Normal hematological values of the african neonate

Summary A longitudinal study of normal hematological values of the newborn infant was undertaken in an effort to provide baseline data for assessing the African Neonate with hematological problems. There were 402 neonates, consisting of 304 full-term, 51 preterm and 47 post-term infants. The Hematocrit (Hct), Hemoglobin (Hb), Red Blood Cell Count (RBC), Reticulocyte count (Retic) and Nucleated Red Blood Cell Count (NRBC) were serially determined. The red cell indices, Mean corpuscular Hemoglobin (MCH), Mean Corpuscular volume (MCV) and Mean corpuscular Hemoglobin Concentration (MCHC) were calculated for each neonate. Our results showed that African neonates have lower hematological values than their North American and European counterparts. This was neither a reflection of an intrauterine anemia nor was it due to variables resulting from the timing of cord blood sampling. On the first day of life, the mean Hct was 45.4%; mean Hb was 15.46 gm/dl; and the RBC was 4.02×10⁶ cells/mm². The Retics, NRBC and other red blood cell indices do not differ from those of neonates reported from other parts of the world. We suggest therefore that the low hematological values of the African neonate may be intrinsic.     

冷凝集对血细胞分析多项参数检测结果的影响

目的 探讨红细胞冷凝集对血细胞分析各项检测参数的影响及处理方法.方法 选择福建省肿瘤医院2017年12月至2020年2月有红细胞冷凝集的全血标本73份.应用Sysmex XN-9000全自动血细胞分析仪对标本进行检测,比较37℃水浴前后红细胞(RBC)、血细胞比容(HCT)、平均红细胞体积(MCV)、平均红细胞血红蛋白...     

Use of capillary blood count parameters in adults

BACKGROUND AND OBJECTIVES: Capillary samples can provide blood for cell counts in haematologic patients and blood donors. However, some accept only values from venous blood. This study compares capillary and venous blood counts to verify the hypothesis that they are equivalent. MATERIALS AND METHODS: We analysed 463 capillary (fingerstick) and venous blood samples from 428 adults of both sexes (71% haematologic patients, 29% potential blood and apheresis donors). Both samples were taken at the same time from each subject. Haemoglobin (Hb), haematocrit (Hct), white blood cells (WBC), platelets, red blood cells (RBC), mean corpuscular volume (MCV), mean corpuscular Hb (MCH) and mean corpuscular Hb concentration (MCHC) were measured using a haematology analyser (Advia 120, Bayer). RESULTS: Capillary Hb, Hct, WBC, RBC, MCV and MCH were all significantly higher than the venous values [+0.2 mmol/l (+0.3 g/dl), +0.02 l/l (+2%), +0.2 x 10(9)/l, +0.1 x 10(12)/l, +3.1 fl and +0.01 fmol, respectively], whereas the capillary MCHC was lower (-0.6 mmol/l). There was no difference in platelets (-1 x 10(9)/l). Capillary Hb and Hct values were higher in patients with anaemia and polycythaemia, respectively. However, no significant differences occurred in severe thrombocytopenia. CONCLUSION: In adult haematologic patients, however, only the differences in Hb and Hct values may be of clinical relevance. For potential blood and apheresis donors, Hb and platelet screening are equivalent with either capillary and venous blood using a haematology analyser.     

Correlations between changes in hematological indices of mothers with preeclampsia and umbilical cord blood of newborns

