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Albarrán-Artahona V, Torres-Jiménez J, Auclin E, Esteban-Villarrubia J, Sánchez-Gastaldo A, Benítez-López G, Garde-Noguera J, Pérez-Gracia J, Soler J, Areses M, Olmedo-García E, Insa A, Torres-Martínez A, Roa D, Dorta M, Cárdenas N, Laguna J, Teixidó C, Mezquita L. EP08.02-149 Spanish Multicenter Retrospective Study of Real-Life Experience of Advanced NSCLC with EGFR Exon 20 Insertions Treated With Amivantamab. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Roa D, Leon S, Paucar O, Gonzales A, Schwarz B, Olguin E, Moskvin V, Alva-Sanchez M, Glassell M, Correa N, Moyses H, Shankar A, Hamrick B, Sarria GR, Li B, Tajima T, Necas A, Guzman C, Challco R, Montoya M, Meza Z, Zapata M, Gonzales A, Marquez F, Neira R, Vilca W, Mendez J, Hernandez J. Monte Carlo simulations and phantom validation of low-dose radiotherapy to the lungs using an interventional radiology C-arm fluoroscope. Phys Med 2021; 94:24-34. [PMID: 34979431 DOI: 10.1016/j.ejmp.2021.12.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/30/2021] [Accepted: 12/27/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To use MC simulations and phantom measurements to investigate the dosimetry of a kilovoltage x-ray beam from an IR fluoroscope to deliver low-dose (0.3-1.0 Gy) radiotherapy to the lungs. MATERIALS AND METHODS PENELOPE was used to model a 125 kV, 5.94 mm Al HVL x-ray beam produced by a fluoroscope. The model was validated through depth-dose, in-plane/cross-plane profiles and absorbed dose at 2.5-, 5.1-, 10.2- and 15.2-cm depths against the measured beam in an acrylic phantom. CT images of an anthropomorphic phantom thorax/lungs were used to simulate 0.5 Gy dose distributions for PA, AP/PA, 3-field and 4-field treatments. DVHs were generated to assess the dose to the lungs and nearby organs. Gafchromic film was used to measure doses in the phantom exposed to PA and 4-field treatments, and compared to the MC simulations. RESULTS Depth-dose and profile results were within 3.2% and 7.8% of the MC data uncertainty, respectively, while dose gamma analysis ranged from 0.7 to 1.0. Mean dose to the lungs were 1.1-, 0.8-, 0.9-, and 0.8- Gy for the PA, AP/PA, 3-field, and 4-field after isodose normalization to cover ∼ 95% of each lung volume. Skin dose toxicity was highest for the PA and lowest for the 4-field, and both arrangements successfully delivered the treatment on the phantom. However, the dose distribution for the PA was highly non-uniform and produced skin doses up to 4 Gy. The dose distribution for the 4-field produced a uniform 0.6 Gy dose throughout the lungs, with a maximum dose of 0.73 Gy. The average percent difference between experimental and Monte Carlo values were -0.1% (range -3% to +4%) for the PA treatment and 0.3% (range -10.3% to +15.2%) for the 4-field treatment. CONCLUSION A 125 kV x-ray beam from an IR fluoroscope delivered through two or more fields can deliver an effective low-dose radiotherapy treatment to the lungs. The 4-field arrangement not only provides an effective treatment, but also significant dose sparing to healthy organs, including skin, compared to the PA treatment. Use of fluoroscopy appears to be a viable alternative to megavoltage radiation therapy equipment for delivering low-dose radiotherapy to the lungs.
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Affiliation(s)
- D Roa
- Department of Radiation Oncology, University of California, Irvine Health, Orange, CA 92868, USA.
