Abstract
We consecutively examined the utility of measurements of percentage of immature platelet fraction (IPF%) and absolute IPF number (A-IPF) in predicting thrombopoietic recovery in 15 adult patients who underwent allogeneic hematopoietic stem cell transplantation (allo-SCT). Four patients were excluded from the evaluation due to insufficient data. Platelet count and IPF were measured by Sysmex XN-1000 (XN), a newer generation analyzer. First, we confirmed that platelet count measured by XN was more accurate than by XE-2100 (XE). IPF measurement was effective to predict the recovery in 7 of the 11 patients examined. Moreover, IPF measurement, especially IPF% measurement, suggested accelerated platelet turnover in two patients who failed to achieve platelet recovery by day 60. In addition to IPF%, A-IPF showed a complementary role on the prediction of thrombopoietic recovery. The increase in IPF% was only transient, while A-IPF values showed lasting increase during platelet recovery. In two patients (cases 6 and 7) an increase in A-IPF, but not in IPF%, was observed during platelet recovery. Our data suggest that IPF% and A-IPF measured by XN are useful for the prediction of thrombopoietic recovery and the assessment of pathogenesis of thrombocytopenia in patients after allo-SCT.
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References
Nash RA, Gadi VK. Hematopoietic cell transplantation. In: Greer JP, Arber DA, Glader B, List AF, Means RT, Paraskevas F, Rodgers GM, editors, Wintrobe’s clinical hematology, 13 edn. Philadelphia: Lippincott Williams & Wilkins; 2014.
Kaufman RM, Djulbegovic B, Gernsheimer T, Kleinman S, Tinmouth AT, Capocelli KE, et al. Platelet transfusion: a clinical practice guideline from the AABB. Ann Intern Med. 2015;162:205–13.
Briggs C, Hart D, Kunka S, Oguni S, Machin SJ. Immature platelet fraction measurement: a future guide to platelet transfusion requirement after haematopoietic stem cell transplantation. Transfus Med. 2006;16:101–9.
Michur H, Maślanka K, Szczepiński A, Mariańska B. Reticulated platelets as a marker of platelet recovery after allogeneic stem cell transplantation. Int J Lab Hematol. 2008;30:519–25.
Takami A, Shibayama M, Orito M, Omote M, Okumura H, Yamashita T, et al. Immature platelet fraction for prediction of platelet engraftment after allogeneic stem cell transplantation. Bone Marrow Transplant. 2007;39:501–7.
Martinelli G, Merlo P, Fantasia R, Gioia F, Crovetti G. Reticulated platelet monitoring after autologous peripheral haematopoietic progenitor cell transplantation. Transfus Apher Sci. 2009;40:175–81.
Yamaoka G, Kubota Y, Nomura T, Inage T, Arai T, Kitanaka A, et al. The immature platelet fraction is a useful marker for predicting the timing of platelet recovery in patients with cancer after chemotherapy and hematopoietic stem cell transplantation. Int J Lab Hematol. 2010;32:e208–16.
Gonçalo AP, Barbosa IL, Campilho F, Campos A, Mendes C. Predictive value of immature reticulocyte and platelet fractions in hematopoietic recovery of allograft patients. Transplant Proc. 2011; 43:241–243.
Kienast J, Schmitz G. Flow cytometric analysis of thiazole orange uptake by platelets: a diagnostic aid in the evaluation of thrombocytopenic disorders. Blood. 1990;75:116–21.
Richards EM, Baglin TP. Quantitation of reticulated platelets: methodology and clinical application. Br J Haematol. 1995;91:445–51.
Barsam SJ, Psaila B, Forestier M, Page LK, Sloane PA, Geyer JT, et al. Platelet production and platelet destruction: assessing mechanisms of treatment effect in immune thrombocytopenia. Blood. 2011;117:5723–32.
Kurata Y, Hayashi S, Kiyoi T, Kosugi S, Kashiwagi H, Honda S, et al. Diagnostic value of tests for reticulated platelets, plasma glycocalicin, and thrombopoietin levels for discriminating between hyperdestructive and hypoplastic thrombocytopenia. Am J Clin Pathol. 2001;115:656–64.
Kuwana M, Kurata Y, Fujimura K, Fujisawa K, Wada H, Nagasawa T, et al. Preliminary laboratory based diagnostic criteria for immune thrombocytopenic purpura: evaluation by multicenter prospective study. J Thromb Haemost. 2006;4:1936–43.
Sakuragi M, Hayashi S, Maruyama M, Kabutomori O, Kiyokawa T, Nagamine K, et al. Clinical significance of IPF% or RP% measurement in distinguishing primary immune thrombocytopenia from aplastic thrombocytopenic disorders. Int J Hematol. 2015;101:369–75.
van der Linden N, Klinkenberg LJ, Meex SJ, Beckers EA, de Wit NC, Prinzen L. Immature platelet fraction measured on the Sysmex XN hemocytometer predicts thrombopoietic recovery after autologous stem cell transplantation. Eur J Haematol. 2014;93:150–6.
Acknowledgements
SH, YK, and YT had substantial contributions to research design, MS, MM, TK, KN, and JF to the acquisition, TM, Hisa K, Hiro K, and YT to analysis or interpretation of data, respectively. MS and YT had substantial contributions to drafting the paper and others to revising it critically, and all authors gave approval of the submitted version. This work was supported by Grant-in Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology in Japan and the Ministry of Health, Labor and Welfare in Japan.
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Automated hematology analyzers, XE-2100 and XN-1000, were supplied by Sysmex Corp during this study. YT reports consultant fees from Sysmex, and other authors have no COI to declare.
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Sakuragi, M., Hayashi, S., Maruyama, M. et al. Immature platelet fraction (IPF) as a predictive value for thrombopoietic recovery after allogeneic stem cell transplantation. Int J Hematol 107, 320–326 (2018). https://doi.org/10.1007/s12185-017-2344-8
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DOI: https://doi.org/10.1007/s12185-017-2344-8