Protocol - Hemoglobin Characterization
- Aspartate Aminotransferase Level
- Bilirubin Level
- Haptoglobin Level
- Lactate Dehydrogenase Level
- Reticulocyte Count
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
Personnel and Training Required
Phlebotomist
Equipment Needs
CLIA certified laboratory with the capability to perform the hemoglobin assay.
Requirements
| Requirement Category | Required |
|---|---|
| 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
| Standard | Name | ID | Source |
|---|---|---|---|
| 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 ID | Variable Description | dbGaP Mapping | |
|---|---|---|---|---|
| PX830301_SCD_Hemoglobin_Assay_Equipment_Coefficients | ||||
| PX830301040000 | What are the coefficients of variation for more | 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 | N/A | ||
| PX830301_SCD_Hemoglobin_BloodDraw | ||||
| PX830301010000 | Was the blood drawn into an appropriate EDTA tube? | N/A | ||
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.