Assessing iron depletion in regular platelet apheresis donors: A comparison of reticulocyte haemoglobin and serum ferritin

BACKGROUND AND OBJECTIVES: Frequent platelet apheresis donations can lead to iron depletion. Serum ferritin is traditionally measured to assess iron status in donors. Reticulocyte haemoglobin (RET-He) has emerged as a rapid, convenient and cost-effective alternative. This study aimed to determine the prevalence of iron depletion among regular platelet apheresis donors and to evaluate the sensitivity and specificity of RET-He compared to serum ferritin in diagnosing iron depletion. MATERIALS AND METHODS: This cross-sectional study involved 100 healthy, regular platelet apheresis donors aged 18-60 years who donated at least once a month. RET-He, serum ferritin and complete blood count results were analysed. The sensitivity and specificity of RET-He were calculated against serum ferritin. RESULTS: Of the 100 donors, 13.00% (13 out of 100 donors) had serum ferritin levels <15 ng/mL, indicating iron depletion. RET-He showed a sensitivity of 76.92% (95% confidence interval [95% CI]: 46.19%-94.96%) and specificity of 44.83% (95% CI: 34.15%-55.87%) in detecting iron depletion. Significant differences in RET-He levels, donation frequency, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, white blood cell count and red cell distribution width were detected between the iron-depleted and non-iron-depleted groups (p = 0.045, 0.032, 0.053, 0.026, 0.069 and 0.027, respectively). CONCLUSION: Frequent platelet donations increase the risk of iron depletion; therefore, iron supplementation is recommended for regular donors. While RET-He testing is convenient, cost effective and fast, it cannot replace serum ferritin testing because of insufficient sensitivity and specificity.