Flow cytometric measurement of hemoglobin F in RBCs: Diagnostic usefulness in the distinction of hereditary persistence of fetal hemoglobin (HPFH) and hemoglobin S-HPFH from other conditions with elevated levels of hemoglobin F

James D. Hoyer, Connie S. Penz, Virgil F. Fairbanks, Curtis A. Hanson, Jerry A. Katzmann

Research output: Contribution to journalArticle

19 Scopus citations


The cellular distribution of hemoglobin F is important for evaluating persistently elevated hemoglobin F levels, such as in hereditary persistence of fetal hemoglobin (HPFH) or delta/beta-thalassemia, and for differentiating homozygous hemoglobin S (or hemoglobin S-beta0-thalassemia) from hemoglobin S-HPFH, traditionally done by using the Kleihauer-Betke (K-B) acid elution test. We evaluated a flow cytometric method using an anti-hemoglobin F antibody as a replacement for the K-B test. We used 172 specimens representing a variety of conditions: HPFH trait, 19 cases; delta/beta-thalassemia trait, 8 cases; hemoglobin S-HPFH, 10 cases. By flow cytometry, all cases of HPFH trait gave a hemoglobin F pattern comparable to the homocellular pattern obtained by the K-B test; all cases of delta/beta-thalassemia tested gave a pattern comparable to a K-B heterocellular pattern. Most cases of hemoglobin S-HPFH gave a homocellular distribution of hemoglobin F, whereas all cases of homozygous hemoglobin S with elevated hemoglobin F levels gave a heterocellular pattern. Flow cytometry provides a more rapid and objective method for assessing cellular distribution of hemoglobin F and is useful for patient evaluation when HPFH trait, delta/beta-thalassemia trait, or hemoglobin S-HPFH trait is suspected.

Original languageEnglish (US)
Pages (from-to)857-863
Number of pages7
JournalAmerican journal of clinical pathology
Issue number6
StatePublished - Jun 6 2002



  • Flow cytometry
  • HPFH
  • Hemoglobin F
  • Hereditary persistence of fetal hemoglobin
  • Kleihauer-Betke

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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