Immature Platelet Fraction as a Predictor of Recovery of Platelets in Febrile Thrombocytopenia Patients

Abstract

Abstract Introduction: Infection is the most common cause of thrombocytopenia. Thrombocytopenia is a common hematological abnormality in infections such as viral (dengue), malaria, rickettsial infections, and leptospirosis which demands platelet transfusion in many severe cases. Although platelet transfusion is lifesaving, it has its own hazards. Hence, we used new parameters such as immature platelet fraction (IPF), which is a measure of reticulated platelets that reflects the rate of thrombopoiesis. This study was performed to assess the role of IPF in predicting platelet recovery in febrile thrombocytopenia patients. Materials and Methods: Blood samples from 50 patients were collected for IPF on day 2 of admission with 5 days of platelet count (day 1 through day 5 of admission). IPF is analyzed by Sysmex XE-2100 hematology analyzer in the platelet channel with fluorescent dye and carefully designed gating system and counted with a special software IPF master 7. IPF values against platelet count were assessed separately from day 1 to day 5. Results: The reference intervals of IPF >8% and IPF <8% were assessed against platelet count. An increase in IPF favored an increase in platelet count on day 4 and day 5. It was found that IPF has a strong correlation with the recovery of platelet counts. In patients with febrile thrombocytopenia, 82.4% of patients showed recovery within 24 h after attaining the peak IPF. One hundred percent of patients showed recovery within 24–48 h of the rise of the IPF. Conclusion: A rapid and inexpensive automated measurement of IPF can be integrated as a standard parameter to evaluate the thrombopoietic state of the bone marrow. From the study, we concluded that IPF is an important predictor of increase in platelet count. Increase in IPF >8% suggests that platelet count will be increased in the next 48 h indicating that further platelet transfusion will not be required.