in a patient with acute leukemia post induction chemotherapy compared with ANC. The IRF is not affected by infection, is easily measured, and inexpensive; thus, it is a reliable parameter to evaluate bone marrow reconstitution.

Original languageEnglish
Pages (from-to)346-349
Number of pages4
JournalSaudi Medical Journal
Issue number4
Publication statusPublished - 2014
Externally publishedYes

ASJC Scopus subject areas

  • General Medicine


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