Hubungan antara Indeks Produksi Retikulosit (IPR) dengan Red Blood Cell Distribution Width (RDW) pada Klasifikasi Anemia berdasarkan Defek Fungsional

Setyawati Setyawati, Endah Pembantjanawati, Linda Rosita


Reticulocyte Production Index (RPI) is a shift correction for the presence of reticulocyte that can assesses the real erythropoietic response of the bone marrow. RPI can be used to classify anemia as result from functional defect, i.e. RPI<2 for hypoproliferative and maturation defect anemia, and RPI>3 for hemolytic anemia. Measurement of Red Blood Cell Distribution Width (RDW) is the mathematical representation of variance within the size distribution of the red cell population. The objective of this study was to identify the variation of the red cell size within the population measured (anisocytosis) enable to determine the cell population as homogeneous (normal RDW) or heterogenous (increased or high RDW). The role of RDW to differentiate functional defect anemia with RPI<2 has not been studied. This study was done at Hematology Department Dr. Sardjito Hospital. In such a cross sectional study, the subjects were considered as anemic patients based on automated laboratory analyzer, peripheral blood smear, and reticulocyte count result. The result showed that seventy patients met the inclusion criteria. Sixty seven patients (95,71%) had RPI<2 classified as hypoproliferative and maturation defect anemia, 2 patients (2,85%) had RPI = 2-3 classified as borderline group and 1 patient (1,42%) had RPI>3 classified as hemolytic anemia. Means for reticulocyte count, corrected reticulocyte count, RPI, and RDW for hypoproliferative and maturation defect anemia were 2,8% and 2,3%; 1,1% and 1,1%; 0,4 and 0,5; 21,8% and 17,8% respectively, with p value by the Wilcoxon Signed Ranks Test are = 0,322; 0,52; 0,273; and 0,27 (CI = 95%). The proportion of anisocytosis and normocytosis for hypoproliferative anemia were 76,08% and 23,9% and for maturation defect anemia were 76,19% and 23,8% with Chi-Square test 0,000 and p = 0,993. No correlation between was observed RDW and RPI<2 with Spearman correlation (r = 0,0297 and p = 0,993). It is concluded that the use of RDW and RPI is not always useful to differentiate hypoproliferative and maturation defect anemia on the group of anemia categorized as RPI<2 without support from another laboratory test especially in combined anemia.


functional defect anemia; anisocytosis; hypoproliferative anemia

Full Text:



Bell A, Rodak BF 2002. Hematology, Clinical Principles and Application. W.B. Saunders Company, Philadelphia, Pensylvania, 119-210.

Brown BA 1993. Hematology: principles and procedures. Six Edition. Philadelphia: Lippincott William & Wilkins, 111-116.

Dacie SJV, Lewis SM 1991. Practical Haematology. Seventh Edition Edinburgh London Melbourne and New York: Churchill Livingstone, 61-63.

Dahesihdewi A, Setyawati 2002. Penetapan Indeks Produksi Retikulosit Berdasarkan Nilai Rerata Hematokrit Normal, dalam Proseding Makalah Bebas Nasional Pertemuan Ilmuah Tahunan (PIT) PPDS Patologi Klinik.

Davidsohn, Henry 1974. Clinical Diagnosis By Laboratory Methods. Philadelphia: W.B Saunders Company, 159-165.

Fraser AR 1995. FIBMS No. 1: Haematology. SP Series for Medical Laboratory Technology. First Edition, 34.

Hillman R, Ault AK 1995. Hematology in Clinical Practice: A Guide to Diagnosis And Management, International Edition McGraw-Hill, Inc, 27-30.

Hillman RS, Finch CA 1996. Red Cell Manual. 7th Edition Philadelphia: F.A. Davis Company, 39-65.

Hoffbrand AV, Pettit JE 1996. Kapita Selekta Haematologi. Edisi Ke2. Alih bahasa Darmawan, I. Penerbit Buku Kedokteran, EGC,


Henry JB, Clinical Diagnosis & Management 1991. 18th Edition W.B. Saunders Company, 581-583.

Kjeldsberg, Carl R MD 1995. Practical Diagnosis of Hematologic Disorders. Second Edition Chicago Illinois, ASCP Press, 18-19.

Ravel, R. 1995. Clinical Laboratory Medicine, Clinical Application of Laboratory Data. Sixth Edition, Mosby-Year Book, Inc. 9-21.

Stiene–Martin EA, Lotspeich–Steininger CA, Koepke JA 1998. Clinical Hematology Principles, Procedures, Correlations. Second Edition Philadelphia New York: Lippincott, 114-115.

Supandiman I 1994. Hematologi Klinik. Penerbit Alumni, Bandung, 1-7.

Sysmex SE-9500. 1999. Operator’s Manual Automated Hematology Analyzer. Japan.

Walters JMT, ACL Lab Link 2002. Hematology Review: RDW Measurement and Their Meaning, Vol.3, Issue 3, 2002.

Winarno AA, Setyawati 2002. IPR (Indeks Produksi Retikulosit) pada Berbagai Klasifikasi Anemia. dalam Proseding Makalah Bebas Nasional Pertemuan Ilmuah Tahunan (PIT) PPDS Patologi Klinik.



  • There are currently no refbacks.

Copyright (c) 2016 YARSI Medical Journal

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.


Copyright of Jurnal Kedokteran YARSI.

Powered by OJS.

Creative Commons License

This work is licensed under a Creative Commons Attribution- NonCommercial 4.0 International License.