Automatic detection of immature platelets for decision making regarding platelet transfusion indications for pediatric patients

Saigo, Katsuyasu; Sakota, Yasuyuki; Masuda, Yuji; Matsunaga, Kyoko; Takenokuchi, Mariko; Nishimura, Kunihiro; Sugimoto, Tsuneaki; Sakurai, Kosuke; Hashimoto, Makoto; Yanai, Tomoko; Hayakawa, Akira; Takeshima, Yasuhiro; Nomura, Tsutomu; Kubota, Yoshihiro; Kumagai, Shunichi

doi:10.1016/j.transci.2008.01.003

Cited by 41 publications

(41 citation statements)

References 8 publications

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“…In this study, the IPF percentage of non-thrombocytopenic neonates was negatively correlated with gestational age, which was consistent with a previous report [18]. A significant inverse correlation between platelet count and IPF percentage was reported in patients with immune thrombocytopenic purpura (ITP) [11,12,19]. The IPF percentage may reflect the severity of platelet destruction and/or increased platelet production.…”

Section: Discussionsupporting

confidence: 92%

Significance of immature platelet fraction and CD41-positive cells at birth in early onset neonatal thrombocytopenia

et al. 2010

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Early thrombocytopenia is a common hematological abnormality in sick neonates. Here, we examined the relationship between early thrombocytopenia in neonates and parameters associated with thrombopoiesis to identify predictive factors at birth. Two hundred and forty-four neonates admitted to the neonatal intensive care unit were divided into thrombocytopenic (n = 55, 23%) and non-thrombocytopenic (n = 189, 77%) groups based on platelet counts, which were monitored within 72 h of birth. Immature platelet fraction (IPF) and platelet count at birth were determined simultaneously soon after phlebotomy with an automated hematology analyzer. Megakaryocytes and their precursors positive for CD41 in peripheral blood were examined at birth by flow cytometry. The thrombocytopenic group showed significantly higher IPF percentage and lower percentage of CD41+ mononuclear cells (MNCs) than did the non-thrombocytopenic group (P < 0.01). Moreover, the percentage of CD41+ MNCs significantly differentiated neonates with platelet counts >150 x 10(3)/microL at birth and nadir platelet count <150 x 10(3)/microL over the clinical course from neonates without thrombocytopenia. These observations suggest that the percentage of CD41+ MNCs at birth and IPF percentage are useful predictors of early thrombocytopenia in the majority of sick neonates.

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Section: Discussionsupporting

confidence: 92%

Significance of immature platelet fraction and CD41-positive cells at birth in early onset neonatal thrombocytopenia

et al. 2010

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“…Following peripheral blood stem cell transplant in adults, the IPF% value rises 1-2 days prior to the increment in platelet count [23,25]. Saigo et al [30] observed platelet recovery within 3-7 days after the day of peak IPF% in pediatric patients with various malignant disorders after chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Immature Platelet Fraction: Establishment of a Reference Interval and Diagnostic Measure for Thrombocytopenia

et al. 2010

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451Background: Immature platelet fraction (IPF, %) is a measure of reticulated platelets (RPs), which represents the state of thrombopoiesis. The IPF is obtained from an automated hematology analyzer as one of the platelet parameters. This study was performed to establish reference intervals of IPF and its cut-off values for the differential diagnosis of thrombocytopenia.Methods: Blood samples from 2,039 healthy individuals (1,161 males, 878 females) were obtained to establish reference intervals. The patient group included patients with idiopathic thrombocytopenic purpura (ITP) (N=150) and aplastic anemia (AA) (N=51) with platelet counts of less than 100×10 9 /L. We evaluated the reliability of the IPF measurements, the reference intervals, and cut-off value for the diagnosis of ITP.Results: The reference intervals of IPF were 0.5-3.2% in males and 0.4-3.0% in females (95% confidence interval). The median IPF% of ITP and AA were 7.7% (range, 1.0-33.8%) and 3.5% (range, 0.6-12.9%), respectively. Statistical analysis revealed a significant difference between the IPF% of ITP and AA (P<0.0001). The cut-off value of IPF for differentiating ITP from AA was 7.3% with a sensitivity and specificity of 54.0% and 92.2%, respectively.Conclusions: A rapid and inexpensive automated measurement of IPF can be integrated as a standard parameter to evaluate the thrombopoietic state of the bone marrow. This study determined the reference intervals of IPF from a large population of healthy individuals, including children. Further studies are needed to establish the clinical utility of IPF. (Korean J Lab Med 2010;30:451-9)

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“…This creates the opportunity to defer platelet transfusions that would be given when transfusion decisions are based on platelet counts only. Until present, limited clinical evidence supporting this concept has been reported and there is an evident need for randomized, controlled clinical studies in this field [82,97,98]. A highly interesting observation that also needs to be confirmed is that prophylactic transfusions with high IPF platelet concentrates seem to be more effective than low IPF platelets [99].…”

Section: Clinical Utility Of Reticulated/ Immature Plateletsmentioning

confidence: 99%

Reticulated platelets: analytical aspects and clinical utility

Hoffmann

2014

Clinical Chemistry and Laboratory Medicine (CCLM)

139

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Reticulated platelets are immature platelets circulating in blood; they reflect the activity of megakaryopoiesis in the bone marrow. Therefore, they can be used as a non-invasive test in patients with thrombocytopenia in various clinical conditions. The preferred method of analysis is by flow cytometry. However, there is an evident lack of analytical standardization, making it difficult to compare results obtained in different laboratories. Currently, two types of hematology analyzers are on the market offering fully automated measurement of reticulated or immature platelets: the high end analyzers manufactured by Sysmex (XE-and XN-series) and Abbott (CELL-DYN Sapphire). Although the methods are essentially different and cannot be used interchangeably, both have been proven to have clinical utility. Reticulated or immature platelet assays are useful for the differential diagnosis of thrombocytopenia and for monitoring bone marrow recovery after chemotherapy or stem cell transplantation. These assays may aid clinicians in platelet transfusion decisions when recovery from thrombocytopenia is imminent. In addition, preliminary findings indicate that there is a rationale for reticulated or immature platelets for risk stratification in acute coronary syndromes and for monitoring the effect of treatment with antiplatelet drugs in patients with coronary artery diseases. The aim of this paper is to present the present technology available for measuring reticulated platelets as well as an overview of the current status of clinical application. This overview also indicates that more research is needed before reticulated or immature platelet assays can be applied in other clinical conditions than thrombocytopenia and after transplantation.

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Automatic detection of immature platelets for decision making regarding platelet transfusion indications for pediatric patients

Cited by 41 publications

References 8 publications

Significance of immature platelet fraction and CD41-positive cells at birth in early onset neonatal thrombocytopenia

Significance of immature platelet fraction and CD41-positive cells at birth in early onset neonatal thrombocytopenia

Immature Platelet Fraction: Establishment of a Reference Interval and Diagnostic Measure for Thrombocytopenia

Reticulated platelets: analytical aspects and clinical utility

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