Hemolysis area: A new parameter of erythrocyte osmotic fragility for screening of thalassemia trait

Thanusak Tatu; Denis Sweatman

doi:10.4103/JLP.JLP_136_17

Journal of Laboratory Physicians, Table of Contents

CC BY-NC-ND 4.0 · J Lab Physicians 2018; 10(02): 214-220
DOI: 10.4103/JLP.JLP_136_17

Original Article

Hemolysis area: A new parameter of erythrocyte osmotic fragility for screening of thalassemia trait

Thanusak Tatu

Division of Clinical Microscopy, Department of Medical Technology, Research Center for Hematology and Health Technology, Faculty of Associated Medical Sciences, Chiang Mai 50200, Thailand

,

Denis Sweatman

Department of Physics and Materials Science, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand

› Author Affiliations

Abstract

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Abstract

BACKGROUND: One-tube osmotic fragility test (OFT) is widely used for screening thalassemia traits. Interobserver variation may occur with 0.36% NaCl-based OFT due to the naked eye result reading style.

PURPOSE: The purpose of this study was to establish and evaluate the novel numerical OFT-based parameter, so-called hemolysis area (HA), in screening thalassemia traits.

MATERIALS AND METHODS: The portable spectrophotometer was invented capable of calculating the HA values. The HA values were then compared among 69, 156, and 19 blood samples having positive, negative, and suspicious 0.36% NaCl-based OFT results, respectively; 109 and 135 blood samples having mean corpuscular volume (MCV) ≤80 fL and >80 fL, respectively; and 138 and 106 blood samples having mean corpuscular hemoglobin (MCH) ≤27 pg and >27 pg, respectively. In addition, the HA values were compared in 166 blood samples having different globin gene genotypes. Finally, the HA cutoff value was determined by receiver operation curve (ROC) analysis.

RESULTS: The HA values in samples having positive, suspicious, and negative 0.36% NaCl-based OFT were 33.3 ± 14.4, 42.9 ± 10.5, and 65.3 ± 13.4, respectively; in sample having MCV ≤80 fL and >80 fL were 43.1 ± 19.6 and 63.8 ± 14.5, respectively; and in samples having MCH ≤27 pg and >27 pg were 46.7 ± 20.1 and 64.8 ± 14.2, respectively. The HA values in normal, hemoglobin E, SEA-a thalassemia 1, and β-thalassemia traits were 67.1 ± 12.6, 36.4 ± 13.9, 20.2 ± 4.8, and 18.6 ± 1.1, respectively. All were significantly different. ROC analysis established 52.4 as the HA cutoff that had comparable effectiveness to the conventional screening tests.

CONCLUSION: The new HA value was effective and could be an alternative choice for screening thalassemia traits.

Keywords

Hemolysis - kinetics - osmotic fragility test - thalassemia heterozygote - thalassemia screen

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References

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