Platelet production and platelet destruction: assessing mechanisms of treatment effect in immune thrombocytopenia

Abstract

This study investigated the immature platelet fraction (IPF) in assessing treatment effects in immune thrombocytopenia (ITP). IPF was measured on the Sysmex XE2100 autoanalyzer. The mean absolute-IPF (A-IPF) was lower for ITP patients than for healthy controls (3.2 vs 7.8 ؋ 10 9 /L, P < .01), whereas IPF percentage was greater (29.2% vs 3.2%, P < .01).

Reticulated platelets: analytical aspects and clinical utility

“…Remarkably, the coefficients of correlation differed between patients groups, from no correlation in healthy individuals to relatively high correlations in patients with thrombocytopenia due to peripheral destruction [66,67]. One study using the Sysmex XT-2000iV, which uses an identical method as XE-2100, demonstrated reasonable correlation between IPF and reference flow cytometry, albeit with a significant systematic bias [68].…”

“…The absolute IPF (IPF#), the concentration of immature platelets (in 10 9 /L), might better reflect real-time platelet production in analogy with what absolute reticulocyte count does for erythropoietic activity [67]. There are indeed some reports indicating the usefulness of IPF# in neonatal infections [74], in chronic liver disease [51] and in differentiating acute ITP and from thrombocytopenia due to acute leukemia [75].…”

Immune thrombocytopenia: antiplatelet autoantibodies inhibit proplatelet formation by megakaryocytes and impair platelet production in vitro

“…12 On examination of bone marrow from ITP patients, Barsam et al found that both responders and non-responders to treatment with eltrombopag, a thrombopoietin receptor (TPO-R) agonist, showed a boost in MK proliferation without, however, the expected increase in platelet production in the nonresponders. 13 These observations may be explained by failure of eltrombopag to counter the antibody-induced defective proplatelet production in non-responding patients, suggesting that antiplatelet autoantibodies can have a direct, deleterious effect not only on MK production and maturation, but also on their crucial capacity to form proplatelets and consequently on platelet production.…”

Dietary α-linolenic acid increases the platelet count in ApoE−/− mice by reducing clearance

“…24,26 Plasma glycocalicin was significantly lower in the mice fed the high-ALA diet (25 6 4 mg/mL compared with 53 6 27 mg/mL; Figure 1. Dietary ALA increases the platelet count but not their production.…”