Immature platelet fraction related parameters in the differential diagnosis of thrombocytopenia

Abstract

The pathogenesis of thrombocytopenia can be divided into increased destruction (ID) of platelets in the peripheral blood and decreased production (DP) of platelets in the bone marrow. This study aimed to analyze the efficacy of immature platelet fraction (IPF) related parameters, including the IPF count (IPF#), IPF percentage (IPF%) and highly fluorescence IPF percentage (H-IPF%), measured by XN-9000, in the differential diagnosis of thrombocytopenia. One hundred and twenty healthy volunteers were enrolled in the healthy control (HC) group, and 180 thrombocytopenia patients were grouped into either the increased destruction (ID) group or the decreased production (DP) group according to their final diagnosis. IPF# was significantly lower in the DP group than in the ID and HC groups (P < .01). Among the three groups, the ID group had the highest IPF% and H-IPF%, and the HC group had the lowest IPF% and H-IPF%. The differences between the three groups were all statistically significant (P < .01). In differentiating the ID patients from the DP patients, the areas under the operating characteristics curve of IPF#, IPF% and H-IPF% were 0.859, 0.944 and 0.930, respectively. False positive rates were below 0.04 when IPF#, IPF% and H-IPF% were above 2.65, 7.55 and 2.35, respectively. IPF related parameters showed high efficacy in the differential diagnosis of thrombocytopenia. However, due to the small numerical values of the IPF related parameters in some thrombocytopenia patients, the fluctuations of IPF% and H-IPF% should also be taken into consideration. Though H-IPF% is a new parameter, its effectiveness in the differential diagnosis of thrombocytopenia is not better than IPF%’s.

Keywords:

• Immature platelet fraction
• platelet
• Thrombocytopenia

Abbreviations

IPF: immature platelet fraction; IPF#: immature platelet fraction count; IPF%: immature platelet fraction percentage; H-IPF%: highly fluorescent immature platelet fraction percentage; PLT-F channel: platelet fluorescence; ITP: immunologic thrombocytopenic purpura; SLE: systemic lupus erythematosus; AA: aplastic anaemia; AL: acute leukaemia; MDS: myelodysplastic syndrome; ID: increase destruction; DP: decreased production; MPV: mean platelet volume; SD, standard deviation; CV%, percentage of coefficient of Variance.

Author contributions

Junxun Li, Fan Zhang and Ying Li collected and analysed data and drafted the manuscript; Fan Zhang, Zhuangjian Ye and Chujia Liang recruited patients; Fan Zhang, Zhuangjian Ye, Shaoqian Chen and Jing Cheng performed CBC and IPF analyses; Juan Ouyang and Ying Li contributed to the study design and provided access to HM patients; Junxun Li and Ying Li drew the conclusions and wrote the manuscript. All authors approved the manuscript.

Acknowledgements

The authors would like to thank all of the individuals who participated in the studies.

Conflict of interest

No potential conflict of interest was reported by the authors.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

GDAS' Project of Science and Technology Development (2018GDASCX-0915);