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Fetal hemoglobin (HbF) in health and untreated disease

Disorder/condition	Typical range of HbF (percent)
Normal (HbA only)	<1
Sickle cell trait (HbAS)	<1 to 2
Sickle cell anemia (HbSS)	1 to 25
HbSC disease	1 to 10
HbS-beta⁰ thalassemia	1 to 25
HbS-beta⁺ thalassemia	1 to 20
HbS-delta-beta thalassemia	15 to 25
HbS-gene deletion HPFH	30 (age >5 years) or more
Heterozygous gene deletion HPFH	17 to 36
Non-gene deletion HPFH	5 to 35
Beta-thalassemia trait	1 to 10 (mean approximately 1.2)
Homozygous beta thalassemia	10 to 95
Delta-beta thalassemia trait	7 to 10
HbE-beta⁰ thalassemia	20 to 70
HbE-beta⁺ thalassemia	8 to 60
HbH disease	<1
Juvenile chronic myeloid leukemia	Up to 70
Erythroleukemia	Up to 60
Hydatidiform mole	Sometimes up to 6
Fanconi anemia	2 to 85
Paroxysmal nocturnal hemoglobinuria	5 to 10
Miscellaneous disorders of bone marrow and some cancers	1 to 10

HbF was measured by different methods including alkali denaturation and high performance liquid chromatography (HPLC). Typical HbF ranges for patients of different ethnicities, ages, and beta thalassemia mutations are provided; for rare mutations, few cases might have been studied. Many of the ranges of values reported were taken from the references.^[1-3]

HbF: hemoglobin F; HPFH: hereditary persistence of fetal hemoglobin.

References:

Weatherall DJ, Clegg JB. The Thalassaemia Syndromes, 3rd ed, Blackwell, London 1981.
Weatherall DJ, Clegg JB. The Thalassaemia Syndromes, 4th ed, Blackwell, London 2001.
Bunn HF, Forget BF. Hemoglobin: Molecular, Genetic and Clinical Aspects, Saunders, Philadelphia 1986.

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