Pretreatment Immature Platelet Fraction as a Surrogate of Reticulated Platelets Predicts the Response to Corticosteroids in Adults with Immune Thrombocytopenia
Pretreatment Immature Platelet Fraction as a Surrogate of Reticulated Platelets Predicts the Response to Corticosteroids in Adults with Immune Thrombocytopenia
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DOI：
10.1159/000510460
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发表时间：
2021-05-01
影响因子：
2.4
通讯作者：
Hanamura, Ichiro
中科院分区：
文献类型：
--
作者：
Takami, Akiyoshi;Mizuno, Shohei;Hanamura, Ichiro
目的：血液中循环的网状血小板反映了巨核细胞生成活性和血小板周转率，并且可以使用 Sysmex XN 血细胞计数器自动、低侵入性地测量未成熟血小板分数 (IPF)。本研究回顾性调查了 IPF 是否可以预测原发性免疫性血小板减少症 (ITP) 成年患者对皮质类固醇的治疗反应。方法：对 46 例新诊断为初治 ITP 并开始接受皮质类固醇治疗的患者进行分析。结果：46 名原发性 ITP 患者中，33 名（72%）对治疗有反应，13 名（28%）没有。无应答者中 IPF 的百分比 (IPF%) 显着低于应答者（6.6 vs. 16.0%；p < 0.001）。在接受者操作特征分析中，预测治疗反应的最佳 IPF% 截止值为 12%，特异性为 85%，敏感性为 76%。结论：因此，我们的研究结果表明，测量 IPF% 作为网织血小板的替代指标有助于识别可能对皮质类固醇产生反应的患者。
Objectives: Reticulated platelets circulating in the blood reflect megakaryopoietic activity and platelet turnover and can be automatically and low-invasively measured as the immature platelet fraction (IPF) using a Sysmex XN hematocytometer. The present study retrospectively investigated whether or not the IPF can predict the treatment response to corticosteroids in adult patients with primary immune thrombocytopenia (ITP). Methods: Forty-six patients who had been newly diagnosed with primary treatment-naive ITP and started treatment with corticosteroids were analyzed. Results: Among the 46 primary ITP patients, 33 (72%) responded to the treatment and 13 (28%) did not. The percentage of IPF (IPF%) among the nonresponders was significantly lower than that of the responders (6.6 vs. 16.0%; p < 0.001). In the receiver operating characteristics analysis, the optimum IPF% cut-off value for predicting the treatment response was 12%, with a specificity of 85% and a sensitivity of 76%. Conclusions: Our findings thus suggest that measuring the IPF% as a surrogate of reticulated platelets is useful to identify patients likely to respond to corticosteroids.