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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, HbA1c results, tested in the Department of Laboratory Medicine at Soonchunhyang University Bucheon Hospital, were analyzed. HbA1c was measured using a G8 Glycohemoglobin Analyzer (Tosho Bioscience, Tokyo, Japan) in the 1.6 minutes HbA1c 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 HbA1c test. However, the minimum HbF and LA1C+ fraction increased with increasing HbA1c, suggesting interference by elevated HbA1c.
Conclusions: Care must be taken when interpreting HbF concentrations in samples with high HbA1c values determined using the HbA1c mode of the G8 Glycohemoglobin Analyzer.
DOI: 10.7754/Clin.Lab.2014.130805
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