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Protocol - Hemoglobin Characterization

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Description

This protocol provides basic instructions for drawing and storing blood and performing the bioassay for hemoglobin characterization. Because there are many assays that may be required to characterize hemoglobin abnormalities, the protocol also provides basic guidelines to increase comparability among different studies.

Specific Instructions

The Sickle Cell Disease Research and Scientific Panel (SRSP) recommends that investigators also capture Complete Blood Count and Reticulocyte Count.

The SRSP recommends that results from Hemoglobin Characterization be interpreted in the context of age appropriate normal values and blood transfusions within the last 120 days.

The results of the Hemoglobin Characterization can be interpreted using the hemoglobinopathy case definition worksheets and classification tables from the Newborn Screening Technical Assistance and Evaluation Program (NewSTEPS, see Sickle Cell Disease Case Definitions) funded by the Health Resources and Services Administration (HRSA). Investigators complete the case definition worksheets using available clinical data including: family history of hemoglobin variants, hemoglobin newborn screening results, laboratory record of complete blood count (CBC) with mean corpuscular volume (MCV), hemoglobin electrophoresis, isoelectric focusing, high performance liquid chromatography, and DNA genotype. Investigators then use the associated classification tables to interpret the results and make a diagnosis. The classification tables indicate the level of certainty (e.g., definite, probable, possible, or unlikely) of the diagnosis based on the type of clinical data available.

Protocol

Hemoglobin Characterization

Blood Draw

Blood should be drawn into an appropriate EDTA tube.

Laboratory Assay for Hemoglobin Characterization

The Sickle Cell Disease Scientific and Research Panel (SRSP) notes that there are numerous different assays and instruments (e.g., hemoglobin electrophoresis, isoelectric focusing, high performance liquid chromatography, DNA sequencing analysis) that are appropriate to characterize hemoglobin variants. Once an assay is chosen for a particular study, the SRSP recommends that no changes in the protocol be made over the course of the study. To aid comparability, the SRSP recommends that the investigator record the make and manufacturer of equipment used and the repeatability and coefficients of variation for the assay.

The SRSP notes that investigators should record the assay results for the following hemoglobins (the exact list of hemoglobins that can be distinguished will depend on the assay being used). The hemoglobins are listed in order of the amount present with the most prevalent coming first.

  • A
  • F
  • S
  • C
  • E/A2
  • D-Punjab
  • G-Philadelphia
  • O-Arab
Availability

Available

Personnel and Training Required

Phlebotomist

Equipment Needs

CLIA certified laboratory with the capability to perform the hemoglobin assay.

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Bioassay

Lifestage

Infant, Toddler, Child, Adolescent, Adult, Senior, Pregnancy

Participants

All ages

Selection Rationale

The Laboratory Diagnosis of Haemoglobinopathies (1998) was compared to other protocols and selected by the Sickle Cell Disease Research and Scientific Panel (SRSP) because it includes advantages and disadvantages of the various techniques as well as the ability of the assays to separate the various hemoglobin variants.

Language

English

Standards
StandardNameIDSource
caDSR Common Data Elements (CDE) Laboratory Procedure Hemoglobin Result Specified Lower Limit of Normal Value 2003886 CDE Browser
caDSR Common Data Elements (CDE) Laboratory Procedure Hemoglobin Result Unspecified Value 2005035 CDE Browser
caDSR Common Data Elements (CDE) Laboratory Procedure Hemoglobin Result Specified Value 2190 CDE Browser
caDSR Common Data Elements (CDE) Laboratory Procedure Hemoglobin Summary Result 3113466 CDE Browser
caDSR Common Data Elements (CDE) Hematology Hemoglobin F Measurement Assessment Percentage Value 3763134 CDE Browser
caDSR Common Data Elements (CDE) Hematology Hemoglobin F Measurement Assessment Lab Unspecified Value 3763197 CDE Browser
caDSR Common Data Elements (CDE) Hematology Hemoglobin F Measurement Assessment Finding Status Indicator 4233132 CDE Browser
Human Phenotype Ontology Abnormal hemoglobin HP:0011902 HPO
Derived Variables

None

Process and Review

Not applicable.

Protocol Name from Source

The Laboratory Diagnosis of Haemoglobinopathies, 1998

Source

The Laboratory Diagnosis of Haemoglobinopathies. (1998). British Journal of Haematology, 101(4), 783-792. doi: 10.1046/j.1365-2141.1998.00809.x

General References

Kutlar, F. (2007). Diagnostic approach to hemoglobinopathies. Hemoglobin, 31(2), 243-250.

Kutlar, A., & Huisman, T. (1996). Detection of hemoglobinopathies. In F. Hommes (Ed.), Techniques in Diagnostic Human Biochemical Genetics: A Laboratory Manual (pp. 519-560). New York, New York: J. Wiley & Sons.

Protocol ID

830301

Variables
Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
PX830301_SCD_Hemoglobin_Assay_Equipment_Coefficients
PX830301040000 What are the coefficients of variation for more
the assay? show less
N/A
PX830301_SCD_Hemoglobin_Assay_Equipment_Make
PX830301030000 What is the make of the equipment used? N/A
PX830301_SCD_Hemoglobin_Assay_Equipment_Manufacturer
PX830301020000 Who is the manufacturer of the equipment used? N/A
PX830301_SCD_Hemoglobin_Assay_Equipment_Repeatability
PX830301050000 Describe the repeatability of the assay: N/A
PX830301_SCD_Hemoglobin_Assay_Results
PX830301060000 Were the assay results recorded for the more
following hemoglobins? A, F, S, C, E/A2, D-Punjab, G-Philadelphia, O-Arab show less
N/A
PX830301_SCD_Hemoglobin_BloodDraw
PX830301010000 Was the blood drawn into an appropriate EDTA tube? N/A
Sickle Cell Disease Core: Tier 1
Measure Name

Hemoglobin Characterization

Release Date

July 30, 2015

Definition

A bioassay for hemoglobin classification.

Purpose

This protocol can be used to identify and characterize the different variants in structure and synthesis of hemoglobin that cause sickle cell disease.

Keywords

hemoglobin characterization, sickle cell disease, SCD, SC disease, anemia, thalassemia, hemoglobin, hemoglobinopathy, high-performance liquid chromatography, HPLC, isoelectric focusing, IEF, immunoassay

Measure Protocols
Protocol ID Protocol Name
830301 Hemoglobin Characterization
Publications

There are no publications listed for this protocol.