Clinical pathology selected abstracts
July 2024—People with sickle cell disease may undergo treatment with the medication voxelotor, which can increase hemoglobin levels and help reduce hemolysis. A clinician treating a sickle cell disease patient with voxelotor may want to know the whole blood concentration of the drug to better monitor the patient’s treatment response, inform therapy, or confirm the patient is complying with the directions for use of the drug. Voxelotor binds to the alpha subunit of hemoglobin and results in the hemoglobin molecule being more likely to stay in the oxygenated conformation. In vivo concentrations of voxelotor cannot be measured in most clinical settings. However, voxelotor has been found to cause peak splitting in common forms of hemoglobin measurement, such as capillary zone electrophoresis (CZE) and high-performance liquid chromatography (HPLC)—that is, the classic peaks for each hemoglobin species split into a peak that has bound drug and a peak that does not.