Platelet production estimation in thrombocytopenic patient: a non-invasive or invasive approach?

Abstract

Aim: To compare platelet production determined using non-invasive (platelet production index, PI) and invasive method (megakaryocyte number, Mk) in thrombocytopenic patients. Methods: PI was calculated on the basis of autologous 111In platelets T1/2, life span (LS) and Pt blood count determination. Megakaryocyte number (Mk) was described as 1=numerous, 2=present, 3=low productive, 4=rare. Fifty-five persons were investigated: 49 thrombocytopenic (40 chronic immune thrombocytopenic purpuras, ITP; 9 myelodysplastic syndromes, MDS) and six healthy control subjects (C). Results: All C and MDS subjects had linear Pt survival curves and normal platelet LS (mean values 8.9 days in C, and 8.2 days in MDS; P>0.05). Exponential platelet survival curve and shortened Pt LS (1.1 day) were obtained in ITP. A highly significant difference was noticed in Pt LS between ITP and MDS (P<0.001) and between ITP and control group. PI was lower in MDS (0.2) than in ITP (1.2) and C (1.0). Mean value for Mk number was the same in MDS and ITP group (1.0). Conclusion: Platelet production in thrombocytopenic patients is better estimated using a non-invasive than an invasive method.