Detection of fetal hemoglobin (HbF) using the G8 glycohemoglobin analyzer.

BACKGROUND

Abnormal HbF concentration has been proposed as a marker of solid tumor and myelodysplastic syndrome. As HbA1c is tested widely for glycemic control monitoring, some commercial glycated hemoglobin assays can provide additional information about these hemoglobin concentrations. However, few studies have investigated the clinical significance of increased HbF in current practice.

METHODS

Between January 2012 and December 2012, HbAlc results, tested in the Department of Laboratory Medicine at Soonchunhyang University Bucheon Hospital, were analyzed. HbAlc was measured using a G8 Glycohemoglobin Analyzer (Tosho Bioscience, Tokyo, Japan) in the 1.6 minutes HbAlc mode. A total of 13,866 specimens from 9,545 patients were tested.

RESULTS

The median HbF concentration was 0.7%, the 99.5th percentile was 3.2%, and 73 samples from 56 patients were > 3.2%. Among these patients, 37.5% (21/56) had malignancies: 16 had solid cancer and 5 had hematologic malignancies. The maximum HbF observed was 8.2% and elevated HbF showed no evidence of interference with the HbAlc test. However, the minimum HbF and LA1C+ fraction increased with increasing HbAlc, suggesting interference by elevated HbAlc.

CONCLUSIONS

Care must be taken when interpreting HbF concentrations in samples with high HbAlc values determined using the HbA1c mode of the G8 Glycohemoglobin Analyzer.