CALIPER Hematology Reference Standards (I)
Houman Tahmasebi1, Victoria Higgins1,2, Mary Kathryn Bohn1,2
1CALIPER Program, Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada.
Insights
This study establishes crucial age- and sex-specific hematologic reference standards for 47 parameters in healthy children and adolescents. These findings highlight the need for pediatric-specific reference values for accurate clinical interpretation.
Area of Science:
- Clinical Hematology
- Pediatric Reference Intervals
- Biostatistics
Background:
- Accurate interpretation of hematologic tests relies on normative reference standards for clinical decision-making.
- A significant lack of healthy pediatric reference data exists for most hematology parameters.
- The Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) cohort provides a unique dataset of healthy children and adolescents.
Purpose of the Study:
- To establish age- and sex-specific hematologic reference standards for the pediatric population.
- To address the critical gap in normative data for pediatric hematology parameters.
- To provide a robust database for improved clinical interpretation of hematologic tests in children and adolescents.
Main Methods:
- Analysis of 47 hematologic parameters from 566 healthy children and adolescents (birth to <21 years).
- Utilized fresh whole blood samples analyzed on the Beckman Coulter DxH 900.
- Calculated age- and sex-specific reference standards following Clinical and Laboratory Standards Institute guidelines.
Main Results:
- Dynamic changes in reference value distributions were observed across the pediatric age range.
- Significant age-specific differences were found for 39 of the 47 hematologic parameters.
- Sex-specific differences were noted for eight parameters, particularly around puberty.
Conclusions:
- Established the first robust database of pediatric reference standards for 47 hematologic parameters in the CALIPER cohort.
- Reported physiologically relevant trends in hematologic markers, emphasizing pediatric-specific needs.
- Demonstrated a clear need for dedicated pediatric reference standards for accurate hematologic test interpretation.
Objectives:
Accurate hematologic test interpretation based on normative reference standards is critical to ensure appropriate clinical decision making. However, healthy pediatric reference data for most hematology parameters are lacking. To address this gap, this study establishes age- and sex-specific hematologic reference standards in the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) cohort of healthy children and adolescents.
Methods:
Fresh whole blood samples collected from a total of 566 healthy children and adolescents (birth to <21 years) with informed consent were analyzed for 47 hematologic parameters on the Beckman Coulter DxH 900. Age- and sex-specific reference standards were calculated based on the Clinical and Laboratory Standards Institute guidelines.
Results:
Reference value distributions for most hematology parameters demonstrated dynamic changes across the pediatric age range with significant age-specific differences observed for 39 of the 47 parameters examined. Sex-specific differences were also observed for eight hematologic parameters, primarily during and after puberty.
Conclusions:
This study establishes a robust database of pediatric reference standards for 47 hematologic parameters in the CALIPER cohort for the first time. These comprehensive reference value data sets report potentially important and physiologically relevant trends in hematologic markers, clearly demonstrating the need for pediatric reference standards for hematologic test interpretation.
