title: Hemoglobin mass and biological passport for the detection of autologous blood doping.
abstract: OBJECTIVE
  The most promising attempt to reveal otherwise undetectable autologous blood doping is the Athlete Biological Passport enabling a longitudinal monitoring of hematological measures. Recently, the determination of hemoglobin mass (tHb) was suggested to be incorporated in the adaptive model of the Athlete Biological Passport. The purpose therefore was to evaluate the performance of tHb as part of the adaptive model for the detection of autologous blood transfusions in a longitudinal blinded study.
  
  
  METHODS
  Twenty-one subjects were divided into a doped group (n = 11) and a control group (n = 10). During the time course of a simulated cycling season (42 wk) including three major competitions (Classics, Grand Tour, World Championships), multiple autologous transfusions of erythrocyte concentrates were assigned in the doped group. A blinded investigator ordered up to 10 tHb measurements (carbon monoxide rebreathing) per subject, mimicking an intelligent doping testing approach in obtaining hematological data (tHb, OFFmass (novel marker including reticulocytes), and respective sequences) for the adaptive model.
  
  
  RESULTS
  The final analysis included 199 of 206 overall tHb measurements. The use of tHb, OFFmass, and their sequences as markers of the adaptive model at the 99% specificity level allowed identification of 10 of 11 doped subjects (91% sensitivity) including one false positive in the control group. At the 99.9% specificity level, 8 of 11 subjects were identified without false positives (73% sensitivity).
  
  
  CONCLUSIONS
  It seems that the problems of tHb determination by carbon monoxide rebreathing limit the application of this method in antidoping. Because of its potential to detect individual abnormalities associated with autologous blood transfusions shown in this study, a method for tHb determination that is compatible with today's standards of testing should be the focus of future research.
authors: Department of Sports Medicine, University Hospital of Freiburg, Freiburg, Germany. torben.pottgiesser@uniklinik-freiburg.de
authors: Torben
authors: T
authors: Pottgiesser
authors: Tobias
authors: T
authors: Echteler
authors: Pierre-Edouard
authors: PE
authors: Sottas
authors: Markus
authors: M
authors: Umhau
authors: Yorck Olaf
authors: YO
authors: Schumacher
mesh_terms: D000328:Adult; D001804:Blood Transfusion, Autologous; D002245:Carbon Dioxide / Q000008:administration & dosage; D004300:Doping in Sports / Q000379:methods*; D006403:Hematologic Tests / Q000379:methods; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D015813:Substance Abuse Detection / Q000379:methods*
chemical_list: D006454:Hemoglobins; D002245:Carbon Dioxide