Preeclampsia is a condition that might severely impact the health of mothers and their newborns. The aim of this investigation is to examine hematological parameters in mothers with preeclampsia and umbilical cord blood. Eighty preecalmptic mothers were recruited in the study. In addition, eighty normal pregnant mothers served as controls. Hematological parameters that include hemoglobin (Hb), red blood cell count (RBC), red cell distribution width (RDW), packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), white blood cell counts (WBC), platelet counts, mean platelet volume (MPV) and Platelet large cell ratio (PLCR) were examined. Results showed a strong association between preeclampsia and low birth weight, premature/cesarean delivery and proteinuria (P < 0.001). Hb and neutrophils were significantly lower (P < 0.01), whereas RDW, PCV, MCV, MCH, MCHC and lymphocytes were significantly higher than normal ones (P < 0.01). When cord blood of preeclamptic mothers were compared with that of normal ones, similar findings were observed. In addition, results showed significant and positive correlations between preeclamptic mothers and their newborn in Hb (r2 = 0.075, P < 0.05), PCV (r2 = 0.084, P < 0.01), MCV (r2 = 0.077, P < 0.05), MCHC (r2 = 0.115, P < 0.01), RBC (r2 = 0.086, P < 0.01) and retics (r2 = 0.306, P < 0.01). In conclusion, changes in several hematological parameters associated with preeclampsia were correlated in affected mothers and their newborns. Such biomarkers can be used to predict pregnancy outcomes in women with preeclampsia.     

Characteristics of red blood cell populations fractionated with a combination of counterflow centrifugation and Percoll separation.

Red blood cell (RBC) fractions were studied after separation of whole blood by means of counterflow centrifugation, Percoll column (Pharmacia, Uppsala, Sweden), and a combination of both separation techniques. Mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), mean corpuscular hemoglobin (MCH), and hemoglobin A1c (HbA1c) were measured in each fraction. From the results it was obvious that the combination of both techniques was the best separation technique of these three. MCV had a good correlation with cell age as measured with HbA1c concentration gradient; MCH and MCHC less so. MCV and MCH decreased in parallel to an increase in HbA1c. MCHC increased with increasing HbA1c. From these data it is concluded that there is a steadily ongoing loss of cellular hemoglobin and proportionally more cellular water during the life of the RBC.     

Erythropoietin concentration in developing harbor seals (Phoca vitulina)

Tissue hypoxia elicits the production of erythropoietin (Epo), a hormone that stimulates red blood cell production. In young diving mammals, oxygen is stored primarily in the blood, and blood oxygen stores increase significantly during the first weeks of life. In an effort to establish the role of Epo during this period of blood development, this study measured Epo concentration in plasma of 134 harbor seal (Phoca vitulina) pups and adults. Concurrent measurements of hematocrit (Hct), hemoglobin concentration [Hb], and red blood cell (RBC) counts allowed the evaluation of the effect of Epo on blood oxygen store capacity. Erythropoietin and most blood parameters varied with age. At birth, neonatal [Hb], Hct, and RBC were elevated, possibly due to the rapid expansion of plasma volume associated with growth rates of 0.5 kg/day. In contrast, Epo concentration increased from 6.64 +/- 0.83 mU/ml in newborns to 9.53 +/- 0.86 mU/ml in early nursing pups. Erythropoietin concentration remained elevated above newborn and adult concentration (5.71 +/- 0.79 mU/ml) through weaning, suggesting that Epo was responding to tissue hypoxia brought on by early anemia. Since similar changes in erythropoietin have been documented in terrestrial mammals, it appears that Epo plays a similar role in the blood development of harbor seals.     

Evaluation of blood rheology in patients with cyanotic congenital heart disease using a microchannel array flow analyzer

Blood hyperviscosity due to secondary erythrocytosis is a common pathologic feature of cyanotic congenital heart disease (CCHD). In CCHD, it is possible that hematological parameters other than red blood cells influence blood rheology. We measured blood passage time to evaluate the blood rheology in patients with CCHD (n=18, age: 15.3+/-11.9 years, mean +/- SD) and age-matched control subjects (n=27) using the microchannel array flow analyzer (MC-FAN), and the results [several hematological parameters, including hematocrit (Hct)] were compared. Blood passage time in the CCHD group was prolonged, compared with the control group (67.6+/-27.2 s vs. 44.6+/-6.7 s). For the CCHD group, blood passage time correlated significantly with red blood cell (RBC) count, hemoglobin (Hb) concentration, Hct, mean corpuscular hemoglobin concentration (MCHC), platelet (Plt) count, high-density lipoprotein cholesterol (HDL-C) level, and triglycerides (TG) level (RBC, r=0.77; Hb, r=0.69; Hct, r=0.73; MCHC, r=-0.64; Plt, r=-0.49; TG, r=0.53; HDL-C, r=-0.49, p<0.05 for each variable). For all 45 subjects, blood passage time correlated significantly with HbA1c level (r=0.45, p<0.01) and tissue-type plasminogen activator (t-PA) antigen level (r=0.46, p<0.01). Our results indicated that blood rheology is reduced in patients with CCHD as expressed by prolonged blood passage time, and it may be defined by several blood parameters in addition to erythrocytosis.     

