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22526 Hemoglobin A2 and F, Quantitative (A2F)

Hemoglobin A2 and F, Quantitative (A2F)
Test Code: MISC
Synonyms/Keywords
​Lab Ref Code:  22526, A2 Hemoglobin, F-Hemoglobin, Hemoglobin A2, Hemoglobin A2 and F Blood, Hemoglobin F
Useful For
Assisting in the diagnosis of beta-thalassemia.
Quantitating the percent of hemoglobin F (Hgb F) present.
Assisting in the diagnosis of disorders with elevated levels of Hgb F.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Whole Blood​ ​EDTA Lavendar Top Tube (LTT) ​ 6 mL​ ​1 mL ​
Collection Processing Instructions
1. Submit fresh specimen.
2. Do not transfer blood to other containers.
Additional Information: Patient's age is required.
Specimen Stability Information
Specimen Type Temperature Time
​Whole blood ​Refrigerated ​10 days
Rejection Criteria
Hemolysis
Mild OK; Gross OK
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Medical Laboratories​​
Monday through Saturday; 7 a.m. and 1 p.m.
Same day/1 day
Cation Exchange/High-Performance Liquid Chromatography (HPLC)
Reference Lab
Mayo Clinic Laboratories
Reference Range Information
Reference Range
HEMOGLOBIN A2
1-30 days: 0.0-2.1%
1-2 months: 0.0-2.6%
3-5 months: 1.3-3.1%
> or =6 months: 2.0-3.3%
 
HEMOGLOBIN F
1-30 days: 22.8-92.0%
1-2 months: 7.6-89.8%
3-5 months: 1.6-42.2%
6-8 months: 0.0-16.7%
9-12 months: 0.0-10.5%
13-17 months: 0.0-7.9%
18-23 months: 0.0-6.3%
> or =24 months: 0.0-0.9%
Interpretation
Hemoglobin A2 (Hgb A2) values of 3.5% to 9% are found in beta-thalassemia trait.
 
In beta-thalassemia major, hemoglobin F (Hgb F) may be 30% to 90% or even more of the total hemoglobin.
 
Hgb F concentration is usually between 5% to 15% of the total hemoglobin in delta/beta-type thalassemia trait (F-thalassemia).
 
Higher concentrations of Hbg F occur in hemoglobin S (Hgb S)/beta zero-thalassemia, in patients who are doubly heterozygous for the Hgb S gene, and in patients who have a gene for hereditary persistence of fetal hemoglobin (HPFH). These disorders may be differentiated by family studies or by flow cytometry studies for Hgb F (HPFH/8270 Hemoglobin F, Red Cell Distribution, Blood), which reveals uniform intraerythrocytic distribution of Hgb F in HPFH and nonuniform distribution in Hgb S/beta thalassemia.
 
The electrophoretic finding of small quantities of Hgb A in a patient who has mostly Hgb S and a moderate increase in Hgb F is strong evidence of Hgb S/beta thalassemia (if the patient has not had a transfusion).
 
Hgb F values greater than normal (2%) may be seen in chronic anemias, beta-thalassemia, and HPFH
​
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​83021 ​ ​ ​ ​
Synonyms/Keywords
​Lab Ref Code:  22526, A2 Hemoglobin, F-Hemoglobin, Hemoglobin A2, Hemoglobin A2 and F Blood, Hemoglobin F
Ordering Applications
Ordering Application Description
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Whole Blood​ ​EDTA Lavendar Top Tube (LTT) ​ 6 mL​ ​1 mL ​
Collection Processing
1. Submit fresh specimen.
2. Do not transfer blood to other containers.
Additional Information: Patient's age is required.
Specimen Stability Information
Specimen Type Temperature Time
​Whole blood ​Refrigerated ​10 days
Rejection Criteria
Hemolysis
Mild OK; Gross OK
Useful For
Assisting in the diagnosis of beta-thalassemia.
Quantitating the percent of hemoglobin F (Hgb F) present.
Assisting in the diagnosis of disorders with elevated levels of Hgb F.
Reference Range Information
Reference Range
HEMOGLOBIN A2
1-30 days: 0.0-2.1%
1-2 months: 0.0-2.6%
3-5 months: 1.3-3.1%
> or =6 months: 2.0-3.3%
 
HEMOGLOBIN F
1-30 days: 22.8-92.0%
1-2 months: 7.6-89.8%
3-5 months: 1.6-42.2%
6-8 months: 0.0-16.7%
9-12 months: 0.0-10.5%
13-17 months: 0.0-7.9%
18-23 months: 0.0-6.3%
> or =24 months: 0.0-0.9%
Interpretation
Hemoglobin A2 (Hgb A2) values of 3.5% to 9% are found in beta-thalassemia trait.
 
In beta-thalassemia major, hemoglobin F (Hgb F) may be 30% to 90% or even more of the total hemoglobin.
 
Hgb F concentration is usually between 5% to 15% of the total hemoglobin in delta/beta-type thalassemia trait (F-thalassemia).
 
Higher concentrations of Hbg F occur in hemoglobin S (Hgb S)/beta zero-thalassemia, in patients who are doubly heterozygous for the Hgb S gene, and in patients who have a gene for hereditary persistence of fetal hemoglobin (HPFH). These disorders may be differentiated by family studies or by flow cytometry studies for Hgb F (HPFH/8270 Hemoglobin F, Red Cell Distribution, Blood), which reveals uniform intraerythrocytic distribution of Hgb F in HPFH and nonuniform distribution in Hgb S/beta thalassemia.
 
The electrophoretic finding of small quantities of Hgb A in a patient who has mostly Hgb S and a moderate increase in Hgb F is strong evidence of Hgb S/beta thalassemia (if the patient has not had a transfusion).
 
Hgb F values greater than normal (2%) may be seen in chronic anemias, beta-thalassemia, and HPFH
​
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Medical Laboratories​​
Monday through Saturday; 7 a.m. and 1 p.m.
Same day/1 day
Cation Exchange/High-Performance Liquid Chromatography (HPLC)
Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​83021 ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.