Evaluation of the immature platelet fraction contribute to the differential diagnosis of hereditary, immune and other acquired thrombocytopenias

Evaluation of the immature platelet fraction contribute to the differential diagnosis of hereditary, immune and other acquired thrombocytopenias

Abstract The differential diagnosis of immune (ITP) and hereditary macrothrombocytopenia (HM) is key to patient management. The immature platelet fraction (IPF) represents the subset of circulating platelets with higher RNA content, and has been shown to distinguish hypo- from hyperproliferative thr...

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Autores principales: F. L. B. Ferreira, M. P. Colella, S. S. Medina, C. Costa-Lima, M. M. L. Fiusa, L. N. G. Costa, F. A. Orsi, J. M. Annichino-Bizzacchi, K. Y. Fertrin, M. F. P. Gilberti, M. C. Ozelo, E. V. De Paula
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Publicado: Nature Portfolio 2017
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spelling oai:doaj.org-article:6646c7dc9c244b0d87f194744b27fe232021-12-02T12:30:16ZEvaluation of the immature platelet fraction contribute to the differential diagnosis of hereditary, immune and other acquired thrombocytopenias10.1038/s41598-017-03668-y2045-2322https://doaj.org/article/6646c7dc9c244b0d87f194744b27fe232017-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-03668-yhttps://doaj.org/toc/2045-2322Abstract The differential diagnosis of immune (ITP) and hereditary macrothrombocytopenia (HM) is key to patient management. The immature platelet fraction (IPF) represents the subset of circulating platelets with higher RNA content, and has been shown to distinguish hypo- from hyperproliferative thrombocytopenias. Here we evaluated the diagnostic accuracy of IPF in the differential diagnosis between HM and other thrombocytopenias in a population of patients with post-chemotherapy thrombocytopenia (n = 56), bone marrow failure (n = 22), ITP (n = 105) and HM (n = 27). TPO levels were also measured in HM and ITP matched for platelet counts. Platelet counts were similar in all patient groups. Higher IPF values were observed in both ITP (12.3%; 2.4–65.6%) and HM (29.8%; 4.6–65.9%) compared to hypoproliferative thrombocytopenias. IPF values were also higher in HM compared to ITP, yielding a diagnostic accuracy of 0.80 (95%CI 0.70–0.90; P < 0.0001) to distinguish these two conditions. Intra- and inter-assays reproducibility of IPF in HM patients revealed that this is a stable parameter. In conclusion, IPF is increased in HM compared to both ITP and other thrombocytopenias and contributes to the differentiation between ITP and HM. Further studies are warranted to understand the biological rationale of these findings and to its incorporation in diagnostic algorithms of HM.F. L. B. FerreiraM. P. ColellaS. S. MedinaC. Costa-LimaM. M. L. FiusaL. N. G. CostaF. A. OrsiJ. M. Annichino-BizzacchiK. Y. FertrinM. F. P. GilbertiM. C. OzeloE. V. De PaulaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-8 (2017)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
F. L. B. Ferreira
M. P. Colella
S. S. Medina
C. Costa-Lima
M. M. L. Fiusa
L. N. G. Costa
F. A. Orsi
J. M. Annichino-Bizzacchi
K. Y. Fertrin
M. F. P. Gilberti
M. C. Ozelo
E. V. De Paula
Evaluation of the immature platelet fraction contribute to the differential diagnosis of hereditary, immune and other acquired thrombocytopenias
description Abstract The differential diagnosis of immune (ITP) and hereditary macrothrombocytopenia (HM) is key to patient management. The immature platelet fraction (IPF) represents the subset of circulating platelets with higher RNA content, and has been shown to distinguish hypo- from hyperproliferative thrombocytopenias. Here we evaluated the diagnostic accuracy of IPF in the differential diagnosis between HM and other thrombocytopenias in a population of patients with post-chemotherapy thrombocytopenia (n = 56), bone marrow failure (n = 22), ITP (n = 105) and HM (n = 27). TPO levels were also measured in HM and ITP matched for platelet counts. Platelet counts were similar in all patient groups. Higher IPF values were observed in both ITP (12.3%; 2.4–65.6%) and HM (29.8%; 4.6–65.9%) compared to hypoproliferative thrombocytopenias. IPF values were also higher in HM compared to ITP, yielding a diagnostic accuracy of 0.80 (95%CI 0.70–0.90; P < 0.0001) to distinguish these two conditions. Intra- and inter-assays reproducibility of IPF in HM patients revealed that this is a stable parameter. In conclusion, IPF is increased in HM compared to both ITP and other thrombocytopenias and contributes to the differentiation between ITP and HM. Further studies are warranted to understand the biological rationale of these findings and to its incorporation in diagnostic algorithms of HM.
format article
author F. L. B. Ferreira
M. P. Colella
S. S. Medina
C. Costa-Lima
M. M. L. Fiusa
L. N. G. Costa
F. A. Orsi
J. M. Annichino-Bizzacchi
K. Y. Fertrin
M. F. P. Gilberti
M. C. Ozelo
E. V. De Paula
author_facet F. L. B. Ferreira
M. P. Colella
S. S. Medina
C. Costa-Lima
M. M. L. Fiusa
L. N. G. Costa
F. A. Orsi
J. M. Annichino-Bizzacchi
K. Y. Fertrin
M. F. P. Gilberti
M. C. Ozelo
E. V. De Paula
author_sort F. L. B. Ferreira
title Evaluation of the immature platelet fraction contribute to the differential diagnosis of hereditary, immune and other acquired thrombocytopenias
title_short Evaluation of the immature platelet fraction contribute to the differential diagnosis of hereditary, immune and other acquired thrombocytopenias
title_full Evaluation of the immature platelet fraction contribute to the differential diagnosis of hereditary, immune and other acquired thrombocytopenias
title_fullStr Evaluation of the immature platelet fraction contribute to the differential diagnosis of hereditary, immune and other acquired thrombocytopenias
title_full_unstemmed Evaluation of the immature platelet fraction contribute to the differential diagnosis of hereditary, immune and other acquired thrombocytopenias
title_sort evaluation of the immature platelet fraction contribute to the differential diagnosis of hereditary, immune and other acquired thrombocytopenias
publisher Nature Portfolio
publishDate 2017
url https://doaj.org/article/6646c7dc9c244b0d87f194744b27fe23
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