Immature platelets: a review of the available evidence

Benlachgar, Naoufal; Doghmi, Kamal; Masrar, Azlarab; Mahtat, El Mehdi; Harmouche, H.; Mezalek, Z. Tazi

doi:10.1016/j.thromres.2020.06.048

Cited by 18 publications

(15 citation statements)

References 95 publications

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“…The correlations between IPF and the clinical features of all patents with SLE (n ¼ 282) were analyzed. Consistent with the previous report describing patients with primary ITP, 4 IPF negatively correlated with the absolute platelet count in SLE patients (r ¼ �0.58, p < 0.001) (Figure 1). IPF also had a negative correlation with CH50 (r ¼ �0.26, p < 0.001), C3 (r ¼ �0.22, p < 0.001), and C4 (r ¼ �0.20, p < 0.001) (Figure 1 and Table S1).…”

Section: Correlations Between Ipf Aipc and Clinical Features Of Sle Patientssupporting

confidence: 92%

“…The immature platelet fraction (IPF) indicates the percentage of immature platelets included within the total platelet count, and it represents those platelets recently produced by megakaryocytes. 3 The IPF was increased in patients with primary immune thrombocytopenia (ITP), 4 and it was significantly higher in patients responding to steroids than in non-responders. 5 Recently, the usefulness of IPF in non-thrombocytopenic settings was reported.…”

Section: Introductionmentioning

confidence: 99%

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Immature platelet levels correlate with disease activity and predict treatment response of thrombocytopenia in lupus patients

Hanata

Shoda

Kono

et al. 2021

Lupus

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Objective The immature platelet fraction (IPF) represents recently produced platelets in bone marrow and this parameter is increased in patient with primary immune thrombocytopenia (ITP). We investigated the associations between IPF and absolute immature platelet count (AIPC), and clinical parameters in systemic lupus erythematosus (SLE), which has more complex pathological mechanisms than in primary ITP. Methods Patients with SLE were retrospectively reviewed at the University of Tokyo Hospital from May, 2012 to January, 2021. The correlations between clinical parameters and the number of immature platelets were assessed with Spearman’s rank correlation coefficients. A multiple logistic regression model was used to identify the independent clinical parameters for IPF and AIPC. The difference in the distribution of time for a complete response (CR) after prednisolone (PSL) administration was also evaluated by log-rank test. Results A total of 282 SLE patients were enrolled, and 12.41% of those patients showed thrombocytopenia. IPF correlated with clinical parameters such as platelet count (r = −0.58), AIPC (r = 0.64) and systemic lupus erythematosus disease activity index 2000 (SLEDAI-2K) (r = 0.24). SLEDAI-2K [odds ratio (OR) (per unit increase), 1.07; 95% CI, 1.013 - 1.13] and thrombocytopenia (OR, 32.23; 95% CI, 11.072 - 93.80) were independent clinical parameters to account for IPF increase. IPF correlated with the number of bone marrow megakaryocytes (n = 19, r = 0.57). Notably, the probability of CR in response to PSL in AIPC-high patients was higher than in AIPC-low patients (hazard ratio, 4.62; 95% CI, 1.07 - 20.02). Conclusion IPF correlated with disease activity of SLE and represented platelet production in the bone marrow, whereas AIPC predicted a rapid response to steroids in thrombocytopenic patients with SLE.

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Section: Correlations Between Ipf Aipc and Clinical Features Of Sle Patientssupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Immature platelet levels correlate with disease activity and predict treatment response of thrombocytopenia in lupus patients

Hanata

Shoda

Kono

et al. 2021

Lupus

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“…The IPF% in the peripheral blood reflects platelet production in the bone marrow [ 5 ]; thus, IPF% can be a useful marker of thrombopoietic activity. The most relevant clinical utility is the differential diagnosis between immune thrombocytopenia (ITP) and thrombocytopenia from thrombopoiesis hypoproduction [ 6 ]. Generally, thrombocytopenia related to platelet destruction or consumption such as ITP can be predicted by high IPF% and thrombocytopenia from thrombopoiesis hypoproduction can be predicted by low IPF% [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…The most relevant clinical utility is the differential diagnosis between immune thrombocytopenia (ITP) and thrombocytopenia from thrombopoiesis hypoproduction [ 6 ]. Generally, thrombocytopenia related to platelet destruction or consumption such as ITP can be predicted by high IPF% and thrombocytopenia from thrombopoiesis hypoproduction can be predicted by low IPF% [ 6 ]. Therefore, IPF% has been used to diagnose various pathological conditions and thrombocytopenic diseases such as ITP, aplastic anemia, and liver cirrhosis, as well as the prediction of platelet recovery after chemotherapy and hematopoietic cell transplantation, and judging indications of platelet transfusion [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

