Cone and platelet analyser (CPA): a new test for the prediction of bleeding among thrombocytopenic patients

Abstract

The risk of bleeding among thrombocytopenic patients was evaluated using our new cone and platelet analyser (CPA) test. Using this test, adherence of platelets was quantitated on extracellular matrix and expressed as percent of surface coverage (SC) and the average size (AS) of aggregates. 42 thrombocytopenic patients with ITP (n=23), post chemotherapy (n= 12) and others (n= 7) were tested over a total of 82 visits. On each visit, complete blood count and CPA tests were performed and patients were evaluated for evidence of bleeding (found in 40 visits). Bleeding patients had significantly lower platelet counts (27.4 +/- 22.0 v 47.1 +/- 21.0 x 10(9)/l), lower haematocrit values (30.2 +/- 8.1 v 35.2 +/- 6.6%), lower MPV (6.83 +/-1.89 v 8.98 +/- 1.13 fl), and lower SC (4.87 +/- 3.95 v 10.33 +/-5.48%) and AS (33.99 +/- 14.94 v 52.9 +/- 24.34 microm2). Univariate analysis yielded platelet count < or =20.0 x 10(9)/l, MPV < or =8 fl, haematocrit <35%, SC <5%, AS< or =40 microm2 as significantly associated with bleeding, whereas only MPV and SC were associated with bleeding (OR 6.95, CI 2.25-21.46 and OR 4.27, CI 1.29-14.16, respectively) by multivariate analysis. When taken together, 21/22 of patients (95%) with both low SC (<5%) and low MPV (<8.0 fl) had bleeding symptoms, whereas only 9/43 (21%) patients with both these parameters above these values experienced bleeding symptoms. We conclude that the CPA test and the parameter SC (<5%) together with MPV (< or =8 fl) might be used as independent predictors of bleeding in the management of thrombocytopenic patients.

Platelet Function of Newborns as Tested by Cone and Plate(let) Analyzer Correlates with Gestational Age

“…CPA is an attractive mode for rapid, feasible evaluation of platelet function in neonates using very small amounts of blood. The method has already been used for diagnostic purposes of various platelet disorders, including infant studies [12,13,14,15,16,17,18,19]. Whereas in previous studies, platelet adhesion and aggregation were examined on ECM, we used polystyrene surface instead of ECM-coated plates in order to make the method simpler and less expensive [20].…”

“…This is a new method for examining platelet adhesion and aggregation on extracellular matrix (ECM) under flow conditions. The method has been used in various platelet disorders, including in infants [12,13,14,15,16,17]. The use of CPA to evaluate platelet function of neonates has previously been reported [17] in a study applying CPA either to neonatal cord blood samples or neonatal venous blood.…”

Antiplatelet Antibodies and Their Correlation with Clinical Findings in Childhood Immune Thrombocytopenic Purpura

“…The prediction criteria for the outcome of disease at diagnosis are age, platelet volume, platelet count, surface coverage and size of adherent platelets [6, 10]. …”

Hormonal, electrolyte disturbances and features of hemostasis in term newborn infants of mothers with gestational diabetes mellitus.

“…Для осуществления этого ре-жима требуется образец крови в объеме 0,2 мл. CPA используется в неонатологии для исследования пупо-винной и венозной крови новорожденных [51][52][53][54]. На-стоящее исследование было проведено с целью оценки функции тромбоцитов крови новорожденных на CPA, родившихся от матерей с заболеваниями, которые могут оказать влияние на неонатальный гемостаз.…”