Usefulness of Measurement of Reticulated Platelets for Diagnosis of Idiopathic Thrombocytopenic Purpura

Sakakura, Miho; Wada, Hideo; Abe, Yasunori; Nishioka, Junji; Tomatsu, Hiroaki; Hamaguchi, Yukio; Oguni, Shinichiro; Shiku, Hiroshi

doi:10.1177/107602960501100303

Cited by 16 publications

(10 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…, 2002] and detectable by flow cytometry on the basis of their RNA content by means of staining with dyes such as Thiazole Orange. Consequently, reticulated platelet analysis has been proposed as a useful indicator of thrombopoiesis [Sakakura et al. , 2005] although this study also demonstrated that similar insights could be obtained with CD‐Sapphire MPV values.…”

Section: Discussionsupporting

confidence: 64%

Relationships between platelet counts, platelet volumes and reticulated platelets in patients with ITP: evidence for significant platelet count inaccuracies with conventional instrument methods

Diquattro¹,

Gagliano²,

Calabrò³

et al. 2009

Int J Lab Hematology

View full text Add to dashboard Cite

The platelet count has a primary role in the diagnosis and treatment of idiopathic thrombocytopenic purpura (ITP). This study analysed the accuracy of ITP patient platelet counts determined by Abbott CD-Sapphire (impedance/optical) and Bayer Advia 120 (optical) analyses, compared with a reference immunoplatelet method. Instrument platelet estimates showed broad equivalence in the higher range of observed values, but significant discrepancies against the immunoplatelet count were seen when platelet counts were <10 x 10(9)/l. CD-Sapphire mean platelet volume (MPV) results revealed increased (>12 fl) platelet volumes in eight of eight ITP patients with counts of <20 x 10(9)/l compared with 6/6 and 5/13 patients with platelet counts of 20-50 and >50 x 10(9)/l. In contrast, Bayer Advia MPV values showed no relationship with the platelet count. Increased reticulated platelets were associated with an increasing CD-Sapphire MPV (R(2) = 0.61) and a decreasing platelet count. High (>40%) reticulated platelet values were seen in 9/9 patients with immunoplatelet counts of <20 x 10(9)/l compared with 0/19 patients with platelet counts above 20 x 10(9)/l. There may be a need for caution in the interpretation of platelet counts in ITP patients obtained with conventional instrument methods, and therapeutic decisions should ideally be validated by reference immunoplatelet procedures.

show abstract

Section: Discussionsupporting

confidence: 64%

Relationships between platelet counts, platelet volumes and reticulated platelets in patients with ITP: evidence for significant platelet count inaccuracies with conventional instrument methods

Diquattro¹,

Gagliano²,

Calabrò³

et al. 2009

Int J Lab Hematology

View full text Add to dashboard Cite

show abstract

“…14,45 RP quantification is achieved using an RNA-specific vital dye (thiazole orange) that does not distinguish between ribosomal and mRNA. 10 We did not quantify RP percentage in this study, although such information has been previously reported, 14,46 with evidence that thrombocytosis patients had RP percentages that were similar to those of normal controls and not different between RT and ET patients. Increased relative and absolute RP counts were primarily restricted to the subset of thrombocytotic patients with concomitant thromboses.…”