| | - S Leon
- Department of Radiology, University of Florida, Gainesville, FL 32610, USA
| | - O Paucar
- Facultad de Ingenieria Electrica y Electronica, Universidad Nacional de Ingenieria, Lima, Peru
| | - A Gonzales
- Facultad de Ciencias, Universidad Nacional de Ingenieria, Lima, Peru
| | - B Schwarz
- Department of Radiology, University of Florida, Gainesville, FL 32610, USA
| | - E Olguin
- Department of Radiology, University of Florida, Gainesville, FL 32610, USA
| | - V Moskvin
- Department of Radiation Oncology, St. Judes Children's Research Hospital, Memphis, TN 38105, USA
| | - M Alva-Sanchez
- Department of Exact and Applied Sciences, University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - M Glassell
- Department of Radiology, University of Florida, Gainesville, FL 32610, USA
| | - N Correa
- Department of Radiology, University of Florida, Gainesville, FL 32610, USA
| | - H Moyses
- Department of Radiation Oncology, University of California, Irvine Health, Orange, CA 92868, USA
| | - A Shankar
- Department of Radiology, University of Florida, Gainesville, FL 32610, USA
| | - B Hamrick
- Environmental Health and Safety, University of California, Irvine Health, Orange, CA 92868, USA
| | - G R Sarria
- University Hospital Bonn, Department of Radiation Oncology, University of Bonn, Bonn, Germany
| | - B Li
- Department of Radiation Oncology, University of California, San Francisco, CA 94115, USA
| | - T Tajima
- Department of Physics and Astronomy, University of California, Irvine, CA 92697, USA
| | - A Necas
- TAE Technologies, 1961 Pauling, Foothill Ranch, CA 92610, USA
| | - C Guzman
- Facultad de Medicina Humana, Universidad Ricardo Palma, Lima, Peru
| | - R Challco
- Facultad de Ciencias, Universidad Nacional de Ingenieria, Lima, Peru
| | - M Montoya
- Facultad de Ciencias, Universidad Nacional de Ingenieria, Lima, Peru
| | - Z Meza
- Facultad de Ciencias, Universidad Nacional de Ingenieria, Lima, Peru
| | - M Zapata
- Facultad de Ciencias, Universidad Nacional de Ingenieria, Lima, Peru
| | - A Gonzales
- Clinica Aliada contra el Cancer, Lima, Peru
| | - F Marquez
- Facultad de Ciencias Físicas, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - R Neira
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - W Vilca
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - J Mendez
- Facultad de Ciencias Naturales y Matemática, Universidad Nacional del Callao, Callao, Peru
| | - J Hernandez
- HRS Oncology International, Las Vegas, NV 89119, USA
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Martinez Perez D, Garcia B, Roa D, Gay H, Chetty I, Hermansen M, Mcleod M, Hao J, Castaneda S, Lo C, Sherry A, Del Castillo Pacora R, Sarria Bardales G, Li B. PO-1284: Evaluation of the Effectiveness of Telehealth Courses for SBRT/SRS Training in Latin America. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01302-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Barrera JB, Sais E, Verdura S, Cuyas E, Roa D, Hernández A, Izquierdo A, Teixidor E, Carbajal W, Lopez M, Brunet J, Menendez J. P1.03-035 Efficacy of Nintedanib and Docetaxel in Combination with the Nutraceutical Use of Silibinin in Advanced NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bosch-Barrera J, Sais E, Izquierdo A, Hernández A, Roa D, Cuyas E, Pedraza S, Priego N, Ortuño P, Sánchez G, Cañete N, Roselló A, Soffietti R, Brunet J, Valiente M, Menendez J. Effect of silibinin nutraceutical supplementation in brain metastases of patients with advanced lung cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx366.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Roa D, Gonzales A, Kuo J. SU-F-T-568: QA of a Multi-Target Multi-Dose VMAT SRS. Med Phys 2016. [DOI: 10.1118/1.4956753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Yu S, Roa D, Hanna N, Sehgal V, Farol H, Kuo J, Daroui P, Ramsinghani N, Al-Ghazi M. SU-E-T-216: Comparison of Volumetrically Modulated Arc Therapy Treatment Using Flattening Filter Free Beams Vs. Flattened Beams for Partial Brain Irradiation. Med Phys 2015. [DOI: 10.1118/1.4924577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Roa D, Lin Y, Hanna N, Al-Ghazi M, Kuo J. SU-C-137-01: Out-Of-Field Fetal Dose Measurement From a Head-And-Neck Treatment with VMAT: An Anthropomorphic Phantom Study. Med Phys 2013. [DOI: 10.1118/1.4813932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Lin Y, Limoli C, Acharya M, Christie L, Bosch O, Kumar V, Hamamura M, Roa D. SU-E-T-271: Irradiating a Single Hippocampus in a Small Rodent Using VMAT- RapidArc SRS: Preliminary Data. Med Phys 2012; 39:3765-3766. [DOI: 10.1118/1.4735338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Y Lin
- University Of California, Irvine, Orange, CA
| | - C Limoli
- University Of California, Irvine, Orange, CA
| | - M Acharya
- University Of California, Irvine, Orange, CA
| | - L Christie
- University Of California, Irvine, Orange, CA
| | - O Bosch
- University Of California, Irvine, Orange, CA
| | - V Kumar
- University Of California, Irvine, Orange, CA
| | - M Hamamura
- University Of California, Irvine, Orange, CA
| | - D Roa
- University Of California, Irvine, Orange, CA
