Population-specific pediatric reference intervals for complete blood count in Vietnamese children and their impact on clinical classification.

IF 4.4 2区医学 Q1 MEDICAL LABORATORY TECHNOLOGY

Clinical chemistry and laboratory medicine Pub Date : 2026-10-01 DOI:10.1515/cclm-2026-0766

Dien Minh Tran, Anh Quynh Mai, Phuc Huu Phan, Tung Viet Cao, Mai Thi Chi Tran, Ronda F Greaves, Tze Ping Loh, Duyen Thi Nguyen

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引用次数: 0

Abstract

Objectives: To establish age- and sex-specific reference intervals (RI) for complete blood count (CBC) parameters in healthy Vietnamese children aged 0 to <19 years and assess the impact of applying locally derived vs. non-local pediatric RI on abnormal flagging and clinical classification.

Methods: A community-based cross-sectional study included 3,885 healthy Vietnamese children aged 0 to <19 years recruited through school-based health screening programs between April 2024 and November 2025. Peripheral venous blood samples were analyzed using the Sysmex XN-9000 hematology analyzer under standardized pre-analytical and analytical conditions with internal and external quality control. Outliers were excluded using the Tukey interquartile range method. Age and sex partitions were established through an integrated assessment of visual inspection, the Mann-Whitney U test, Cliff's delta, the Harris-Boyd method, and biological and clinical considerations. Reference intervals were established according to CLSI EP28-A3c using a nonparametric approach (2.5-97.5th percentiles), with 90 % confidence intervals estimated by bootstrap.

Results: All CBC parameters showed age-related variation, supporting age-specific RI. Sex differences were limited to erythrocyte parameters, including red blood cell count, hemoglobin, and hematocrit, emerging after puberty; sex partitioning was unnecessary for most analytes. Application of the Vietnamese vs. CALIPER reference intervals in an outpatient cohort resulted in bidirectional reclassification, with 0.0-32.6 % of CALIPER-abnormal results reclassified as normal and 0.0-24.4 % of CALIPER-normal results reclassified as abnormal, depending on the analyte.

Conclusions: This study establishes population-based pediatric CBC RI for Vietnamese children. Non-local pediatric RI may alter abnormal flagging and result interpretation in routine practice.

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越南儿童全血细胞计数的人群特异性儿科参考间隔及其对临床分类的影响。

目的：建立越南0 ~ 0岁健康儿童全血细胞计数（CBC）参数的年龄和性别特异性参考区间（RI）方法：一项基于社区的横断面研究，包括3885名0 ~ 0岁健康的越南儿童结果：所有CBC参数均显示年龄相关变化，支持年龄特异性RI。性别差异仅限于红细胞参数，包括红细胞计数、血红蛋白和红细胞压积，在青春期后出现；对大多数分析物来说，性别划分是不必要的。在门诊队列中应用越南与CALIPER参考区间导致双向重新分类，0.0- 32.6% 的CALIPER异常结果被重新分类为正常，0.0-24.4 %的CALIPER正常结果被重新分类为异常，这取决于分析物。结论：本研究为越南儿童建立了以人群为基础的儿童CBC RI。非局部儿科RI可能改变常规实践中的异常标记和结果解释。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical chemistry and laboratory medicine 医学-医学实验技术

CiteScore

11.30

自引率

16.20%

发文量

306

审稿时长

3 months

期刊介绍： Clinical Chemistry and Laboratory Medicine (CCLM) publishes articles on novel teaching and training methods applicable to laboratory medicine. CCLM welcomes contributions on the progress in fundamental and applied research and cutting-edge clinical laboratory medicine. It is one of the leading journals in the field, with an impact factor over 3. CCLM is issued monthly, and it is published in print and electronically. CCLM is the official journal of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and publishes regularly EFLM recommendations and news. CCLM is the official journal of the National Societies from Austria (ÖGLMKC); Belgium (RBSLM); Germany (DGKL); Hungary (MLDT); Ireland (ACBI); Italy (SIBioC); Portugal (SPML); and Slovenia (SZKK); and it is affiliated to AACB (Australia) and SFBC (France). Topics: - clinical biochemistry - clinical genomics and molecular biology - clinical haematology and coagulation - clinical immunology and autoimmunity - clinical microbiology - drug monitoring and analysis - evaluation of diagnostic biomarkers - disease-oriented topics (cardiovascular disease, cancer diagnostics, diabetes) - new reagents, instrumentation and technologies - new methodologies - reference materials and methods - reference values and decision limits - quality and safety in laboratory medicine - translational laboratory medicine - clinical metrology Follow @cclm_degruyter on Twitter!