OSAHS患儿血FIB、RBC相关指标变化及其临床意义探讨

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿血纤维蛋白原(FIB)、红细胞计数(RBC)相关指标变化及其临床意义.方法 回顾性分析2018年1月～2020年5月医院收治的90例OS-AHS患儿的资料,记为A组,另回顾性分析同期在该院体检的84例健康儿童的资料,记为B组.对比A组和B组血FIB、RBC、血红...     

Impact of hookworm deworming on anemia and nutritional status among children in Thailand

Hookworm infection is associated with anemia, especially among children and deworming can improve anemic status; however, little information is available about the degree to which anemia improves after deworming. We chose hookworm-endemic rural areas of Thailand, Nan Province in the north, Kanchanaburi Province in the west and Nakhon Si Thammarat Province in the south, to evaluate this problem. Subjects were selected by primary school-based stool egg examinations. Blood tests of 182 hookworm-positive primary school children, composed of 22 heavy, 65 moderate and 95 light infections, were compared with a control group of 57 children who were helminth-free both before and after receiving deworming medicine. Before deworming, the red blood cell (RBC), hemoglobin (Hb), hematocrit (Hct), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) and albumin levels of the hookworm-infected groups were significantly lower than the helminth-free control group. The Hb and Hct levels showed an inverse relationship with intensity of hookworm infection. After deworming, the Hb, Hct, total protein and albumin levels of the hookworm-infected children improved within 2 months to become comparable with the helminth-free control group. One year after deworming, the mean blood test results in the 2 groups were not significantly different from each other.     

Haematological reference values in Spanish adolescents: the AVENA study

Objectives: To provide reference values for haematological indices in Spanish adolescents according to age and gender. Methods: A cross sectional study conducted in five Spanish cities was performed. Blood was drawn from a representative sample of 581 adolescents with age ranging from 13 to 17–18.5 yr. Age‐ and gender‐specific means, standard deviations and percentiles were determined for the following parameters: total red blood cell counts (RBC), haemoglobin concentration (Hb), haematocrit percentage (Hct), mean corpuscular volume (MCV), mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, red cell distribution width and total white blood cell (WBC) counts as well as counts and percentage of neutrophils, lymphocytes, monocytes, eosinophils and basophils; platelet count (PLT), mean platelet volume and plateletcrit percentage. Results: Younger male subjects presented lower RBC, Hb, Hct and MCV means that their older counterpart. By contrast these differences were not observed in female subjects. As expected, RBC, Hb and Hct mean values in males were found significantly higher than in girls for all studied age groups. No significant differences were observed in WBC by age and gender. PLT values gradually decreased with age, except for females aged 17–18.5 yr. Conclusion: The present study provides reference data on the distribution of haematological indices of Spanish adolescents. These data can be useful biomarkers of the nutritional status in adolescents.     

