CALIPER Hematology Reference Standards (I)

Abstract

Objectives Accurate hematologic test interpretation based on normative reference standards is critical to ensure appropriate clinical decision making. However, healthy pediatric reference data for most hematology parameters are lacking. To address this gap, this study establishes age- and sex-specific hematologic reference standards in the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) cohort of healthy children and adolescents. Methods Fresh whole blood samples collected from a total of 566 healthy children and adolescents (birth to <21 years) with informed consent were analyzed for 47 hematologic parameters on the Beckman Coulter DxH 900. Age- and sex-specific reference standards were calculated based on the Clinical and Laboratory Standards Institute guidelines. Results Reference value distributions for most hematology parameters demonstrated dynamic changes across the pediatric age range with significant age-specific differences observed for 39 of the 47 parameters examined. Sex-specific differences were also observed for eight hematologic parameters, primarily during and after puberty. Conclusions This study establishes a robust database of pediatric reference standards for 47 hematologic parameters in the CALIPER cohort for the first time. These comprehensive reference value data sets report potentially important and physiologically relevant trends in hematologic markers, clearly demonstrating the need for pediatric reference standards for hematologic test interpretation.

Comprehensive pediatric reference intervals for 79 hematology markers in the CALIPER cohort of healthy children and adolescents using the Mindray BC‐6800Plus system

“…These age-related trends have been previously observed and are suggested to be due to immune system immaturity and differential distribution of lymphocyte subsets from early life to adulthood. 9,10,[13][14][15] No sex-specific differences were observed in our pediatric cohort for leukocyte parameters. Previous studies have reported conflicting findings, with some demonstrating statistically significant elevations in neutrophil counts in adolescent females.…”

“…10 Platelet counts consistently decreased throughout the pediatric age range in concordance with published studies. 6,10,[13][14][15] However, variation was observed in quantitative upper and lower reference limits across studies. Specifically, Canadian studies in the CALIPER cohort have established similar RIs of 170-380, 173-361, and 190-388 Â 10 9 /L on the Beckman DxH900, Sysmex XN3000, and Mindray BC-6800Plus in adolescents.…”

“…Specifically, Canadian studies in the CALIPER cohort have established similar RIs of 170-380, 173-361, and 190-388 Â 10 9 /L on the Beckman DxH900, Sysmex XN3000, and Mindray BC-6800Plus in adolescents. 10,14,15 However, variation is observed in other study populations and analytical methodologies (e.g., 195-464 Â 10 9 /L 9 ). Genetic factors have been shown to contribute to platelet counts in healthy individuals at the population level and may explain observed discrepancies.…”

“…Available studies vary by population studied (e.g., ethnicity, health status, age range), parameters assessed, and analytical methodology. [6][7][8][9][10][11][12][13][14][15] The Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) derived health-associated RIs for hematology parameters in their cohort of healthy children on three modern hematology systems, including Sysmex XN-3000, Beckman DxH 520, and Beckman Dx900 platforms. [13][14][15] Other groups have established pediatric RIs on the Siemens Advia, Abbott Cell-Dyn, Beckman GenST, and Beckman HmX instruments.…”

“…[6][7][8][9][10][11][12][13][14][15] The Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) derived health-associated RIs for hematology parameters in their cohort of healthy children on three modern hematology systems, including Sysmex XN-3000, Beckman DxH 520, and Beckman Dx900 platforms. [13][14][15] Other groups have established pediatric RIs on the Siemens Advia, Abbott Cell-Dyn, Beckman GenST, and Beckman HmX instruments. [6][7][8][9][10][11][12] Most studies have limited sample size in the first few years of life and do not comprehensively cover all hematological indices and emerging research parameters.…”