UK NEQAS Haematology pilot scheme: Reticulocyte haemoglobin content quantitation.

Area of Science:

• Clinical Chemistry
• Haematology
• Laboratory Medicine

Background:

• Established iron deficiency diagnostics have limitations in sensitivity and specificity.
• Reticulocyte haemoglobin content (RHC) is a sensitive biomarker for iron deficiency and response to therapy.
• Lack of external quality assessment (EQA) for RHC hinders its clinical application in the UK.

Purpose of the Study:

• To pilot the feasibility of establishing RHC EQA in the UK.
• To assess the stability and usability of RHC EQA material across different platforms.
• To evaluate the potential for RHC EQA to improve iron deficiency diagnostics.

Main Methods:

• Collected blood from polycythaemia vera patients and a healthy donor.
• Distributed stabilized blood aliquots to 20 laboratories for RHC analysis on automated analysers (Abbott, Horiba, Siemens, Sysmex) over 7 days.
• Analyzed RHC results for inter-platform and inter-day variations.

Main Results:

• No significant within-platform differences were observed across testing days (p > 0.5).
• Statistically significant differences in RHC results were found between different analytical platforms (p < 0.001).
• Despite platform differences, defined cut-offs correctly classified 95% of results for iron deficiency, borderline, and normal states.

Conclusions:

• Reticulocyte haemoglobin content (RHC) EQA material can be successfully provided using UKNEQAS standard procedures.
• The developed RHC EQA material yields clinically relevant results.
• Inter-user comparison is necessary to address inter-platform variations and enhance RHC's clinical utility.