Three New Hemoglobin Variants with Abnormal Oxygen Affinity: Hb Saratoga Springs [α40(C5)Lys→Asn (α1)], Hb Santa Clara [β97(FG4)His→Asn], and Hb Sparta [β103(G5)Phe→Val]

Abstract

β-Thalassemia (β-thal) and iron deficiency cause most microcytic anemias. Red cell indices and formulas have been established as simple, fast, and inexpensive in discrimination between these two hematological disorders in school children. However, whether these formulas could be applied to diagnose β-thal trait and iron deficiency in adult Thai subjects is unclear. The aim of this study was to examine the diagnostic accuracy of five red cell indices [red blood cell (RBC) counts, mean corpuscular volume (MCV), mean corpuscular hemoglobin (Hb) (MCH), mean corpuscular Hb concentration (MCHC), and red cell distribution width (RDW)] and nine formulas (RDW/RBC, RDW Index, Sirdah, Green and King, Mentzer, England and Fraser, Ehsani, Srivastava and Shine and Lal). Their sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV), efficiency, and Youden’s Index were analyzed in 102 β-thal trait and 64 iron deficiency adult Thai subjects. The RDW/RBC formula proved to be the most reliable index as they had 100.0% specificity and PPV and the highest efficiency (94.58%) and Youden’s Index (91.18%), as well as high sensitivity (91.18%) and NPV (87.67%). Therefore, this formula could be used in initial discrimination of β-thal trait from iron deficiency in adult Thai subjects.     

Effects of hydroxyurea on hemoglobin F and water content in the red blood cells of dogs and of patients with sickle cell anemia.

A rationale for clinical trials of hydroxyurea (HU) treatment in sickle cell disease is that the agent increases red blood cell (RBC) fetal hemoglobin content. However, an additional effect of HU is to raise the mean corpuscular volume (MCV). To investigate the action of HU in a species that makes no electrophoretically distinguishable fetal hemoglobin, we treated dogs with the drug and compared their response to that of five patients with sickle cell anemia. Both dogs and patients had an increase in MCV, but the effect of HU treatment on the mean corpuscular hemoglobin concentration (MCHC), density, and water content of the RBCs differed in the two species. The dog RBCs became low in MCHC, high in ion and water content, and low in mean density. Thus, HU can raise MCV and lower MCHC without influencing fetal hemoglobin synthesis. A different pattern was seen in the sickle cell patients during HU treatment. Although the MCV of their RBCs increased, there was no change in MCHC, ion content, or mean density. A notable change in the sickle cell patients' blood was that two subpopulations of cells were nearly eliminated during HU treatment; the hypodense reticulocyte fraction and the hyperdense fraction that contains irreversibly sickled cells. These findings lead us to suggest that trials of HU in sickle cell disease must recognize the possibility that any beneficial effect of this agent might be due not only to an increase in hemoglobin F alone, but perhaps also to the associated increase in MCV or the altered RBC density profile.     

Effect of bioactive compounds extracted from euphorbious plants on hematological and biochemical parameters of Channa punctatus

Channa punctatus was exposed to four different concentrations of Rutin, Taraxerol and Apigenin. Changes in some hematological parameters of Channa punctatus were assessed to determine the influence of these compounds on test fish. Fish were exposed to sublethal concentrations (80% of LC50 of 24h) of these compounds for one week. Control fish were also administered for one week. Thereafter, blood samples were obtained from the control and experimental fish. Blood was assayed for selected hematological parameters (hematocrit, hemoglobin, red blood cell count, white blood cell count total plasma protein and plasma glucose concentration). The derived hematological indices of mean corpuscular hemoglobin concentration (MCHC), mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV) were calculated. Sublethal concentrations of these compounds caused a dose dependent decrease in hemoglobin values coupled with a decrease in hematocrit values and red blood cell counts are an obvious indication of anemia. The total white blood cell counts and the differential white blood cell counts were decreased except for the lymphocytes, where there was a slight increase. Plasma protein and glucose were also lower in exposed fish when compared with control. The hematological indices MCH, MCHC, MCV were also lowered. The result from this study reveals high mortality rate and deleterious consequences on the health of fish subjected to acute exposure of Rutin, Taraxerol and Apigenin and therefore, should not be used directly in aquaculture without having the proper knowledge.     

