Mean platelet volume is more important than age for defining reference intervals of platelet counts

Ittermann, Till; Feig, Martin Andreas; Petersmann, Astrid; Radke, Dörte; Greinacher, Andreas; Völzke, Henry; Thiele, Thomas

doi:10.1371/journal.pone.0213658

Cited by 21 publications

(27 citation statements)

References 44 publications

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“…We identified 14 studies and five authoritative sources describing reference intervals for platelet counts in seniors [ 15 , 16 , 17 , 18 , 19 , 20 , 23 , 24 , 25 , 47 , 48 , 49 , 50 , 51 , 55 , 56 , 57 , 58 ]. One of the studies applied an approach incorporating MPV (mean platelet volume) and sex as defining reference limits [ 15 ], whereas most of the other studies used age and/or sex as partitioning factors, as can be seen in Table 6 . Only a few of the studies were designed to prospectively include participants with the aim to define reference intervals [ 18 , 23 , 48 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

“…Regarding platelet counts, there is no clear position on whether platelet count reference intervals should be age- and sex-specific. Whereas some authors propose stratification according to sex, age, or other characteristics [ 15 , 16 , 17 , 18 , 19 , 20 ], sex- and age-independent reference intervals are commonly used in clinical practice [ 21 , 22 , 23 , 24 , 25 ]. The importance of having accurate reference intervals for platelet counts available has been evident for a long time [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

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Reference Intervals for Platelet Counts in the Elderly: Results from the Prospective SENIORLAB Study

Hermann

Risch

Grebhardt

et al. 2020

JCM

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Currently, age- and sex-independent reference limits (RLs) are frequently used to interpret platelet counts in seniors. We aimed to define and validate reference intervals (RIs) for platelet counts within the framework of the prospective SENIORLAB study. Subjectively healthy Swiss individuals aged 60 years and older were prospectively included and followed for morbidity and mortality. Participants who had circumstances known to affect platelet counts were excluded. The obtained RIs were validated with indirect statistical methods. Frequencies of abnormal platelet counts in a population-based setting, including 41.5% of the entire age-specific population of the Principality of Liechtenstein, were compared by using age- and sex-independent RIs and the RLs obtained in the present study. For males (n = 542), 95% RIs for platelet counts were defined as follows: 150–300 × 109/L (60–69 years); 130–300 × 109/L (70–79 years); and 120–300 × 109/L (80 years and above). For females (n = 661), the consolidated age-independent 95% RI was 165–355 × 109/L. These RI values were validated by indirect RI determination of 51,687 (30,392 female/21,295 male) patients of the same age. Age- and sex-independent RIs exhibited imbalanced frequencies of abnormal platelet counts between the two sexes, which were corrected by introducing age- and sex-specific RLs. In conclusion, females have higher platelet counts than males. Whereas the upper RL for males remains constant, the lower RL decreases with age. We propose to abandon the practice of employing sex- and age-independent RL for platelet counts in the elderly.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reference Intervals for Platelet Counts in the Elderly: Results from the Prospective SENIORLAB Study

Hermann

Risch

Grebhardt

et al. 2020

JCM

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“…Steiropoulos et al found a significantly higher MPV in 85 COPD patients compared to 34 otherwise healthy smokers 119 . Control subjects were younger and included more females (having lower MPVs than males 44 ) than COPD patients, which may account for some of the differences. Other studies consistently revealed an elevated MPV in COPD patients, and a further increase in severe COPD and acute exacerbation 120,121 .…”

Section: How Does Platelet Size Change In Disease?mentioning

confidence: 97%

“…In neonates MPV is rather independent of the gestational age, but increases significantly during the first two postnatal weeks while gradually decreasing thereafter 43 . The MPV remains stable in healthy individuals over the lifetime 44 with an inverse non‐linear relationship between the platelet count and MPV 45 . Men have slightly higher MPVs and lower platelet counts compared to women, who have an overall higher platelet mass (plateletcrit) 46 …”

Section: Does Platelet Size Change Over the Lifetime?mentioning

confidence: 99%

Large and small platelets—(When) do they differ?

Handtke

Thiele

2020

Journal of Thrombosis and Haemostasis

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Platelets are most important in providing cellular hemostasis but also take part in inflammation and immune processes. Increased platelet size has been regarded as a feature describing a young and more reactive subpopulation until studies were published which questioned this concept. Moreover, changes of platelet size given by the mean platelet volume (MPV) were described for immune thrombocytopenia, cardiovascular disease, atherosclerosis, venous thromboembolism, chronic lung disease, sepsis, cancer‐associated thrombosis, autoimmune disorders, and others. This review summarizes the literature on what is known about platelets with different size and describes controversies of studies with large and small platelets putting a focus on their thrombogenicity, age, and on the association of MPV with the mentioned diseases.

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“…By contrast, in patients with thrombocytopenia resulting from bone marrow failure, MPV and megakaryocyte ploidy are substantially lower than in normal people or the above-mentioned patients. This result was confirmed in well-defined conditions (impedance-based count on Sysmex XE 5000), by Till Ittermann et al in 2019 who stated that since MPV inversely correlates with the platelet count in normal subjects [75], its value must be interpreted in relation to the platelet count.…”

Section: • Benefits and Limitations Of The Mean Platelet Volume (Mpv)mentioning

confidence: 68%

Platelet Counting: Ugly Traps and Good Advice. Proposals from the French-Speaking Cellular Hematology Group (GFHC)

Baccini

Geneviève

Jacqmin

et al. 2020

JCM

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Despite the ongoing development of automated hematology analyzers to optimize complete blood count results, platelet count still suffers from pre-analytical or analytical pitfalls, including EDTA-induced pseudothrombocytopenia. Although most of these interferences are widely known, laboratory practices remain highly heterogeneous. In order to harmonize and standardize cellular hematology practices, the French-speaking Cellular Hematology Group (GFHC) wants to focus on interferences that could affect the platelet count and to detail the verification steps with minimal recommendations, taking into account the different technologies employed nowadays. The conclusions of the GFHC presented here met with a "strong professional agreement" and are explained with their rationale to define the course of actions, in case thrombocytopenia or thrombocytosis is detected. They are proposed as minimum recommendations to be used by each specialist in laboratory medicine who remains free to use more restrictive guidelines based on the patient's condition.

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Mean platelet volume is more important than age for defining reference intervals of platelet counts

Cited by 21 publications

References 44 publications

Reference Intervals for Platelet Counts in the Elderly: Results from the Prospective SENIORLAB Study

Reference Intervals for Platelet Counts in the Elderly: Results from the Prospective SENIORLAB Study

Large and small platelets—(When) do they differ?

Platelet Counting: Ugly Traps and Good Advice. Proposals from the French-Speaking Cellular Hematology Group (GFHC)

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