CALIPER Hematology Reference Standards (II)

Higgins, Victoria; Tahmasebi, Houman; Bohn, Mary Kathryn; Hall, Alexandra; Adeli, Khosrow

doi:10.1093/ajcp/aqaa057

Cited by 12 publications

(25 citation statements)

References 33 publications

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“…The latest report from the CALIPER study enrolling 536 children and adolescents of multi-ethnic origin aged 0-21 years has shown that neither haematocrit, MCV or RDW values differed between sexes in the age group correspondent to our study. Although, monocyte percentage was higher in boys than in girls, such increase was significant only in subjects older than 15 years ( 21 ). Yet, Aldrimer et al in a study of paediatric population of Caucasian origin pointed towards higher MCV values in girls starting at age of 4, which is consistent with our findings ( 22 ).…”

Section: Discussionmentioning

confidence: 87%

Indirect reference intervals for haematological parameters in capillary blood of pre-school children

Balog¹,

Dukai²,

Zeljković

et al. 2021

Biochem. med. (Online)

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Introduction: Indirect estimation of reference intervals (RIs) is straightforward and inexpensive procedure for determination of intra-laboratory RIs. We applied the indirect approach to assess RIs for haematological parameters in capillary blood of pre-school children, using results stored in our laboratory database. Materials and methods: We extracted data from laboratory information system, for the results obtained by automatic haematology analyser in capillary blood of 154 boys and 146 girls during pre-school medical examination. Data distribution was tested, and logarithmic transformation was applied if needed. Reference intervals were calculated by the nonparametric percentile method. Results: Reference intervals were calculated for: RBC count (4.2-5.4 x1012/L), haemoglobin (114-146 g/L), MCH (25.0-29.4 pg), MCHC (321-368 g/L), RDW-SD (36.1-43.5 fL), WBC count (4.5-12.3 x109/L), neutrophils count (1.7-6.9 x109/L) and percentage (29.0-69.0%), lymphocytes count (1.6-4.4 x109/L) and percentage (21.9-60.7%), PLT (165-459 x109/L), MPV (8.1-11.4 fL) and PDW (9.2-14.4%). Gender specific RIs were calculated for monocytes count (male (M): 0.2-1.6 x109/L; female (F): 0.1-1.4 x109/L) and percentage (M: 2.5-18.3%; F: 1.8-16.7%), haematocrit (M: 0.34-0.42 L/L; F: 0.34-0.43 L/L), MCV (M: 73.4-84.6 fL; F: 75.5-84.2 fL) and RDW (M: 12.1-14.3%; F: 11.7-13.9%), due to observed gender differences in these parameters (P = 0.031, 0.028, 0.020, 0.012 and 0.001; respectively). Estimated RIs markedly varied from the literature based RIs that are used in the laboratory. Conclusions: Indirect method employed in this study enables straightforward assessment of RIs in pre-school children. Herein derived RIs differed from the literature-based ones, indicating the need for intra-laboratory determination of RIs for specific populations and sample types.

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Section: Discussionmentioning

confidence: 87%

Indirect reference intervals for haematological parameters in capillary blood of pre-school children

Balog¹,

Dukai²,

Zeljković

et al. 2021

Biochem. med. (Online)

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“…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.…”

Section: Caliperdatabaseorg)mentioning

confidence: 60%

“…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.…”

Section: Introductionmentioning

confidence: 99%

“…[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.…”

Section: Introductionmentioning

confidence: 99%

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

Bohn

Wilson

Steele

et al. 2023

Int J Lab Hematology

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Background: Hematological parameters vary significantly throughout growth and development due to physiological processes such as fetal-to-adult erythropoiesis and puberty.Pediatric age-and sex-specific reference intervals (RIs) are thus essential for appropriate clinical decision-making. The current study aimed to establish RIs for both common and novel hematology parameters on the Mindray BC-6800Plus system.Methods: Six hundred and eighty-seven healthy children and adolescents (30 days to 18 years) were enrolled. Participants were recruited as part of the Canadian Laboratory Initiative on Pediatric Reference Intervals Program upon informed consent or identified from apparently healthy outpatient clinics. Whole blood was collected and assayed for 79 hematology parameters on the BC-6800Plus system (Mindray).Age-and sex-specific RIs were established as per Clinical and Laboratory Standards Institute EP28-A3c guidelines.Results: Dynamic reference value distributions were observed for several hematology parameters, including erythrocytes, leukocytes, platelets, reticulocytes, and research-useonly markers. Age partitioning was required for 52 parameters, demonstrating changes in infancy and puberty. Sex partitioning was required for 11 erythrocyte parameters (i.e., red blood cell (RBC), hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, RBC distribution width coefficient of variation, hemoglobin distribution width, macrocyte count, macrocyte percentage, RBC (optical), and reticulocyte production index). Few parameters had undetectable levels in our healthy cohort (i.e., nucleated RBC count and immature granulocyte count). Conclusions:The current study completed hematological profiling for 79 parameters on the BC-6800Plus system in a healthy cohort of Canadian children and adolescents. These data emphasize the complex biological patterns of hematology parameters in childhood, particularly at the onset of puberty, and support the need for age-and sex-specific RIs for clinical interpretation.

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“…In the current study, continuous reference intervals were calculated for 19 hematological parameters in the CALIPER cohort (1‐<18.5 years) and directly compared to published CALIPER partitioned reference intervals through flagging rate analysis. Hematology parameters, particularly erythrocytes, are known to exemplify significant fluctuations with age and sex throughout childhood and adolescence 17,20‐22 . Thus, continuous reference intervals present potential advantages in the consistency and accuracy of hematological test interpretation.…”

Section: Discussionmentioning

confidence: 99%

Continuous reference curves for common hematology markers in the CALIPER cohort of healthy children and adolescents on the Sysmex XN‐3000 system

Wilson

Bohn

Hall

et al. 2021

Int J Lab Hematology

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Introduction: Clinicians and healthcare professionals rely heavily on health-associated standards, such as reference intervals (RIs), for appropriate laboratory test result interpretation. RIs are commonly partitioned into discrete age/sex bins based on statistical and/or clinical significance. In pediatric hematology, such partitioning does not adequately represent complex variation in analyte concentrations throughout maturation. The objective of this study was to establish continuous RIs for common hematological parameters in the healthy pediatric Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) cohort.Methods: Data from healthy CALIPER children and adolescents (6 months-<19 years) were used to generate continuous RIs (ie, 2.5th and 97.5th quantiles) for 19 hematological parameters. Continuous curves were statistically established with nonparametric quantile regressions. Flagging rate analysis was completed for the established continuous upper and lower reference limits and subsequently compared to previously published discrete CALIPER reference intervals for all parameters.Results: Continuous RIs were established for 19 hematology parameters, where seven required sex-specific reference curves. Based on flagging rate assessment, continuous RIs appear to more accurately estimate hematological reference limits over the pediatric age range, especially for analytes with complex age-and sexspecific reference value patterns.Conclusions: This is the first study to generate continuous RIs for a breadth of hematological markers in a healthy pediatric Canadian population. The increased power of continuous reference intervals to accurately estimate the complex relationship between hematological analyte concentration and age during a time of extensive growth and development is expected to improve laboratory test result interpretation and, subsequently, pediatric clinical decision-making.

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CALIPER Hematology Reference Standards (II)

Cited by 12 publications

References 33 publications

Indirect reference intervals for haematological parameters in capillary blood of pre-school children

Indirect reference intervals for haematological parameters in capillary blood of pre-school children

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

Continuous reference curves for common hematology markers in the CALIPER cohort of healthy children and adolescents on the Sysmex XN‐3000 system

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