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Lin Y, Chang D, Bota D, Roa D, Al-Ghazi M, Yu H, Kuo J, Nie K, Fwu P, Su M. SU-E-J-108: Quantitative Analysis of Longitudinal Cognitive Impairment Due to Radiation Therapy Based on Automatic Segmentation of Hippocampus and Subcortical Structure. Med Phys 2012; 39:3677. [PMID: 28519814 DOI: 10.1118/1.4734944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE In this study, we developed a quantitative analysis tool based on patient's longitudinal MR images to 1) measure the radiation dose received by each subcortical structure, 2) follow the change of volume and shape of each structure longitudinally. This tool provides a systematic approach to study the radiation therapy (and subsequent chemotherapy) associated with cognitive impairments. METHODS MRI scans of one patient taken before and after radiation therapy are demonstrated in this study. 3D Conformal radiation therapy was performed on RapidArc™. An open source MRI analysis tool, FMRIB's Integrated Registration and Segmentation Tool (FIRST), was used for segmentation. The images are registered to a standard template with expert-defined labeling for all sub-cortical structures, and the labeling of each structure is mapped back to the individual MRI space for segmentation. After the segmentation, the radiation dose map was coregistered to the MRI space to calculate the dose received by each structure. RESULTS For the structure that is contained within the radiation zone, we can calculate the total dose based on the volumetric distribution of radiation dose. For the structure that is outside the radiation field, we can calculate the distance from the radiation zone. We have demonstrated in this work that the analysis can be done for all segmented sub-cortical structures. The change of volume before and after radiation treatment can be analyzed, and the results can be correlated with the change of cognitive performance over time. CONCLUSIONS We presented an automated tool for efficient, quantitative and user-independent measurements of radiation dose in subcortical structures. The obtained results can be correlated with the cognitive test score and the clinical outcome to evaluate radiation and the subsequent chemotherapy induced changes in brain structures and functions.
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Affiliation(s)
- Y Lin
- University of California, Irvine, CA
| | - D Chang
- University of California, Irvine, CA
| | - D Bota
- University of California, Irvine, CA
| | - D Roa
- University of California, Irvine, CA
| | | | - H Yu
- University of California, Irvine, CA
| | - J Kuo
- University of California, Irvine, CA
| | - K Nie
- University of California, Irvine, CA
| | - P Fwu
- University of California, Irvine, CA
| | - M Su
- University of California, Irvine, CA
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Zhang J, Sehgal V, Roa D, He Q, Martin M, Al-Ghazi M. SU-GG-J-34: Comprehensive Clinical Commissioning and Quality Assurance Procedures of a Big Bore CT Simulator in a Radiation Oncology Department. Med Phys 2010. [DOI: 10.1118/1.3468258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Roa D, Vanderbeck G, Zhang J, Schiffner D, Wong J, Kuo J, Ramsinghani N, Al-Ghazi M. SU-GG-T-154: Special Radiation Treatment Procedures Using RapidArc™. Med Phys 2010. [DOI: 10.1118/1.3468544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Zhang J, Vanderbeck G, Dietrich S, Schiffner D, Wong J, Kuo J, Ramsinghani N, Al-Ghazi M, Roa D. SU-GG-T-109: Comprehensive RapidArc™ Treatment Planning and Quality Assurance for Head and Neck Cancers. Med Phys 2010. [DOI: 10.1118/1.3468498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Roa D, Chung R, Ramsinghani N, Al-Ghazi M. SU-FF-T-104: Simultaneous Boost and Skin Dose Toxicity Reduction for Breast Cancer Treatments Using IMRT and RapidArc. Med Phys 2009. [DOI: 10.1118/1.3181578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Song H, Roa D, Ahmad M, Luo W, Yin F, Chen Z. SU-FF-T-438: Using Diode Dosimeters to Characterize Dose in the Buildup Region of High-Energy Photon Beams. Med Phys 2007. [DOI: 10.1118/1.2761163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Roa D, Song H, Ahmad M, He Q, Al-Ghazi M. SU-FF-T-260: In-Vivo Dosimetry Verification of a 3D Treatment Plan Prescription Dose at a Depth Beyond Dmax Using Diodes. Med Phys 2007. [DOI: 10.1118/1.2760921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Workie D, Sehgal V, Roa D, Al-Ghazi M, Kuo J, Ramsinghani N. SU-FF-J-61: Evaluation of Two CT/MRI Fusion Algorithms Used for Treatment Planning. Med Phys 2006. [DOI: 10.1118/1.2240839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Roa D, Smither R, Shieh Y, Nie K, Zhang X, Al-Ghazi M, Milne N, Caligiuri P. TH-D-330A-03: Development of a High Resolution Imaging System for Nuclear Medicine. Med Phys 2006. [DOI: 10.1118/1.2241894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Iyamu EW, Fasold H, Roa D, del Pilar Aguinaga M, Asakura T, Turner EA. Hydroxyurea-induced oxidative damage of normal and sickle cell hemoglobins in vitro: amelioration by radical scavengers. J Clin Lab Anal 2001; 15:1-7. [PMID: 11170226 DOI: 10.1002/1098-2825(2001)15:1<1::aid-jcla1>3.0.co;2-i] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Hydroxyurea (HU) induces fetal hemoglobin (Hb F) production in patients with sickle cell anemia. The therapeutic dosage of HU used for Hb F induction often elicits myelosuppression, which becomes its major associated complication. We examined the effect of HU on hemoglobin modulation and the role of radical scavengers on these induced changes. In vitro exposure of human blood to various concentrations of HU at predetermined time intervals induced a progressive dose-dependent oxidation (MetHb formation) of both adult (Hb AA) and sickle (Hb SS) hemoglobins. The oxidative effect of HU on Hb SS was 3 times greater than its effect on Hb AA. Similar but less profound changes were observed in H2O2-treated samples. Hb F was, however, observed to be relatively resistant to HU-induced oxidative damage. A substantial protective effect of Hb by alpha-tocopherol, ascorbic acid, and D-mannitol was observed during pretreatment of Hb AA and Hb SS blood samples. Analyses of the hemoglobins and their globin chain components by high-performance liquid chromatography revealed a considerable protective effect by these free radical scavengers. These results indicate that the HU-induced damage of hemoglobin and their component globin chains can be reduced by radical scavengers.
