From Wintrobe to the XXI century. A Story of Inspiration and Effort

MMWintrobe the pioneerIn 2014 we are celebrating the 80 th anniversary of Maxwell Myer Wintrobe´s pioneer publications, one of the most important contributions in Clinical and Laboratory Medicine.Red cell indices, widely known as Wintrobe´s indices, continue to provide an essential support to the diagnosis and classification of anemia.From the measurements of the average volume and Hemoglobin (Hb) concentration of erythrocytes, the underlying etiology of anemia was brilliantly unveiled [1][2][3][4].Anemia is a disease itself, but it is often symptomatic of other illness; every clinician deals with anemia in daily practice, taking into account that concomitant anemia makes the prognosis of the underlying disease worse for those patients.His textbook Clinical Hematology, first published in 1942 and now in its 13 th edition [5], remains a prototype of excellence and for many years stood alone as the premier text in the field.He had written and edited the first six editions by himself, though always depending on the critical peer review of his talented colleagues at Utah University, with his wife Becky, as he said his severest and most helpful critic [6].Hematology, the Blossoming of a Science: A Story of Inspiration and Effort was published on 1985, shortly before his demise [7].Writing this book partially as his memoirs, partially as history, Wintrobe realized that he could never cover the lives of all who had contributed to what he called "the Golden Age of Hematology".Wintrobe's methods were based on manual measurements of hemoglobin, hematocrit and erythrocyte count.Reading his articles published the 30's [1-4], his concern with the accuracy of the methods and the reliability of the measurements become evident.First, he proposed a classification of anemia, based on the new Abstract In 2014 we are celebrating the 80th anniversary of the Maxwell Myer Wintrobe´s pioneer works, one of the most important contributions in Clinical Laboratory and Medicine.Red cell indices continue to provide an essential support to the diagnosis and classification of anemia.The erythrocyte indices mean cell volume, mean cell hemoglobin concentration, mean cell hemoglobin are called the Wintrobe indices.Hematology automation has progressed steadily since Wallace Coulter first applied electrical impedance technology to counting red cells and white cells.Technological advances being incorporated into hematology analyzers since then are now allowing the access to more cellular information than was ever available before through a "simple routine CBC".Current research is beginning to demonstrate that this information also has great potential to identify cellular changes that typically occur in several important medical conditions-bringing us all one step closer to using hematology analyzers as more than simple cell counters, but instead as powerful tools for the management of any medical condition that impacts the biology of blood cells.There are increasing amounts of data provided, which require specialist knowledge to interpret as well as understand the limitations in the measurement of the parameter.Both laboratory scientists and clinicians need to keep up to date with new parameters and methods in hematology, implying a stronger collaboration between them to improve clinical decision making.