HBS MONITORING ON TOSOH G8 IN VARIANT HBA1C MODE IN CASE OF URGENT RCE.
(Abstract release date: 05/18/17)
EHA Library. Kieffer D. 05/18/17; 182865; PB2152
Davy Kieffer
Contributions
Contributions
Abstract
Abstract: PB2152
Type: Publication Only
Background
Pre- and post-transfusion HbS levels are used to document the efficacy of red blood cell exchange (RCE) in patients with sickle cell disease (SCD). In case of urgent RCE a 24/7 STAT analysis, with the ability to identify and quantify hemoglobin (Hb) S, is warranted.
Aims
We evaluated the use of Tosoh Automated Glycohemoglobin Analyzer HLC-723G8 (Tosoh Europe, Amsterdam, The Netherlands) for this purpose, using the variant HbA1c mode. Results were compared to our routine CZE Minicap Flex Piercing (Sebia, Lisses, France).
Methods
Within- and between-run imprecision were assessed using a sickle cell trait and a sickle cell anemia sample, aliquoted and stored at -80°C, twice daily in duplicate for ten days. A linearity study was performed using duplicate measurements of a dilution set of 11 samples (HbS range: 0% - 88%). Additionally, a comparison study was conducted between TOSOH G8 and Minicap Flex Piercing using 32 whole blood left-over HbS samples (HbS range: 9% - 93%). Data analysis was performed using Microsoft Excel Analyze-it version 4.65.3 and differences were considered as statistically different if the P-value was < 0.05.
Results
Within- and between-run imprecision were < 2% and an acceptable linearity was observed. Passing-bablok regression analysis comparing TOSOH G8 and Minicap Flex Piercing showed an acceptable correlation coefficient of 0.998 (> 0.95) and a slope and intercept of 0.94 (95%CI: 0.92 to 0.98) and 0.057 (95% CI: -2.5 to 1.3), respectively. Differences in HbS results between TOSOH G8 and Minicap Flex Piercing ranged from -8.76% to +0.36% (mean difference: -3.54%). More specifically, for samples with a HbS concentration < 25% HbS results on TOSOH G8 differed between -0.34% to +0.36% compared to Minicap Flex Piercing. For samples with a HbS concentration > 25%, differences in HbS results ranged from -8.76% to -0.43%.
Conclusion
In our clinical laboratory, TOSOH G8 is used in variant HbA1c mode to quantify HbA1c. Previous studies demonstrated reliable HbS identification using TOSOH G8 in variant HbA1c mode. Our study showed a good analytical performance for HbS quantification using TOSOH G8. Good correlation with Minicap Flex Piercing system was found, although results were statistically not interchangeable. Our results suggest that TOSOH G8 in variant HbA1c mode generates lower HbS results in samples with a high HbS concentration (>25%) compared to our routine analyzer. However, the goal of RCE is to achieve a post-transfusion HbS level of 30% or less. Therefore, results obtained with TOSOH G8 are clinically acceptable to monitor post-transfusion HbS levels. Importantly, HbS on TOSOH G8 can only be requested in case of urgent RCE. Our routine hemoglobinopathy screening will still be performed using CZE Minicap Flex Piercing in combination with CE-HPLC Variant IITM.
Session topic: 25. Sickle cell disease
Abstract: PB2152
Type: Publication Only
Background
Pre- and post-transfusion HbS levels are used to document the efficacy of red blood cell exchange (RCE) in patients with sickle cell disease (SCD). In case of urgent RCE a 24/7 STAT analysis, with the ability to identify and quantify hemoglobin (Hb) S, is warranted.
Aims
We evaluated the use of Tosoh Automated Glycohemoglobin Analyzer HLC-723G8 (Tosoh Europe, Amsterdam, The Netherlands) for this purpose, using the variant HbA1c mode. Results were compared to our routine CZE Minicap Flex Piercing (Sebia, Lisses, France).
Methods
Within- and between-run imprecision were assessed using a sickle cell trait and a sickle cell anemia sample, aliquoted and stored at -80°C, twice daily in duplicate for ten days. A linearity study was performed using duplicate measurements of a dilution set of 11 samples (HbS range: 0% - 88%). Additionally, a comparison study was conducted between TOSOH G8 and Minicap Flex Piercing using 32 whole blood left-over HbS samples (HbS range: 9% - 93%). Data analysis was performed using Microsoft Excel Analyze-it version 4.65.3 and differences were considered as statistically different if the P-value was < 0.05.
Results
Within- and between-run imprecision were < 2% and an acceptable linearity was observed. Passing-bablok regression analysis comparing TOSOH G8 and Minicap Flex Piercing showed an acceptable correlation coefficient of 0.998 (> 0.95) and a slope and intercept of 0.94 (95%CI: 0.92 to 0.98) and 0.057 (95% CI: -2.5 to 1.3), respectively. Differences in HbS results between TOSOH G8 and Minicap Flex Piercing ranged from -8.76% to +0.36% (mean difference: -3.54%). More specifically, for samples with a HbS concentration < 25% HbS results on TOSOH G8 differed between -0.34% to +0.36% compared to Minicap Flex Piercing. For samples with a HbS concentration > 25%, differences in HbS results ranged from -8.76% to -0.43%.
Conclusion
In our clinical laboratory, TOSOH G8 is used in variant HbA1c mode to quantify HbA1c. Previous studies demonstrated reliable HbS identification using TOSOH G8 in variant HbA1c mode. Our study showed a good analytical performance for HbS quantification using TOSOH G8. Good correlation with Minicap Flex Piercing system was found, although results were statistically not interchangeable. Our results suggest that TOSOH G8 in variant HbA1c mode generates lower HbS results in samples with a high HbS concentration (>25%) compared to our routine analyzer. However, the goal of RCE is to achieve a post-transfusion HbS level of 30% or less. Therefore, results obtained with TOSOH G8 are clinically acceptable to monitor post-transfusion HbS levels. Importantly, HbS on TOSOH G8 can only be requested in case of urgent RCE. Our routine hemoglobinopathy screening will still be performed using CZE Minicap Flex Piercing in combination with CE-HPLC Variant IITM.
Session topic: 25. Sickle cell disease
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