Hematological Characterizations and Molecular Diagnostic Aspects of Hb Wiangpapao [α44(CE2)Pro→Ser (α1), CCG>TCG; HBA1: c.133C>T], a New α-Globin Variant Found in a Pregnant Thai Woman

We report the hematological parameters and provide a rapid molecular analysis method for detection of Hb Wiangpapao [α44(CE2)Pro→Ser, CCG>TCG; HBA1: c.133C>T], a new α-globin variant found in a pregnant Thai woman. Her red cell indices were measured by an automated blood counter. The results were: red blood cell (RBC) count 4.03?×?10¹²/L, Hb 13.1 (g/dL), packed cell volume (PCV) 0.39?L/L, mean corpuscular volume (MCV) 97.0 fL, mean corpuscular hemoglobin (Hb) (MCH) 32.5?pg, mean corpuscular Hb concentration (MCHC) 33.4?g/dL, and RBC distribution width (RDW) 9.4%. The Hb typing by high performance liquid chromatography (HPLC) showed 13.6% abnormal Hb at a retention time of 2.20?min. that was difficult to distinguish from Hb A. On the capillary electrophoresis (CE) electropherogram, this hemoglobinopathy peak did not separate from the Hb A peak. DNA sequencing showed a C>T transition at the first position of codon 44 (CCG>TCG) of the α1-globin gene that led to a substitution of proline for serine. This mutation has not been recorded in the public databases. Therefore, we named it Hb Wiangpapao as it was first discovered in the Wiangpapao District, Chiang Rai, Thailand. The multiplex allele-specific polymerase chain reaction (ASPCR) for detection of Hb Wiangpapao was developed and revealed a 510?bp specifically amplified fragment. The better understanding of hematological characterizations and the newly developed multiplex ASPCR for diagnosis of Hb Wiangpapao are useful for genetic counseling and family education.     

贵州省毕节市燃煤型氟中毒地区人群血常规分析

目的 通过贵州省毕节市燃煤型地方性氟中毒地区汉族人群血常规调查,了解其健康状况及所存在问题.方法 在贵州省毕节市燃煤污染型地氟病病区,对已改良炉灶的长春镇长春村的全体居民(干预组)和未改良炉灶的鸭池镇十八村的全体居民(非干预组)进行血常规检查,检查指标包括白细胞(WBC)、红细胞(RBC)、血红蛋白(Hb)、红细胞压积(HCT)、红细胞平均压积体积(MCV)、平均红细胞血红蛋白(MCH)、平均红细胞血红蛋白浓度(MCHC)、红细胞体积分布宽度(RDW-CV)、血小板(PLT).结果 在男性中,干预组RBC、Hb、HCT、MCHC、PLT分别为(4.95±1.18)×1012/,L、(138.46±15.90)g/L、(50.19±11.48)%、(284.90±48.73)g/L、(334.92±119.34)× 109/L,非干预组分别为(4.02±0.47)x 1012/L、(131.00±15.90)g/L、(40.90±7.60)%、(323.14±41.95)g/L、(280.79±100.34)×109/L,组间比较差异均有统计学意义(U值分别为7.72、3.50、7.12、6.28、3.66.P＜0.01.);在女性中,干预组RBC、HCT、MCV、MCH、MCHC、RDW-CV、PLT分别为(4.75±1.20)×1012/L、(46.91±11.20)%、(99.30±6.88)f1、(28.10±8.66)pg、(275.61±54.49)g/L、(16.95±1.63)%、(351.23±150.37)×109/L,非干预组分别为(3.85±0.65)×1012/L、(38.80±6.60)%、(100.80±7.00)f1、(33.10±5.40)pg、(327.14±44.52)g/L、(16.60±1.58)%、(279.40±98.07)×109/L,组间比较差异有均统计学意义(U值分别为8.92、10.72、2.04、6.61、9.82、2.06、5.39,P＜0.01或＜0.05).非干预组的RBC和Hb异常率[32.62%(92/282)、16.67%(47/282)]高于干预组[9.73%(29/298)、6.71%(20/298)],组问比较差异均有统计学意义(x2值分别为45.992、14.054,P＜0.01).结论 氟中毒病区干预组人群血常规检查情况优于非干预组,尤其是干预组的贫血情况改善较好.     

