Diagnostic value of immature platelet fraction for detecting production disorders in thrombocytopenia

I Wayan Losen Adnyana; Ni Made Renny Anggreni  Rena; Nyoman Martha Chrismayana; Putu Gizha Satria Gautama

doi:10.15562/bmj.v12i3.4860

Diagnostic value of immature platelet fraction for detecting production disorders in thrombocytopenia

I Wayan Losen Adnyana ,

Ni Made Renny Anggreni Rena ,

Nyoman Martha Chrismayana ,

Putu Gizha Satria Gautama ,

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DOI: https://doi.org/10.15562/bmj.v12i3.4860 |
Published: 2023-11-03

Abstract

Link of Video Abstract: https://youtu.be/FrXavnzSY3Q

Introduction: Impaired platelet production is one of the causes of thrombocytopenia. Immature platelet fraction (IPF) shows the proportion of young platelets in peripheral blood. A decrease in the number of young platelets reflects a decrease in the thrombopoiesis process. This suggests that young platelets can be a marker for measuring megakaryopoiesis activity. This study aimed to determine the diagnostic value of IPF.

Methods: The sample will be divided into two groups; groups suspected of production disturbances and groups not suspected of production disturbances. In the group with suspected production disorders, bone marrow aspiration (BMA) will be carried out to determine a definitive diagnosis. Meanwhile, in the group not suspected of production disruption, bias work-up will be carried out. After that, descriptive statistical analysis, ROC analysis and diagnostic tests will be carried out.

Result: This study used 81 cases of thrombocytopenia with a proportion of 49 (60.5%) in the production disorder group and 32 (39.5%) in the non-production disorder group. The IPF% value in the production disruption group is significantly lower than the non-production disruption group 3.1% (0.3-21.4) vs 13% (2.0-49.2) p value <0.001. The results of calculations using ROC analysis in this study showed an AUC of 0.917 (95% confidence interval (CI): 0.853-0.981, p<0.001). The results of the analysis set a cut-off value of 7.5% at sensitivity 83.7%, specificity 84.4%, PPV 89.1%, NPV 77.1%, LR+ 5.53, LR- 0.19, prevalence 60.4%, and 83.9% accuracy.

Conclusion: The results of this study showed that IPF% AUC was 0.917, indicating that IPF% was very good for distinguishing production disorders from theombocytopenia with an accuracy of 83.9%.

References

Hoffbrand AV, Moss PAH, Pettit JE. Bleeding disorders caused by vascular and platelet abnormalities. In: Essential haematology. 7thed. London Blackwell Science. 2016;279-89.
Moulis G, Christiansen CF, Darvalics B, Nørgaard M. Prevalence of thrombocytopenia and thrombocytosis upon acute hospital admission to internal medicine units. A cross-sectional study in Denmark. EJIM. 2018;57:34-7.
Brace LD. Thrombocytopenia and thrombocytosis. In: Rodak BF, Fritsma GA, editors. Hematology clinical principles and applications. Missouri-Saunders. 2012;4:694-713.
Margareth D. Gambaran nilai Immature Platelet Fraction pada pasien dengan trombositopenia di Departmen Penyakit Dalam RSUP Haji Adam Malik Medan. Repositori Institusi Universitas Sumatera Utara. 2019;25-31.
Harrison P, Robinson MS, Mackie IJ, Machin SJ. Reticulated platelets. Platelets. 1997;8(6):379–83.
Jimenez MM, Guedan MJ, Martin LM, Campos JA, Martinez IR, Vilella CT. Measurement of reticulated platelets by simple flow cytometry: an indirect thrombocytopoietic marker. Eur J Intern Med. 2006;17(8):541–4.
Briggs C, Longair I, Kumar P, Singh D, Machin SJ. Performance evaluation of the Sysmex haematology XN modular system. J Clin Pathol. 2012;65(11):1024–30.
Feng G, Gale RP, Cui W, Cai W, Huang G, Xu Z, et al. A systematic classification of megakaryocytic dysplasia and its impact on prognosis for patients with myelodysplastic syndromes. Exp Hematol Oncol. 2016;5:12.
Abe Y, Wada H, Tomatsu H, Sakaguchi A, Nishioka J, Yabu Y, et al. A simple technique to determine thrombopoiesis level using immature platelet fraction (IPF). Thromb Res. 2006;118(4):463–9.
Van De Wyngaert Z, Fournier E, Bera E, Carrette M, Soenen V, Gauthier J, et al. Immature platelet fraction (IPF): A reliable tool to predict peripheral thrombocytopenia. Curr Res Transl Med. 2020;68:37-42.
Jeon K, Kim M, Lee J, Lee JS, Kim HS, Kang HJ, et al. Immature platelet fraction: A useful marker for identifying the cause of thrombocytopenia and predicting platelet recovery. Medicine (Baltimore). 2020;99(7):e19096.
Jung H, Jeon HK, Kim HJ, Kim SH. Immature platelet fraction: establishment of a reference interval and diagnostic measure for thrombocytopenia. Korean J Lab Med. 2010;30(5):451–62.

