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Hematopoiesis01:21

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The process of blood cell formation is called hematopoiesis. Hematopoiesis starts early during development, on the seventh day of embryogenesis. This phase of hematopoiesis is called the primitive wave, wherein the extraembryonic yolk sac allows the production of erythroid cells and endothelial cells from a common precursor called hemangioblast. The erythroid cells provide oxygen to support the growth of the rapidly dividing embryo. Hemangioblasts later develop into hematopoietic stem cells or...
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Establishment and Temporal Validation of Next-Generation Reference Intervals for Routine Hematological Parameters

Chaochao Ma1,2, Lihua Guan1, Qian Chen1

  • 1Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing 100730, China.

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PubMed
Summary
This summary is machine-generated.

Next-generation reference intervals (NGRIs) provide dynamic, age- and sex-specific limits for hematological parameters. These stable NGRIs, derived from large health data, improve laboratory medicine accuracy across the lifespan.

Keywords:
GAMLSSage-continuous modelingbig datahematological parametersnext-generation reference intervalstemporal validation

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Area of Science:

  • Clinical Biochemistry
  • Hematology
  • Biostatistics

Background:

  • Conventional reference intervals (RIs) are static and fail to capture continuous biological variation.
  • Next-generation reference intervals (NGRIs) offer dynamic modeling across age and sex.
  • Existing RIs may not adequately represent diverse populations.

Purpose of the Study:

  • To establish age- and sex-specific NGRIs for routine hematological parameters.
  • To evaluate the temporal stability of these NGRIs.
  • To utilize large-scale health examination data for NGRIs.

Main Methods:

  • Defined a healthy reference population (18-80 years) from health examination data.
  • Employed generalized additive models for location, scale, and shape (GAMLSS) with Box-Cox Cole and Green distribution.
  • Generated age-dependent percentile curves and validated temporally across five annual cohorts (2019-2023).

Main Results:

  • Observed significant age- and sex-dependent patterns in RBC, HGB, and HCT.
  • Continuous percentile curves revealed gradual age-related trends, with notable female changes post-midlife.
  • Temporal validation showed consistent performance with <10% individuals outside intervals.

Conclusions:

  • Established stable, age-continuous NGRIs for routine hematological parameters using real-world data.
  • The GAMLSS approach offers a reproducible strategy for modernizing RI construction.
  • This method supports broader implementation in population-based laboratory medicine.