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Affiliation(s)
- E W Iyamu
- Comprehensive Sickle Cell Center, Meharry Medical College, Nashville, Tennessee, USA
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Abstract
Use of hydroxyurea (HU) to treat sickle cell disease is usually associated with increments in fetal hemoglobin (Hb F) production; however, in vitro studies show that HU may also induce hemoglobin denaturation. Whole blood samples from Hb AA, Hb AS, and Hb SS patients were treated in vitro with 100, 150, 200, 250, and 300 micrograms/mL HU, incubated at 30 degrees C for up to 12 days, and analyzed by high-performance liquid chromatography (HPLC). Hb AA levels show decrements of 91 to 14% with 100 micrograms/mL and 89 to 4% with 150 micrograms/mL after 12 days; 86 to 2% with 200 micrograms/mL after 10 days; 86 to 8% with 250 and 300 micrograms/mL after 8 days. Similar treatment and incubation times for Hb AS whole blood demonstrate that HU equally degrades the A and S components of Hb AS. A comparable approach for Hb SS whole blood samples, using a 300 micrograms/mL HU treatment, showed a hemoglobin denaturing pattern that went from 93% to 1% after 12 days. Globin chain analysis of these samples by reverse-phase HPLC showed that the denaturing effects occur mostly on the beta-globin chain.
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Affiliation(s)
- D Roa
- Comprehensive Sickle Cell Center, Meharry Medical College, Nashville, Tennessee 37208-3599, USA
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Roa D, Turner EA, Aguinaga MD. Reference ranges for hemoglobin variants by HPLC in African Americans. Ann Clin Lab Sci 1995; 25:228-35. [PMID: 7605104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
High performance liquid chromatography (HPLC) demonstrated advantages over conventional procedures employed in newborn and adult hemoglobinopathy screening programs for the identification of Hb variants has promoted the need to reassess our knowledge of hemoglobin reference ranges as it relates to HPLC quantitation. In this study, the HPLC hemoglobin reference ranges derived from 200 normal African American adults are expressed as follows: Hb A mean 93.6 percent (s.d. 1.3, ranges 89.8 to 95.2), Hb A1 mean 2.0 percent (s.d. 0.6, ranges 0.8 to 5.2), Hb F mean 3.2 percent (s.d. 0.7, ranges 1.7 to 5.3) and Hb A2 mean 1.2 percent (s.d. 0.4, ranges 0.5 to 3.4); while the HPLC results for normal newborns and babies (n = 99) in the African American population fluctuates from Hb F mean 82.0 percent (s.d. 7.7, range 66.6 to 89.9) and Hb A mean 19.0 percent (s.d. 7.7, ranges 10.1 to 33.4) at 4 days to a mean of 15. percent (s.d. 4.8, range 9.3 to 22.8) for Hb F and a mean of 85.0 percent (s.d. 5.1, ranges 76.4 to 90.7) for Hb A at 300 days after birth. In case of the most common hemoglobin variants for this population, it has been shown that the A/S and A/C ratios for adults (Hb AS, Hb AC) and newborns (Hb FAS, and FAC) remained within the 1.5 (range 1.0 to 2.2) limits regardless of age group. Application of these HPLC ranges to confront other abnormalities will prove most useful during blood screening processes.
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Affiliation(s)
- D Roa
- Department of Pediatrics, Meharry Medical College, Nashville, TN 37208, USA
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