Stability and utility of flow cytometric platelet activation tests: A modality to bridge the gap between diagnostic demand and supply

Dave, Rutvi Gautam; Geevar, Tulasi; Chellaiya, Gayathiri K; Mammen, Joy John; Vijayan, Ramya; Samuel, Ashok; Gowri, Mahasampath; Nair, Sukesh C.

doi:10.1080/09537104.2022.2042232

Cited by 4 publications

(2 citation statements)

References 36 publications

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“…Flow cytometry‐based assessments of platelet function, including for patients with thrombocytopenia, have been used to identify PFD although the endpoints and agonist responses evaluated differ from LTA 2,18–22 . Flow cytometry has been used to assess ristocetin‐induced VWF binding to platelets, 16,18,23 and a prospective comparison with VWF levels and RIPA findings would help assess the diagnostic potential. As LTA with L‐PRP has not been prospectively compared to flow‐based platelet function tests for the purposes of diagnosing a bleeding disorder in thrombocytopenic patients, the optimal method remains uncertain.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a diagnostic platelet aggregation test strategy for platelet rich plasma samples with low platelet counts

Altahan,

Mathews,

Bourguignon

et al. 2023

Int J Lab Hematology

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IntroductionLight transmission aggregometry (LTA) is important for diagnosing platelet function disorders (PFD) and von Willebrand disease (VWD) affecting ristocetin‐induced platelet aggregation (RIPA). Nonetheless, data is lacking on the utility of LTA for investigating thrombocytopenic patients and platelet rich plasma samples with low platelet counts (L‐PRP). Previously, we developed a strategy for diagnostic LTA assessment of L‐PRP that included: (1) acceptance of referrals/samples, regardless of thrombocytopenia severity, (2) tailored agonist selection, based on which are informative for L‐PRP with mildly or severely low platelet counts, and (3) interpretation of maximal aggregation (MA) using regression‐derived 95% confidence intervals, determined for diluted control L‐PRP (C‐L‐PRP).MethodsTo further evaluate the L‐PRP LTA strategy, we evaluated findings for a subsequent patient cohort.ResultsBetween 2008 and 2021, the L‐PRP strategy was applied to 211 samples (11.7% of all LTA samples) from 192 unique patients, whose platelet counts (median [range] × 109/L) for blood and L‐PRP were: 105 [13–282; 89% with thrombocytopenia] and 164 [17–249], respectively. Patient‐L‐PRP had more abnormal MA findings than simultaneously tested C‐L‐PRP (p‐values <0.001). Among patients with accessible electronic medical records (n = 181), L‐PRP LTA uncovered significant aggregation abnormalities in 45 (24.9%), including 18/30 (60%) with <80 × 109 platelets/L L‐PRP, and ruled out PFD, and VWD affecting RIPA, in others. The L‐PRP LTA strategy helped diagnose VWD affecting RIPA, Bernard Soulier syndrome, familial platelet disorder with myeloid malignancy, suspected ITGA2B/ITGB3‐related thrombocytopenia, and acquired PFD.ConclusionDiagnostic LTA with L‐PRP, using a strategy that considers thrombocytopenia severity, is feasible and informative.

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Section: Discussionmentioning

confidence: 99%

Evaluation of a diagnostic platelet aggregation test strategy for platelet rich plasma samples with low platelet counts

Altahan,

Mathews,

Bourguignon

et al. 2023

Int J Lab Hematology

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“…By Dave et al ., under comparing the flow cytometry and LTA, flow cytometry had excellent agreement with LTA (sensitivity: 94.1% and specificity: 98.5%). Flow cytometry could be used in thrombocytopenic patients[ 26 ]. Another study was published by Saraymen et al .…”

Section: F Low Cytometry For Assessing Markers Of Platelet ...mentioning

confidence: 99%

Flow cytometry for evaluating platelet immunophenotyping and function in patients with thrombocytopenia

Shen

2022

Tzu Chi Medical Journal

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Platelets play an essential role in primary hemostasis through bleeding and thromboembolism. Thus, the diagnosis or evaluation of impaired hereditary, acquired, and drug-related platelet dysfunction has become imperative. The assessment of the platelet function is too complex for routine platelet function study. The major methods involved in platelet function study include platelet function analyzer testing, thromboelastography, thromboelastometry, light transmission aggregometry, and flow cytometry. The current review article focuses on the methods with flow cytometry for immunophenotyping of platelet and evaluating platelet function for platelet disorders, especially in patients with thrombocytopenia. According to the consensus published by the International Society on Thrombosis and Haemostasis, for inherited and acquired platelet disorders, the two major measures by which flow cytometry determines platelet function are glycoprotein IIb/IIIa/P-selectin (CD62p) expression and percentage of leukocyte–platelet aggregates. Using flow cytometry to determine platelet function has several advantages, including good sensitivity to low platelet counts, small blood volume required, and the nonnecessity of centrifugation. However, flow cytometry has still many limitations and challenges, with standardization for routine laboratory testing also proving difficult. Although flow cytometry is available for multipurpose and sensitive study of platelet functions at the same time, the challenging analysis gradually increases and needs to be addressed before reality.

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Consensus report on flow cytometry for platelet function testing in thrombocytopenic patients: communication from the SSC of the ISTH

Jourdi

Ramström

Sharma

et al. 2023

Journal of Thrombosis and Haemostasis

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Stability and utility of flow cytometric platelet activation tests: A modality to bridge the gap between diagnostic demand and supply

Cited by 4 publications

References 36 publications

Evaluation of a diagnostic platelet aggregation test strategy for platelet rich plasma samples with low platelet counts

Evaluation of a diagnostic platelet aggregation test strategy for platelet rich plasma samples with low platelet counts

Flow cytometry for evaluating platelet immunophenotyping and function in patients with thrombocytopenia

Consensus report on flow cytometry for platelet function testing in thrombocytopenic patients: communication from the SSC of the ISTH

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