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Narrowed reference intervals for complete blood count in a multiethnic population

Seungok Lee1,2, Chui Mei Ong3, Yu Zhang3

  • 1Department of Laboratory Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Republic of Korea.

Clinical Chemistry and Laboratory Medicine
|February 13, 2019
PubMed

Insights

Complete blood count (CBC) reference intervals (RIs) vary significantly by race/ethnicity. Tailoring CBC RIs for diverse populations improves diagnostic accuracy and advances precision medicine.

Area of Science:

  • Clinical Chemistry
  • Hematology
  • Population Health

Background:

  • Biological variation studies reveal narrow within-individual and wide group variation in complete blood count (CBC) parameters.
  • This inherent variability presents challenges for the standard use of reference intervals (RIs).

Purpose of the Study:

  • To investigate ethnic and racial differences in CBC RIs within a multiethnic patient cohort.
  • To enhance the clinical utility of CBC testing through race/ethnicity-specific RIs.

Main Methods:

  • Retrospective analysis of outpatient CBC results from Zuckerberg San Francisco General Hospital (April 2017 - January 2018).
  • Calculation of sex- and race/ethnicity-specific CBC RIs (2.5th to 97.5th percentiles) for 552 subjects across four racial/ethnic groups.
  • Statistical comparison of RIs among White, Black, Hispanic, and Asian individuals.

Main Results:

  • Significant differences (p<0.05) in RIs were observed among racial/ethnic groups for several CBC parameters.
  • In males, neutrophil, lymphocyte, and eosinophil counts, and mean corpuscular hemoglobin concentration (MCHC) showed significant variations.
  • In females, hemoglobin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and MCHC exhibited significant differences across groups.

Conclusions:

  • Race/ethnicity-specific CBC RIs are crucial for accurate interpretation in multiethnic populations.
  • Implementing tailored RIs can lead to improved patient status assessment.
  • This approach is a step forward in achieving precision medicine.

Keywords:
complete blood countmultiethnic populationrace/ethnicityreference interval

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