Impact of Delayed Analysis on Hemoglobin Levels in EDTA Blood: Implications for Cancer Management

Ni Putu Riska Pradnya Dewi, Ni Made Dwijastuti, I Gusti Ayu Sri Dhyanaputri, I Gusti Agung Ayu Putu Swastini

Abstract


Cancer remains a leading global health challenge, with anemia being one of the most common complications affecting patient prognosis and treatment outcomes. Hemoglobin (Hb) plays a critical role as a biomarker for transfusion decisions, therapeutic monitoring, and survival prediction. Accurate Hb measurement, however, is highly dependent on the preanalytical phase, particularly the time between blood collection and analysis. Although several studies have explored hematological stability during long-term storage, evidence regarding the short-term impact of delayed analysis on Hb measurement remains limited. This study aimed to evaluate differences in Hb levels of EDTA-anticoagulated blood samples subjected to immediate analysis, 2-hour delay, and 6-hour delay. Thirty-five venous blood samples were analyzed using the cyanmethemoglobin method with spectrophotometric reading at 546 nm. Descriptive statistics showed a progressive decline in Hb values with increasing delay: mean Hb was 14.3 g/dL (0 h), 13.3 g/dL (2 h), and 12.4 g/dL (6 h). Data distribution met normality and homogeneity assumptions. One-Way ANOVA demonstrated a significant difference among groups (F = 11.139, p < 0.001). At the same time, Post Hoc LSD tests confirmed significant pairwise differences between immediate and delayed measurements, as well as between 2-hour and 6-hour delays (p < 0.05). These findings indicate that even short-term delays significantly reduce measured Hb concentration, with potential clinical implications for oncology practice where Hb values inform transfusion thresholds and prognosis. Laboratories should ensure that hemoglobin is measured within two hours of blood collection to minimize preanalytical errors and optimize cancer patient management.

Keywords


Hemoglobin; Pre-analytical phase; Cancer management

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DOI: https://doi.org/10.33992/icmahs.v3i1.4748

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