Standardization of hemoglobin A2 and hemoglobin F: Achievements and perspectives

The establishment of reference systems for the standardization of hemoglobin A2 (HbA2) and fetal hemoglobin (HbF), both critical for improving diagnostic accuracy in conditions such as β-thalassemia and sickle cell disease, are here described. Efforts led by the IFCC and other groups aim to address and to reduce the variability in laboratory measurements of these hemoglobins. The document details the production of certified reference materials (CRMs) for HbA2 and the development of a reference measurement procedure using isotope dilution mass spectrometry. Similarly, standardizing HbF is essential for supporting diagnos-tic and therapeutic strategies, particularly in managing sickle cell disease. HbF levels can predict disease outcomes and guide treatment plans. Significant challenges remain in achieving consistent measurement across laboratories, and the process for standardization for this minor hemoglobin has just been started. We are confident that the implementation of these reference systems will promise greater accuracy and traceability in the future.

MOSCA Andrea;  ARSENE Cristian-Gabriel;  PALEARI Cristina;  KAISER Patricia;  HARTEVELD Kees;  DANIEL Yvonne;  AMANO Chie;  MURAKAMI A;  AUCLAIR Guy; 

2026-03-13

ELSEVIER

JRC139775

1873-3492 (online),   

https://www.sciencedirect.com/science/article/pii/S0009898124023404,    https://publications.jrc.ec.europa.eu/repository/handle/JRC139775,   

10.1016/j.cca.2024.120087 (online),