Personalizing the Complete Blood Count Test Could Improve Patient Care

In a retrospective analysis of more than 12,000 adults who received multiple CBC tests across 20 years, the researchers showed that these reference intervals are far from widely generalizable.

It’s known that people’s CBC ranges can shift due to factors such as genetics, disease history, and age. However, the new study suggests that individual patients have a set point — a stable value around which their CBC measures fluctuate.

The study revealed that each patient’s set of nine CBC set points — such as red and white blood cell count, platelet count, hemoglobin levels, and cell sizes — can be distinguished like a fingerprint from those of 98 percent of other healthy adults.

Therefore, comparing a patient’s new CBC results to their own past results would provide a better picture of their health than comparing their numbers to an external standard, the team said.

“Our study suggests CBCs vary a lot from person to person even when completely healthy,” said senior author John Higgins, HMS professor of systems biology in the Center for Systems Biology and the Department of Pathology at Mass General. “A more personalized approach could give more insight into a person’s health or disease.”

By considering CBC set points tailored to an individual, clinicians may be able to diagnose certain diseases in earlier stages, the researchers said. For many of these illnesses — including diabetes, heart disease, and kidney failure — patients would benefit from early intervention.

The researchers found that CBC set points are comparable to many common disease screening factors currently in use for predicting the risk of multiple diseases. Adding CBC set points to the other factors could make disease screening more precise, they argue.

“The long-term stability and patient specificity of set points may provide new opportunities for the personalized management of healthy adults envisioned by precision medicine,” Higgins said.

The researchers also note that the work creates new opportunities to investigate the mechanisms of why CBC set points vary. The information could also be used to develop more specific treatment plans, including determining whether a patient needs additional tests for an accurate diagnosis.

Adapted from a Mass General news release.