So what do you need to do to get popped for an ABP violation?
Well, a 20.1 g/dL HGB / 0.83% RET / 148.30 OFF-SCORE some days before competition followed by an 18.7 g/dL HGB / 0.53% RET / 143.70 OFF-SCORE a few days after the competition seems to be sufficient to get you on the "maybe needs further testing" list.
No wonder he broke the half marathon world record in that competition.
Ok. I may be completely mistaken, but this is worrying from Kiptum's health point of view.. unknown mid to late 20s runners - especially Kenyans - appearing out of nowhere to dominate has been happening a lot the past decade. Maybe the theory is that you can (mostly) get away with high hemoglobin if you first raise it sky high before the first ever test and then keep it there in perpetuity, so that the blood values appear to be naturally high? That would not seem particularly healthy for the athlete, but when has that ever stopped unscrupulous doctors, trainers, and managers?
This is an interesting case with an altitude native and
first ABP ban of a Kenyan athlete (The new WADA-approved "PLK" lab in Nairobi came on online in 2018 and started more thorough testing for the ABP-ADAMS system. There are also 3 more Kenyan runners provisional-suspended for ABP violations with Tribunal hearings still pending).
Kiptum's very first sample taken was already at the 99.99% specificity level (1 in 10,000 chance of being
undoped) for extremely high Hgb (20.3) and Off-score (148.30) taken a few weeks before the HM world-record at the Valencia Half Marathon on 28 October 2018.
Sample #2, taken 3 days after Valencia, was also
flagged for high Hgb (18.9) with low RET% (0.57) and a very high Off-score (143.70).
The expert panel said the extremely high Hgb was "massive erthrocythosis" consistent with a diagnosis of "polycythemia" or "congenital erthrocythosis." However, the panel noted those pathologies are associated with high RET% and not the low RET% observed in Kiptum's profile - so any pathological reasons for the anomalies was ruled out. The expert panel is said to also have ruled out the effects of
altitude in contributing to the high HGB values (this was one of Kiptum's main defenses as an altitude native training at ~2300m).
The Tribunal noted that sample #1 (20.3/0.83/148.30) would be accepted as an ADRV. However, it is important to obtain more samples over a period time particularly in connection with the athlete's competition schedule to prove a
doping scheme (sample #6 taken 2 two days after the Abu Dhabi marathon, 9 December 2018, was
flagged for elevated Hgb (18.7) with very low RET% (0.48) and an extremely high Off-score of 145.40).
In reference to his very high Off-scores the expert panel noted:
"The probability of a male athlete recording an OFFscore of
145, even in the
worst case at altitude, is less than 1 in 10,000 (i.e., 99.99% specificity)"
The huge 61% drop in RET% (1.25/0.48) from Dec 2 to Dec 9 (2018) while maintaining elevated Hgb (18.4/18.7) is classic "off-phase" use of an ESA.
The ABP worked extremely well in detecting blood doping with an
altitude native in a situation where anti-doping countermeasures were apparently used very effectively in avoiding a positive drug test for an ESA. Not only did sample #1 trigger a "red flag," but it independently could have been used for an ADRV.
Here's a paper co-authored by Dr. Schumacher, who's a member of the IAAF's & UCI's anti-doping expert panel, that goes into detail on the ABP's detection process:
The increase of the body's capacity to transport oxygen is a prime target for doping athletes in all endurance sports. For this pupose, blood transfusions or erythropoiesis stimulating agents (ESA), such as erythropoietin, NESP, and CERA are used. As direct detection of such manipulations is...
www.ncbi.nlm.nih.gov
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