Hemoglobin S monitoring on TOSOH G8 in hemoglobin A1c mode in case of urgent red blood cell exchange

Abstract

Hemoglobin S results obtained with TOSOH G8 in variant HbA1c mode are clinically acceptable to monitor urgent RCE. The observed underestimation will not alter clinical decision-making.

Rapid haemoglobin A and S quantification using Tosoh HLC‐723G8 in variant mode for patients with sickle cell disease

“…HbS can be visually detected on the chromatogram even at very low values (2%) but may be quantified only above values close to 7%. Its quantification is reproducible and linear up to high values (>70%), which is consistent with results observed by Van Aelst et al (2018). This quantification range is compatible with clinical contexts requiring HbS quantification because a target threshold of 30% of HbS for transfusions is commonly found in literature (Chou et al, 2020; Padmanabhan et al, 2019).…”

“…When a dedicated analyser is not available always, this is difficult to achieve and may disrupt laboratory routine. Existing literature already highlighted that the G8 can be effectively used in a variant mode for quantifying HbS, for pre‐/post‐transfusion monitoring and for confirming the presence of HbS in a blood sample with a few interferences (Van Aelst et al, 2018). This method has a short turnaround time with a HPLC duration of 1.6 min and is always compatible.…”

“…Changing mode, analysing quality control samples and the patients' samples and reverting the analyser to routine use often require a significant amount of time and technician availability. To address this issue, Van Aelst et al (2018) used the HLC‐723G8 ‘G8’ (Tosoh Corporation, Tokyo, Japan) HPLC analyser in variant mode, routinely used for quantifying HbA1c, for immediate monitoring of HbS. However, this method is associated with a significant underestimation bias and cannot quantify the HbA fraction, thus limiting its usefulness for the diagnosis of DHTR.…”