Platelet Indices as a Tool for Differentiation between Clonal Thrombocytosis and Reactive Thrombocytosis

Abstract

Objective: To determine the efficacy of platelet indices as a tool for differentiation between clonal thrombocytosis and reactive thrombocytosis. Study Design: Cross sectional study. Place and Duration of Study: Department of Pathology, Combined Military Hospital, Lahore Pakistan, from Nov 2019 to Oct 2020. Methodology: Fifty-six subjects were included in Reactive thrombocytosis group and 56 in Clonal thrombocytosis group. Fresh blood in EDTA anticoagulant was analyzed to determine complete blood counts and platelet parameters (Platelet distribution width, mean platelet volume, Platelet large cell ratio, Plateletcrit) using the automated hematological analyzer Sysmex KX-21. Results: Mean age of the patients was 45.76 years with a range of 17-75 years. Assessing the cause of reactive thrombocytosi revealed that 20(35.7%) was infection and 16(28.5%) was iron deficiency anemia. In clonal thrombocytosis group 21(37.5%) were diagnosed with Chronic myeloid leukemia, 13(23.2%) with Essential thrombocythemia and 14(25%) with Polycythemia rubera vera. Platelet indices were compared in clonal thrombocytosis group and the reactive thrombocytosis group. Mean platelet volume, Platelet large cell ratio and Plateletcrit were significantly higher in the clonal thrombocytosis group (p=0.001). Difference in Platelet distribution width was not found to be statistically significant in the two groups (p=0.07) Conclusion: Platelet indices were higher in the clonal thrombocytosis group. Along with platelet count, they can serve as an efficient and cost-effective method in differentiating between clonal and reactive thrombocytosis.