Usefulness of Immature Platelet Fraction for the Clinical Evaluation of Myelodysplastic Syndromes

Abstract

Ratios of young platelets or reticulated platelets can be routinely obtained as an immature platelet fraction (IPF) with the XE-2100 automated hematology analyzer (Sysmex, Kobe, Japan). We combined IPF analysis of 31 patients with myelodysplastic syndrome (MDS) with a complete blood count, a bone marrow examination, and a chromosome analysis. The patients with >40 x 10(9)/L platelets were classified as group A, and those with > or =40 x 10(9)/L were placed in group B. The 2 groups were subclassified as A1 or B1 for patients with an IPF of <10% and as A2 or B2 for those with an IPF > or =10%. Categories A1, A2, B1, and B2 comprised 12 patients, 6 patients, 7 patients, and 6 patients, respectively. Patients with a relatively high IPF (>10%) (category A2 or B2) showed distinctive characteristics. Group B2 showed a higher frequency of chromosomal abnormalities than B1 (P = .029), and group A2 tended to show a higher incidence of clinical improvement than A1 (P = .08). IPF determination may be clinically useful for the assessment of prognosis for MDS patients.

Measurements of immature platelets with haematology analysers are of limited value to separate immune thrombocytopenia from bone marrow failure

“…Increased levels of imPLT in situations of decreased platelet production in the bone marrow have already been shown (Saigo et al , ; Sugimori et al , ; Jung et al , ; Pons et al , ; Meintker et al , ), with Pons et al () showing this phenomenon in a small cohort using two different methods, i.e. IPF by a Sysmex XE analyser and custom‐made flow cytometry of platelets.…”

“…IPF by a Sysmex XE analyser and custom‐made flow cytometry of platelets. In two reports, the authors speculate that high imPLT in MDS may be linked to different clinical subtypes; however, patient numbers are too small to firmly establish this fact (Saigo et al , ; Sugimori et al , ). In order to prospectively evaluate the diagnostic relevance of imPLT measurements in the situation of thrombocytopenia of unknown aetiology, our study was performed with well‐defined cohorts of thrombocytopenic patients, excluding any patient with an ambiguous diagnosis.…”

“…thrombotic thrombocytopenic purpura or disseminated intravascular coagulation, and for patients recovering after chemotherapy (Briggs et al , ; Abe et al , ; Kickler et al , ; Jung et al , ; Meintker et al , ). However, elevated imPLT were also measured in situations with bone marrow suppression and decreased platelet production (Saigo et al , ; Sugimori et al , ; Jung et al , ; Meintker et al , ). Thus we undertook a study to directly test the clinical relevance of imPLT measurements in thrombocytopenic patients as they might appear in the clinic and determine if imPLT measurements can discriminate between ITP versus bone marrow failure (BMF) due to acute myeloid leukaemia (AML), MDS or AA with two different analysers, the Sysmex XE‐5000 and the Abbott CD Sapphire.…”

Correlation between immature platelet fraction and reticulated platelets. Usefulness in the etiology diagnosis of thrombocytopenia

“…A recent paper communicates about the potential usefulness as a marker of progression to cirrhosis in patients with chronic liver disease (26). It has been postulated also the value of the determination of IPF in the myelodysplastic syndrome, where IPF rates > 10% would be associated with a greater number of karyotypic abnormalities (including abnormalities of chromosome 7), thus conferring a worse prognosis in myelodysplastic syndromes (27, 28).…”

“…, thus conferring a worse prognosis in myelodysplastic syndromes (27,28). IPF is an automated technique for RP determination, standardized, reproducible and it is a methodology that saves time, so it could be a useful screening technique in patients with isolated thrombocytopenia to discriminating peripheral platelet destruction from other causes of thrombocytopenia.…”