The immature platelet fraction affects the efficacy of platelet rich plasma therapy for knee osteoarthritis

Uchino

Saita

Wada

et al. 2021

Regenerative Therapy

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Introduction Platelet-rich plasma (PRP) therapy is used to treat pathological conditions such as degenerative inflammatory diseases including osteoarthritis (OA) by enhancing tissue repair and promoting anti-inflammatory effects. Although PRP therapy for patients with knee OA improved pain and functional scores, the association of clinical outcomes and quality of PRP including cell composition and concentration is unclear. Methods Therefore, this study analyzed blood cell counts, including the immature platelet fraction (IPF), in peripheral blood and PRP of 144 patients with knee OA who underwent PRP therapy. The mean leukocyte and platelet concentrations in whole blood and PRP were analyzed using an XN-1000 automated hematology analyzer. Visual analogue scale (VAS) scores and knee injury and osteoarthritis outcome scores (KOOS) before and 1 month after a single PRP injection were also determined. Results Higher platelet and lower leukocyte concentration rates were observed in PRP compared with whole blood. The platelet concentration in whole blood was negatively correlated with VAS improvement. The percentage of IPF (IPF%) in whole blood was positively correlated with VAS improvement and KOOS (pain) improvement, whereas the IPF% in PRP tended to correlate with VAS improvement. Furthermore, multivariate logistic regression demonstrated the high IPF% in whole blood was significantly associated with VAS improvement. The low percentage of neutrophil (neutrophil%) in PRP was significantly associated with the VAS improvement and KOOS (ADL) improvement. Conclusions Therefore, PRP efficacy for OA might depend on the patient's biological status.

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“…One of these markers, readily obtainable in modern automated hematology analyzers with fluorescence capability, is the immature platelet fraction (%-IPF) and specifically the absolute immature platelet count (A-IPC). Regardless of how the acronyms are presented in the literature, such as designation of either immature or reticulated platelets, it has become more evident that this is an important variable when discerning processes leading to a thrombocytopenic state which has long been overlooked in clinical practice (3)(4)(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Immature Platelet Dynamics in Immune-Mediated Thrombocytopenic States

Reeves

Maitta

2020

Front. Med.

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A major challenge encountered by clinicians is differentiating presentations characterized by significant thrombocytopenia due to overlapping clinical symptoms and signs in the setting of ambiguous laboratory results. Immature platelets represent the youngest platelets that can be measured in peripheral blood by current hematology analyzers. These young platelets are larger, with higher RNA content recently released from the bone marrow. Thrombocytopenic presentations caused directly or indirectly by immune responses can lead to compensatory bone marrow responses seeking to normalize the platelet count; thus obtaining absolute immature platelet counts may be informative while triaging patients. Over the last decade, their use has expanded beyond being an early biomarker of bone marrow reconstitution post-hematopoietic stem cell transplantation to being used to establish bone marrow responses to infection and thrombocytopenias due to immune etiologies. Its accessibility as part of more detailed platelet indices obtained with routine laboratories makes it a promising option to understand the bone marrow's real-time response to disease states characterized by thrombocytopenia. This review will look at the immature platelet count as a biomarker, while presenting current attempts trying to understand how it could be used in thrombocytopenias occurring secondary to a given immune etiology.

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Immature platelets: a review of the available evidence

Cited by 18 publications

References 95 publications

Immature platelet levels correlate with disease activity and predict treatment response of thrombocytopenia in lupus patients

Immature platelet levels correlate with disease activity and predict treatment response of thrombocytopenia in lupus patients

The immature platelet fraction affects the efficacy of platelet rich plasma therapy for knee osteoarthritis

Immature Platelet Dynamics in Immune-Mediated Thrombocytopenic States

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