 In sickle cell anemia and other hemoglobinopathies, we are not expecting to see fragmentation. What you expect to see will be an extra vascular hemolysis, that is the red blood cells are damaged and then taken out by the spleen. Therefore, the dumbbell curve must reflect in the peripheral blood picture measurement of hemoglobinopathies. There should be no fragmentation. However, the key would be the disparity between the variation of cell shapes and sizes that you see on the peripheral smear and the measurements made with the distribution curve, that is the statistical measurement. So in hemoglobinopathies, your eyes will see bizarre shapes that the statistical counter would not pick up. The counter would not identify bizarre shapes. So that's the key in extra vascular hemolysis.