背景:基于血红蛋白的氧载体,例如HBOC-201(血液净化),目的是在患者无法输血或拒绝输血时弥合急性贫血。然而,由于HBOC-201在血浆中游离,它会干扰实验室测试。本研究概述了HBOC-201对四种常用血液学分析仪的干扰,并提出了治疗监测的可能性。
方法:用治疗剂量的HBOC-201掺入血液样本,并用SysmexXN-20,SiemensAdvia2120i测量9个血液学参数,AbbottAlinityHq和AbbotCellDynSapphire血液分析仪。将结果与对照样品进行比较,并确定偏倚。
结果:大多数参数,包括所有细胞计数,血细胞比容和MCV,与对照组相比,显示出不显著的偏差。然而,标准,总血红蛋白(Hb)测量以及MCH和MCHC显示与对照的一致性差,因为HBOC-201包括在此测量中。然而,基于流式细胞术的Hb方法定量了加标样品中的细胞内Hb,不包括HBOC-201。
结论:在所有纳入的血液学参数中,只有总Hb和相关的MCH和MCHC受到干扰。相比之下,基于流式细胞术的Hb测量提供了细胞内Hb的准确测量。总Hb和细胞Hb之间的差异代表HBOC-201浓度,可用于监测HBOC-201治疗。
BACKGROUND: Hemoglobin-based oxygen carriers, for example HBOC-201 (Hemopure), are aimed to bridge acute anemia when blood transfusion is not available or refused by the patient. However, since HBOC-201 appears free in plasma, it interferes with laboratory tests. This study presents an overview of HBOC-201 interference on four commonly used hematology analyzers and suggests treatment monitoring possibilities.
METHODS: Blood samples were spiked with therapeutic doses of HBOC-201 and nine hematology parameters were measured with the Sysmex XN-20, Siemens Advia 2120i, Abbott Alinity Hq and Abbot Cell Dyn Sapphire hematology analyzers. The results were compared to control samples and the bias was determined.
RESULTS: Most parameters, including all cell counts, hematocrit and MCV, showed a non-significant bias compared to control. However, the standard, total hemoglobin (Hb) measurement as well as MCH and MCHC showed poor agreement with control, as HBOC-201 was included in this measurement. Yet, the flow cytometry-based Hb method quantified intracellular Hb in spiked samples, excluding HBOC-201.
CONCLUSIONS: Of all included hematology parameters, only total Hb and the associated MCH and MCHC suffered from interference. In contrast, the flow cytometry-based Hb measurement provided an accurate measure of intracellular Hb. The difference between total Hb and cellular Hb represents the HBOC-201 concentration and can be used to monitor HBOC-201 treatment.