A joint research between a physician and a mathematician has led to development of a mathematical model on how red blood cells change in size and hemoglobin content, which can lead to predicting earlier anemia among patients.

John Higgins, MD, MGH, Center for Systems Biology and Department of Pathology and L. Mahadevan, PhD, Harvard School of Engineering and Applied Sciences (SEAS), built the model that is being published in the PNAS Early edition.

"This study describes a promising way to predict who is likely to become anemic before they actually do, and it is based on tests routinely performed in hospitals," said Higgins. "More generally, we found that a type of mathematical analysis commonly used in physics can be applied to clinical data and uncover new details of human physiology which can help improve diagnosis."

"We show that it is possible to use minimal models to compress the information available in existing clinical data into few parameters, which can then serve as a quantitative basis for comparing characteristics across the entire population," said Mahadevan.

Researchers have little knowledge on how red blood cells that develop in a body mature and eventually get destroyed. Around 250 billion oxygen-carrying red blood cells are released from the bone marrow every day in healthy adults, and a similar number are cleared from the bloodstream.

The researchers found that RBCs continue shrinking beyond the clearance threshold of healthy cells in patients with mild iron-deficiency anemia or a genetic condition called thalassemia trait. In a healthy individual, RBCs are cleared from the bloodstream before they shrink beyond a specific size.

In healthy adults, around 250 billion oxygen-carrying red blood cells (RBCs) are released from the bone marrow each day, and a similar number are cleared from the bloodstream. While a good deal is known about how these cells initially develop from blood-system stem cells, much less is known about how RBCs mature and are eventually destroyed.

"Looking for the initial shifting of this threshold may allow us to identify a developing anemia significantly earlier than we can now," said Higgins. "Unexplained iron-deficiency anemia in adults is often a sign of a much more serious disorder. One study showed that 11 percent of those with iron-deficiency anemia not caused by obvious bleeding actually had colon cancer. In cases like those, diagnosing anemia 90 days earlier would be comparable to diagnosing the underlying cancer 90 days sooner."