Recent Advances in the Knowledge of Total Red Cell Volume, Production and Destruction

Since anemia or polycythemia can result only from a change in rate of formation of red cells or a change in the life span of the red cells, a determination of the total red cell volume, Fe⁵⁹ studies to estimate the rate and site of production of red cells, and C¹⁴-labeled glycine or Fe⁵⁹ studies to determine the life span of red cells permit a description of the pathogenesis of any alterations in the erythropoietic state. This has been of great value in clinical hematology from the stand-point of understanding the basic nature of the various diseases and, in particular, the selection of patients with unusual anemias possibly related to hypersplenism who might benefit from splenectomy. Splenic erythropoiesis can be easily differentiated from splenic red cell destruction.

Since two of these methods—the determination of the blood volume and the Fe⁵⁹ studies—are now possible in general commumnity hospitals and since modifications of the Fe⁵⁹ method permit the determination of the life span of the red cell, adequate evaluation of the erythropoietic state is now possible in general hospitals.