Screening and Diagnosis of Hb Quong Sze [HBA2: c.377T > C (or HBA1)] in a Prenatal Control Program for Thalassemia

Hb Quong Sze [Hb QS, HBA2: c.377T?>?C (or HBA1)] is a common nondeletional thalassemia in southern China. It is one of the major alleles causing nondeletional Hb H (β4) disease in the Chinese population. There is no strategy currently in place that aims to screen using hematological index cutoffs for this variant. This study was carried out to evaluate whether it is effective to use mean corpuscular hemoglobin (MCH) <27.0?pg as a screening test in the first step of screening for Hb QS carriers in southern China. The data of hematological testing in the Hb QS carriers obtained from couples who underwent prenatal thalassemia screening, regardless of the red blood cell (RBC) indices, were retrospectively reviewed. A total of 51 Hb QS carriers were identified, giving a prevalence rate of 0.2%; among these, 45 were Hb QS heterozygotes. The values of hemoglobin (Hb), MCV and mean corpuscular Hb (MCH) in the 45 Hb QS heterozygotes were 13.2?±?1.8?g/dL, 75.2?±?3.3?fL and 24.5?±?0.5?pg, respectively. Eight heterozygotes (17.8%) had an MCV value of >80.0?fL, ranging from 80.9 to 84.1?fL, and would not be detected using the cutoff value of MCV <80.0?fL as a criterion for thalassemia screening. However, if screening had been based on the MCH <27.0?pg value, all 45 Hb QS heterozygotes would have been detected. Using a cutoff value of MCH <27.0?pg in nondeletional thalassemia screening would greatly decrease the DNA diagnosis burden.     

Hematological and Molecular Characterization of a Novel Hb A2 Variant with Homozygous α-Thalassemia-2 in a Southern Thai Individual

We report here the hematological and molecular features of a novel δ-globin chain variant found in a Southern Thai woman. Her complete blood count was as follows: red blood cell (RBC) count 5.90?×?10¹²/L, hemoglobin concentration (Hb) 12.6?g/dL, packed cell volume (PCV) 0.41?L/L, mean corpuscular volume (MCV) 69.5 fL, mean corpuscular Hb (MCH) 21.4?pg, mean corpuscular Hb concentration (MCHC) 30.7?g/dL and RBC distribution width (RDW) 13.1%. The blood smear demonstrated microcytic hypochromic RBCs suggestive of thalassemia trait. Hemoglobin analysis identified Hb A₂?+?Hb A₂-Kiriwong (2.4%) and Hb F (0.1%) on high performance liquid chromatography (HPLC). To characterize the α-thalassemia (α-thal) genotype, common α-thal-1 and α-thal-2 alleles were characterized by multiplex gap-polymerase chain reaction (gap-PCR). The results revealed homozygous α-thal-2 (–α^3.7/–α^3.7) in this case. DNA sequencing showed the presence of a novel δ-globin gene mutation [δ77(EF1)His→Arg; HBD: c.233A>G] that we named Hb A₂-Kiriwong for the village from where the proband lived. In summary, the presence of microcytic hypochromic RBCs in this case was likely the result of the homozygous –α^3.7 (rightward) deletion and was not affected by this Hb A₂ variant.     

