Immature platelet fraction measurement is influenced by platelet size and is a useful parameter for discrimination of macrothrombocytopenia
Immature platelet fraction measurement is influenced by platelet size and is a useful parameter for discrimination of macrothrombocytopenia
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DOI：
10.1179/1607845415y.0000000021
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发表时间：
2015-12-01
期刊：
影响因子：
1.9
通讯作者：
Higashihara, Masaaki
中科院分区：
文献类型：
--
作者：
Miyazaki, Koji;Koike, Yukako;Higashihara, Masaaki
背景资料：使用流式细胞术测量的网织血小板（RP）是血小板生成的有用参数;然而，实验室之间的标准化仍然存在困难。另一方面，使用自动血液分析仪测定的未成熟血小板分数（IPF）测量简单、可重复，并与RP显示出良好的相关性，尽管特定因素可能影响其值。我们以前注意到，一小部分患者表现出极高的IPF值，这与流式细胞术测量的RP无关。目的：我们研究了不同类型巨血小板减少症的IPF值异常增加的机制。患者/方法：使用来自12个家族的15名先天性巨血小板减少症患者的样本分析IPF、RP和其他血小板指数，150例免疫性血小板减少症患者和27例正常人。我们进一步监测了血小板凝集过程中IPF值和形态的变化。结果：与血小板计数相似的免疫性血小板减少症患者（IPF 9.2 +/- 0.3%）相比，MYH 9疾病（IPF 48.6 +/- 1.9%）的IPF值约高5倍，其他巨噬细胞减少症（IPF 18.4 +/- 2.1%）约高2倍。然后，我们检查了在乙二胺四乙酸和巨球蛋白血症诱导的血小板凝集过程中IPF值的变化。IPF值随血小板聚集体的形成呈时间依赖性沿着增加，并受少量血小板聚集体的强烈影响。结论：IPF值受血小板大小的影响。此外，IPF可能是筛查巨血小板减少症的有用和方便的参数，其表现为不成比例的高IPF值。
Background: Reticulated platelets (RPs) as measured using flow cytometry are useful parameters of thrombopoiesis; however, difficulties remain with standardization between laboratories. On the other hand, immature platelet fraction (IPF) measurement, as determined using an automated hematology analyzer, is simple, reproducible, and displays a good correlation with RP, although specific factors may affect its value. We previously noticed that a small proportion of patients exhibit extremely high IPF values that do not correlate with flow cytometrically measured RP.Objectives: We investigated the mechanism of the aberrant increase in IPF values of different types of macrothrombocytopenia.Patients/methods: IPF, RP, and other platelet indexes were analyzed using samples from 15 congenital macrothrombocytopenic patients from 12 families, 150 immune thrombocytopenic patients, and 27 normal individuals. We further monitored the change in IPF values and morphology during platelet agglutination.Results: IPF values were about five times higher in MYH9 disorders (IPF 48.6 +/- 1.9%) and about twice as high in other macrothrombocytopenias (IPF 18.4 +/- 2.1%) than in immune thrombocytopenic patients with similar platelet counts (IPF 9.2 +/- 0.3%). We then examined changes in IPF values during ethylenediaminetetraacetic acid-and macroglobulinemia-induced platelet agglutination. The IPF value significantly increased in a timedependent manner along with the formation of platelet clumps and was strongly influenced by a few tiny platelet aggregates.Conclusions: These results suggested that IPF values are influenced by platelet size. Furthermore, IPF could be a useful and convenient parameter for screening of macrothrombocytopenia, which presents with a disproportionately high IPF value.