Immature platelet fraction measurement: a future guide to platelet transfusion requirement after haematopoietic stem cell transplantation
Immature platelet fraction measurement: a future guide to platelet transfusion requirement after haematopoietic stem cell transplantation
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DOI：
10.1111/j.1365-3148.2006.00654.x
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发表时间：
2006-04-01
影响因子：
1.5
通讯作者：
Machin, SJ
中科院分区：
文献类型：
--
作者：
Briggs, C;Hart, D;Machin, SJ
预防性输注血小板的决定取决于血小板计数、仔细的定期临床评估和商定的局部方案。预测血小板何时恢复的能力应该可以为血小板输注提供一种更合理的方法。网状血小板的增加表明血小板即将恢复。本文描述了一种新的快速自动评估网织血小板的新方法--未成熟血小板分数(IPF)，并对其临床应用进行了评估。用50名健康成年志愿者建立正常范围。研究了血小板骨髓产生或破坏可能异常的患者，一些患者在治疗期间进行了连续随访。30名接受细胞毒性化疗的患者接受了测试，其中13名患者进行了连续随访。对15例自体或同种异体移植后的患者进行了每天的血小板计数和IPF百分比跟踪监测，该方法具有良好的重复性和稳定性。在大多数化疗和移植患者中，血小板减少的恢复期在血小板恢复前几天出现IPF百分比的升高。特别是，接受外周干细胞自体移植的患者(n=8)有一个特征的IPF百分比模体，在植入前一到两天上升。自动化的IPF是临床评估血小板减少患者的有用参数，并有可能实现最佳浓缩血小板的输注。
The decision to prophylactically transfuse platelets is dependent on the platelet count, careful regular clinical assessment and agreed local protocol. The ability to predict when platelet recovery will occur should allow a more reasoned approach to platelet transfusion. An increase in reticulated platelets demonstrates impending platelet recovery. A new rapid automated method to assess reticulated platelets, the immature platelet fraction (IPF), is described, and its clinical utility assessed.The IPF is identified by flow cytometry with the use of a nucleic acid specific dye in the reticulocyte channel on the Sysmex XE-2100. Fifty healthy adult volunteers were used to establish the normal range. Patients where platelet marrow production or destruction might be abnormal were studied, and some patients followed serially during treatment. Thirty patients receiving cytotoxic chemotherapy were tested, and 13 of these patients followed serially. Fifteen patients post-autologous or allogeneic transplant were followed daily for platelet count and IPF percentage to monitor platelet recovery.The method demonstrates good reproducibility and stability. The recovery phase of thrombocytopenia in most chemotherapy and transplant patients was preceded by a rise in IPF percentage several days prior to platelet recovery. In particular, patients undergoing autologous transplantation (n = 8) using peripherally collected stem cells have a characteristic IPF percentage motif, with a rise one or two days prior to engraftment.The automated IPF is a useful parameter in the clinical evaluation of the thrombocytopenic patient and has the potential to allow optimal transfusion of platelet concentrates.