ISSN 2997-1036
International Journal of Hematology | Vol. 6, No. 10, October 2015 | pp. 73–80
DOI: 10.46882/2015/IJH/000070
Short Communication
Title: Screening for alpha-thalassemia trait using red blood cell distribution width ratios in microcytic blood donors
Names of Authors: B. C. Akpan¹, D. E. Usman²
Authors’ Affiliations: ¹Department of Haematology, University of Calabar, Calabar, Nigeria; ²Department of Clinical Pharmacology, Ahmadu Bello University, Zaria, Nigeria
Abstract: Differentiating benign inherited microcytosis from iron deficiency in blood donors is essential to prevent inappropriate donor deferrals or unnecessary iron treatments. This diagnostic study evaluated the screening performance of the red blood cell distribution width (RDW) index and the Mentzer formula for identifying alpha-thalassemia trait in 110 healthy blood donors presenting with isolated microcytosis (MCV < 75 fl) and normal iron panels. Molecular multiplex PCR served as the confirmatory standard for identifying alpha-gene deletions (-alpha³.⁷). Alpha-thalassemia trait was confirmed in 22.7% (25 of 110) of the microcytic donors. Confirmed thalassemia carriers exhibited a significantly narrower red blood cell distribution width range (12.8 ± 0.9%) compared to donors with latent iron depletion (16.4 ± 1.5%, P < 0.001). An RDW value below 14.0% combined with a Mentzer index below 13 achieved a sensitivity of 88.0% and a specificity of 84.7% for predicting alpha-thalassemia deletions. Utilizing automated cell counter RDW ratios offers an accessible, low-cost screening protocol to detect hemoglobin gene traits during routine blood donor assessments.
Keywords: Alpha-thalassemia trait, blood donors, microcytosis, red blood cell distribution width, Mentzer index
Manuscript Timeline: Received: July 20, 2015; Revised: August 25, 2015; Accepted: September 14, 2015; Published: October 18, 2015