Usefulness of Cell Counter–Based Parameters and Formulas in Detection of β-Thalassemia Trait in Areas of High Prevalence

Abstract

The present study aimed to retrospectively evaluate the usefulness of cell counter-based parameters and formulas in beta-thalassemia trait (BTT) detection. The study included 170 BTT cases (hemoglobin [Hb]A(2) >4.0% [0.04]) and 30 non-BTT cases (HbA(2), 2.3%-3.5% [0.02-0.04]). Depending on the hemoglobin level and iron deficiency, the BTT group was further classified into classic BTT (n = 112) and BTT with iron deficiency anemia (n = 58). The RBC count, MCH, MCV, RDW, and Shine and Lal, Mentzler, Srivastava, England and Fraser, Ricerca, and Green indexes were applied. For the first time in the population of India, these 10 cell counter parameters and manual formulas were compared with high-performance liquid chromatography-derived HbA2 levels for deriving a cost-effective alternative method; and receiver operating characteristic curves were applied. We found that the Shine and Lal, Srivastava, and Mentzler indexes, MCV, and MCH have better discriminative function than the RBC count and red cell distribution width and their related formulas.

A Multicentre Based Observation of a Screening tool to Differentiate Microcytosis and Hypochromia

“…Automated measurement of the red cells (RBC) microcytosis and hypochromia has proven clinical usefulness for the differential diagnosis. The present study was undertaken with the main objective of evaluating efficiency of M/H ratios in screening for beta thalassaemia only, which is proved to be a reliable index according to the other studies 10,12,13,[17][18][19][20][21] . Our MH ratio showed similarity to the published indices evaluated by Urrechaga E study, with a Youden index of 76.3% 13,[17][18][19][20][21] .…”

“…There are only few studies reported previously on the M/H ratio [10][11][12] . Moreover, cell counter-based formula has been used in the differential diagnosis of microcytic anemia [10][11][12][13][14][15][16][17][18][19][20] . The reference ranges for these new RBC extended parameters and their values in anaemic patients with red cells abnormalities have been recently established as a good indicator by showing the % microcytosis was more increased in thalassaemia than IDA 5,17 .…”

A study of Serological and Hematological Parameters in Thalassaemic Patients of Gujarat, Western India

“…[18] South East Asia, [7], [8], [9] India, [5], [6] Mediterranean region [2], [3], [4] and Middle East including Saudi Arabia [2], [3], [4] are the regions from where large number of cases are reported. The change in hematological parameters depends on the type of thalassemia.…”

“…On the basis of the affected globin chain, the thalassemias are classified into α or β types. The β thalassemia is prevalent throughout the world while α is found more in the Mediterranean region, [1] Middle East, [2], [3], [4] South Asia [5], [6] and South East Asia. [7], [8], [9] The hematological parameters in the thalassemic patients vary with the type and severity of anemia.…”

Study of parents of β-thalassemia major children to determine cutoff values of hematological parameters for diagnosis of β-thalassemia trait and assessment of anemia in them

“…Many studies are available in the literature dealing with the dilemma of difficulties in BTT diagnosis during mass screening of population because of the overlapping of cutoff values in BTT and non-BTT subjects. [2][3][4][5][6][7][8][9] Hence we decided to establish the cutoff values in our setup by investigating the parents of children suffering from thalassemia major and receiving blood transfusion in our center who have been confirmed as having BTT.…”