Erythrocyte size, number and haemoglobin content in vertebrates

Relationships between erythrocyte number, size and haemoglobin content were examined in 441 species (101 families) of mammals, birds and reptiles. Whereas the total number of red cells (RBC), the mean cell volume (MCV) and mean cell haemoglobin (MCH) showed much variation, the haemoglobin level (Hb), packed cell volume (PCV) and mean cell haemoglobin concentration (MCHC) were relatively constant in all adult mammals and birds but lower in reptiles. There was a strong positive correlation between MCV and MCH and a strong negative correlation between MCV and RBC across all species. Mammals had more, smaller erythrocytes per unit volume of blood than birds, which, in their turn, had more, smaller erythrocytes than reptiles. The findings confirm that the oxygen-carrying capacity of the blood is highly conserved in birds and mammals but is lower in exothermic groups such as reptiles. Although the significance of the observed species differences in RBC and MCV has yet to be explained, the findings have considerable evolutionary, physiological and diagnostic interest.     

RBC 6-TGN and hematological parameters in patients with Crohn's disease treated by azathioprine

OBJECTIVE: The immunosuppressive properties of azathioprine (AZA) are mediated by intracellular metabolism of 6-MP into its active metabolites 6-thiguanine nucleotide (6-TGN) and 6-methylmercaptopurine (6-MMP). The aims of this study were to correlate red blood cell (RBC) 6-TGN and hematological parameters and their change in adult patients with Crohn's disease (CD) treated by AZA and to determine independent factors enabling determination of RBC 6-TGN. METHODS: RBC 6-TGN concentration was determined with high performance liquid chromography (HLPC) performed on 74 hepa-rinized blood samples from 32 patients. Changes of hematological parameters were measured for each RBC 6-TGN concentration. RBC 6-TGN concentration above 235 pmol/8x108 RBC was proposed as the therapeutic level in patients treated by AZA. Correlations between the various parameters were assessed as appropriate. Logistic regression analysis was used to determinate independent variables. P<0.05 was considered significant. RESULTS: There was a positive correlation between RBC 6-TGN and decreased red cell count (DeltaRBC) (r=0.314; P=0.006), platelet count (DeltaPlatelets) (r=0.314; P=0.007), White cell count (DeltaWC) (r=0.241; P=0.04) and neutrophil count (DeltaPMN) (r=0.292; P=0.02). RBC 6-TGN in the therapeutic zone was positively correlated with mean corpuscular volume (MCV) (r=0.527; P=0.01), mean corpuscular hemoglobin concentration (MCHC) (r=0.437; P=0.04), increase in MCV (DeltaMCV) (r=0.512; P=0.012), decrease in White cell count (DeltaWC) (r=0451; P=003) and in neutrophil count (DeltaPMN) (r=0.463; P=0.03). Multivariate analysis showed that low activity of CD (P<0.02), young age at onset of treatment by AZA (P<0.03) and a low red cell distribution width (RDW) (P=0.003) were independent factors for RBC 6-TGN situated in therapeutic zone. RBC 6-TGN could be determined by logistic regression from AZA dose (mg/kg/d) and MCV increase. CONCLUSION: This study confirms that hematological parameters or their change can be used to determine whether RBC 6-TGN concentration has reached the therapeutic level. Logistic regression analysis showed that decreased RDW and increased MCV were independent factors for RBC 6-TGN level.     

Hematological findings in 375 Sicilians with Hb S trait

We evaluated hematological parameters in 375 Sicilian adults with Hb S trait: Hb S levels were 41.91 +/- 2.65% in males and 40.92 +/- 2.8% in females. RBC, MCV, PCV, MCH, MCHC and total hemoglobin levels were within the normal range. Only mean Hb A2 and Hb F levels were increased (Hb A2 = 2.78 +/- 0.2%; Hb F = 1.05 +/- 0.18%), although they remained inside the normal ranges when compared to healthy controls (Hb A2 = 2.48 +/- 0.19%; Hb F = 0.93 +/- 0.14%) (p less than 0.0005). We conclude that our population does not show the hematological abnormalities such as microcytosis and decreased Hb levels, observed in the Black, Indian, Saudi Arabian carriers, and that the presence of those abnormalities is probably related to the coexistence of alpha-thalassemia, rarely observed in Sicily.