Letter to the Editor: Comparing the Novel Parameter 'Slope of the Steepest Part of Hemolysis Curve' to Standard Median Corpuscular Fragility for Evaluating Erythrocyte Stability during Prolonged Storage.

Objective: Several ways for presenting the results of osmotic fragility test have been described in the literature. Our aim was to compare the utility of a novel parameter for assessment of erythrocyte osmotic properties, i.e., 'Slope of the steepest part of hemolysis curve' with the most frequently used parameter 'Median corpuscular fragility' in order to assess the stability of erythrocytes in a blood sample during prolonged storage.

Methods: Ten whole blood samples were obtained from healthy donors. The osmotic fragility test was initially conducted on the day of venipuncture, and subsequent analyses were carried out on days 1, 2, 4, 7, 9, 11, and 14 after the venipuncture. Mean hemolysis percentage values were used to construct hemolysis curves. The steepest parts of hemolysis curves were estimated to be linear, and lines that overlapped those parts of the curves were created. The slope of these lines was calculated, and the resulting mean values are presented.

Results: A significant increase in Median corpuscular fragility values was observed, starting from day of venipuncture. We compared the average values for each day of analysis. The first significant difference in Median corpuscular fragility values was observed on day 4 compared to the day of venipuncture (p=0.006), with values 0.53±0.030 % and 0.41±0.014% respectively. Meanwhile, differences in the values of the slopes of the steepest parts of hemolysis curves were observed as early as day 2 when compared to the day of venipuncture (p=0.046), with values of -966.23±233.07 and -588.01±222.85, respectively.

Conclusion: Prolonged storage of whole blood samples leads to an increase in osmotic fragility and alters the shape of the hemolysis curve. These changes suggest that postponing the osmotic fragility test could lead to diagnostic inaccuracies. These findings suggest that slope value is a more accurate parameter for evaluating erythrocyte stability during storage, compared to commonly used Median corpuscular fragility value. Hence, it has potential importance and can be complementary to the laboratory result of the OFT. Therefore, it can be useful to provide these results jointly with the results of the OFT test.