A comparison of the accuracy of the corpuscular fragility and mean corpuscular volume tests for the alpha‐thalassemia 1 and beta‐thalassemia traits

Sirichotiyakul, Supatra; Wanapirak, Chanane; Srisupundit, Kasemsri; Luewan, Suchaya; Tongsong, Theera

doi:10.1016/j.ijgo.2009.05.012

Cited by 13 publications

(12 citation statements)

References 11 publications

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“…Not only have MCV and MCH values been shown to be highly inaccurate predictors of parental genotype, but also multiple cut off points (between 70–80 for MCV and 20–30 for MCH) have been reported 12. This mandates the development of more accurate indices and formulas.…”

Section: Introductionmentioning

confidence: 99%

Reliability of Different RBC Indices and Formulas in Discriminating Between Β-Thalassemia Minor and Other Causes of Microcytic Hypochromic Anemia

Bordbar

Taghipour

Zucconi³

2015

Mediterr J Hematol Infect Dis

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ObjectiveDifferent indices and formulas of CBC parameters have been suggested as indicators of early stage screenings to detect couples with β-thalassemia minor (BTMi). In this study, we evaluated the accuracy of five previous published formulas and compared them to our new formula (│80-MCV│×│27-MCH│) in screening of β-thalassemia.MethodsAll couples in the premarital β-thalassemia screening program of Roodbar, Iran, for whom molecular analysis had been done, were selected during two years. The red blood cell parameters were applied to each formula, and a ROC curve was plotted for each one to check its discriminative effectiveness in β-thalassemia detection.ResultNone of the studied indices and formulas demonstrated 100% precision. However, we found that the Shine–Lal formula and our formula had the highest sensitivity in identifying BTMi individuals. The highest specificity belonged to our formula and Sirdah formula.ConclusionPrevious studies reported different sensitivities and specificities for the formulas. This can be attributed to different kinds of HBB gene mutations in various populations. Undoubtedly, physicians in different areas should evaluate the accuracy of published formulas for their own populations in the discrimination of BTMi from other causes of microcytic hypochromic anemia.

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Section: Introductionmentioning

confidence: 99%

Reliability of Different RBC Indices and Formulas in Discriminating Between Β-Thalassemia Minor and Other Causes of Microcytic Hypochromic Anemia

Bordbar

Taghipour

Zucconi³

2015

Mediterr J Hematol Infect Dis

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“…In this regard, HbA2 determination plays a very important role in screening programs for βTT, since increased HbA2 level is one of the most typical markers for βTT. Consequently, many laboratories have used a normal or an increased red blood cell (RBC) count, decreased hemoglobin (Hb), microcytic indices and elevated HbA2 level as a diagnosis method for βTT (Kneifati-Hayek et al 2007;Sirichotiyakul et al 2009). In addition, other methods have been proposed for βTT diagnosis, such as red blood cell flags (Eivazi-Ziaei et al 2008;Ntaios 2009), microcytic (M)/ hypochromic (H) ratio (Ntaios and Chatzinikolaou 2009a;Urrechaga 2009), red cell distribution width (Harrington et al 2008 ;Ntaios and Chatzinikolaou 2008a), and reticulocytic parameters (Ceylan et al 2007;Ntaios and Chatzinikolaou 2009b).…”

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confidence: 99%

Elevated Hemoglobin A2 as a Marker for .BETA.-Thalassemia Trait in Pregnant Women

Liu

et al. 2011

Tohoku J. Exp. Med.

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β-thalassemia is one of the most prevalent inherited hemoglobin disorders. Compound heterozygotes or homozygous mutations of the β-globin chain gene account for severe cases of β-thalassemia that require lifelong transfusion, and make it necessary to identify β-thalassemia carries for prenatal diagnosis. The increase in hemoglobin A2 (HbA2) level is the most significant parameter in the identification of β-thalassemia carriers. HbA2, composing of two α chains and two δ chains, is a minor component of the hemoglobin present in normal adult red blood cells, accounting for about 2.5% of the total hemoglobin in healthy individuals. However, HbA2 level is also elevated in some pregnant women. This study aimed to evaluate the value of HbA2 level in the screening of pregnant women with β-thalassemia trait. Pregnant and non-pregnant women were randomly recruited who attended the prenatal care or diagnosis at our hospital located in Guangdong, a province in South China. Hemoglobin capillary electrophoresis was performed on high performance liquid chromatography to measure HbA2 levels in blood. The β-globin gene mutations were detected by the PCR-reverse dot-blot assay, and some were verified by direct sequencing. Pregnant women (n = 96) and non-pregnant women (n = 114) with normal HbA2 level (< 3.5%) had no β-thalassemia mutation. In contrast, pregnant women (n = 55) and non-pregnant women (n = 85) with elevated HbA2 level (≥ 3.5%) are β-thalassemia carriers. In conclusion, HbA2 level is a good marker for screening β-thalassemia trait in pregnant women in South China population.

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“…Based on the previous study, MCV had a sensitivity and specificity in predicting alpha‐thalassemia 1 trait at 93.0% and 93.4%, respectively . To gain power of 90% at 95% confidence interval, based on the prevalence of alpha‐thalassemia 1 carrier of 8.5% and error allowance at 0.05, this study would need a sample size of at least 100 cases of alpha‐thalassemia 1 trait.…”

Section: Methodsmentioning

confidence: 99%

Optimal cutoff of mean corpuscular volume (MCV) for screening of alpha‐thalassemia 1 trait

Nunchai

Sirichotiyakul

Tongsong

2020

J of Obstet and Gynaecol

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Aim: To identify the optimal cutoff of mean corpuscular volume (MCV) for screening of alpha-thalassemia 1 trait. Methods: The database of pregnant women who attended antenatal care clinic at Department of Obstetrics and Gynecology, Chiang Mai University during January 1st, 2015 to December 31st, 2017 was accessed and reviewed. A total of 1264 cases who had MCV ≤80 fL and met the inclusion criteria were enrolled to the study. Cases with hemoglobin level ≤10.0 gm/dL, iron deficiency anemia, chronic medical diseases and other types of thalassemia trait except alpha-thalassemia 1 trait were excluded. Results: After exclusion, 438 cases were available for analysis. Of them, 139 were alpha-thalassemia 1 trait. Based on the receiver operating characteristic curves, the best cutoff value of MCV for screening of alphathalassemia 1 trait was ≤76.15 fL, giving 100% sensitivity, and 60.9% specificity with the area under curve of 0.925. Compared to the conventional cutoff (≤80 fL), the new cutoff gave much less false positive tests (117 vs 299 cases), whereas capability to detect alpha-thalassemia 1 trait was the same. Conclusion: With the new MCV cutoff (≤76.15 fL) as a secondary cutoff for screening alpha-thalassemia 1 carrier, a substantial number of positive cases requiring DNA analysis could be avoided without compromising the detection efficacy.

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A comparison of the accuracy of the corpuscular fragility and mean corpuscular volume tests for the alpha‐thalassemia 1 and beta‐thalassemia traits

Cited by 13 publications

References 11 publications

Reliability of Different RBC Indices and Formulas in Discriminating Between Β-Thalassemia Minor and Other Causes of Microcytic Hypochromic Anemia

Reliability of Different RBC Indices and Formulas in Discriminating Between Β-Thalassemia Minor and Other Causes of Microcytic Hypochromic Anemia

Elevated Hemoglobin A2 as a Marker for .BETA.-Thalassemia Trait in Pregnant Women

Optimal cutoff of mean corpuscular volume (MCV) for screening of alpha‐thalassemia 1 trait

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