[1] Hoffbrand AV, Moss PAH, Pettit JE. Bleeding disorders caused by vascular and platelet abnormalities. In: Essential haematology. 7thed. London Blackwell Science. 2016;279-89.

[2] Moulis G, Christiansen CF, Darvalics B, Nørgaard M. Prevalence of thrombocytopenia and thrombocytosis upon acute hospital admission to internal medicine units. A cross-sectional study in Denmark. EJIM. 2018;57:34-7.

[3] Brace LD. Thrombocytopenia and thrombocytosis. In: Rodak BF, Fritsma GA, editors. Hematology clinical principles and applications. Missouri-Saunders. 2012;4:694-713.

[4] Margareth D. Gambaran nilai Immature Platelet Fraction pada pasien dengan trombositopenia di Departmen Penyakit Dalam RSUP Haji Adam Malik Medan. Repositori Institusi Universitas Sumatera Utara. 2019;25-31.

[5] Harrison P, Robinson MS, Mackie IJ, Machin SJ. Reticulated platelets. Platelets. 1997;8(6):379–83.

[6] Jimenez MM, Guedan MJ, Martin LM, Campos JA, Martinez IR, Vilella CT. Measurement of reticulated platelets by simple flow cytometry: an indirect thrombocytopoietic marker. Eur J Intern Med. 2006;17(8):541–4.

[7] Briggs C, Longair I, Kumar P, Singh D, Machin SJ. Performance evaluation of the Sysmex haematology XN modular system. J Clin Pathol. 2012;65(11):1024–30.

[8] Feng G, Gale RP, Cui W, Cai W, Huang G, Xu Z, et al. A systematic classification of megakaryocytic dysplasia and its impact on prognosis for patients with myelodysplastic syndromes. Exp Hematol Oncol. 2016;5:12.

[9] Abe Y, Wada H, Tomatsu H, Sakaguchi A, Nishioka J, Yabu Y, et al. A simple technique to determine thrombopoiesis level using immature platelet fraction (IPF). Thromb Res. 2006;118(4):463–9.

[10] Van De Wyngaert Z, Fournier E, Bera E, Carrette M, Soenen V, Gauthier J, et al. Immature platelet fraction (IPF): A reliable tool to predict peripheral thrombocytopenia. Curr Res Transl Med. 2020;68:37-42.

[11] Jeon K, Kim M, Lee J, Lee JS, Kim HS, Kang HJ, et al. Immature platelet fraction: A useful marker for identifying the cause of thrombocytopenia and predicting platelet recovery. Medicine (Baltimore). 2020;99(7):e19096.

[12] Jung H, Jeon HK, Kim HJ, Kim SH. Immature platelet fraction: establishment of a reference interval and diagnostic measure for thrombocytopenia. Korean J Lab Med. 2010;30(5):451–62.

Diagnostic value of immature platelet fraction for detecting production disorders in thrombocytopenia

Abstract

References

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