Section: Discussionmentioning

confidence: 82%

Class prediction models of thrombocytosis using genetic biomarkers

Gnatenko¹,

Zhu

et al. 2010

Blood

View full text Add to dashboard Cite

Criteria for distinguishing among etiologies of thrombocytosis are limited in their capacity to delineate clonal (essential thrombocythemia [ET]) from nonclonal (reactive thrombocytosis [RT]) etiologies.We studied platelet transcript profiles of 126 subjects (48 controls, 38 RT, 40 ET [24 contained the JAK2V 617 F mutation]) to identify transcript subsets that segregated phenotypes. Cross-platform consistency was validated using quantitative real-time polymerase chain reaction (RT-PCR). Class prediction algorithms were developed to assign phenotypic class between the thrombocytosis cohorts, and by JAK2 genotype. Sex differences were rare in normal and ET cohorts (< 1% of genes) but were male-skewed for approximately 3% of RT genes. An 11-biomarker gene subset using the microarray data discriminated among the 3 cohorts with 86.3% accuracy, with 93.6% accuracy in 2-way class prediction (ET vs RT). Subsequent quantitative RT-PCR analysis established that these biomarkers were 87.1% accurate in prospective classification of a new cohort. A 4-biomarker gene subset predicted JAK2 wild-type ET in more than 85% patient samples using either microarray or RT-PCR profiling, with lower predictive capacity in JAK2V 617 F mutant ET patients. These results establish that distinct genetic biomarker subsets can predict thrombocytosis class using routine phlebotomy. (Blood. 2010;115:7-14) IntroductionPlatelets mediate the initial first step in hemostasis while simultaneously providing the negatively charged phospholipid surface required for contact phase-mediated propagation of the coagulation cascade. Despite these key functions, molecular defects causally implicated in platelet-associated bleeding or thrombotic risk are largely unknown, best characterized by loss of glycoproteins (GP) IIb/IIIa (␣ IIb ␤ 3 ; Glanzmann thrombasthenia) or the GPIb-IX-V complex (Bernard-Soulier syndrome). 1 Similarly, protein overexpression may favor platelet activation and thrombus formation, providing conceptual support for the presence of biomarkers that may confer enhanced thrombosis susceptibility risk. Thus, polymorphisms within the ITGA2 gene encoding the ␣2 polypeptide of the heterodimeric ␣ 2 ␤ 1 collagen receptor increase receptor surface density and are associated with an increased risk of ischemic heart disease in homozygotes (especially smokers), 2,3 although confirmatory results using meta-analyses for a distinct subset of hemostatic proteins have been somewhat disappointing. 4,5 Similarly, platelet membrane polymorphisms have been linked to stroke in small studies, but the evidence is not strong. [6][7][8][9] Such studies highlight the relevance of identifying additional gene/protein biomarkers that may be causally linked to clinically relevant platelet phenotypes.Platelets retain megakaryocyte-derived mRNA, although the platelet transcriptome is less complex than that of nucleated cells. 10,11 Furthermore, platelets have evolved unique adaptive molecular signals for maintenance of genetic and protein diversity. 12 Quiescent platelets...

show abstract

“…If during the course of treatment or monitoring atypical features develop-for example, abnormalities in the white blood cell count, lymphadenopathy, multiple cytopenias-then the diagnosis of ITP should be reassessed. As in childhood ITP, we found insufficient evidence to recommend or suggest the routine use of antiplatelet, [61][62][63][64][65][66][67][68][69][70][71] antiphospholipid [72][73][74][75] and antinuclear antibodies, 13,76 thrombopoietin levels, 64,65,77 or platelet parameters obtained on automated analyzers 64,65,[78][79][80][81][82][83][84] in the evaluation of patients with suspected ITP.…”

Section: Question: What Testing Is Required To Confirm the Diagnosis mentioning

confidence: 99%

The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia

Neunert

Lim

Crowther

et al. 2011

Blood

1,664

1,783

View full text Add to dashboard Cite

Immune thrombocytopenia (ITP) is commonly encountered in clinical practice. In 1996 the American Society of Hematology published a landmark guidance paper designed to assist clinicians in the management of this disorder. Since 1996 there have been numerous advances in the management of both adult and pediatric ITP. These changes mandated an update in the guidelines. This guideline uses a rigorous, evidence-based approach to the location, interpretation, and presentation of the available evidence. We have endeavored to identify, abstract, and present all available methodologically rigorous data informing the treatment of ITP. We provide evidence-based treatment recommendations using the GRADE system in those areas in which such evidence exists. We do not provide evidence in those areas in which evidence is lacking, or is of lower quality-interested readers are referred to a number of recent, consensus-based recommendations for expert opinion in these clinical areas. Our review identified the need for additional studies in many key areas of the therapy of ITP such as comparative studies of "front-line" therapy for ITP, the management of serious bleeding in patients with ITP, and studies that will provide guidance about which therapy should be used as salvage therapy for patients after failure of a first-line intervention. (Blood. 2011;117(16):4190-4207)

show abstract

Usefulness of Measurement of Reticulated Platelets for Diagnosis of Idiopathic Thrombocytopenic Purpura

Cited by 16 publications

References 22 publications

Relationships between platelet counts, platelet volumes and reticulated platelets in patients with ITP: evidence for significant platelet count inaccuracies with conventional instrument methods

Relationships between platelet counts, platelet volumes and reticulated platelets in patients with ITP: evidence for significant platelet count inaccuracies with conventional instrument methods

Class prediction models of thrombocytosis using genetic biomarkers

The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia

Contact Info

Product

Resources

About