Use of PLT-F channel and immature platelet fraction parameters in differential diagnosis of thrombocytopenia

Abstract

Establishing the true causes of thrombocytopenia is of paramount importance, since the tactics of managing patients depend on it. Obtaining information about the activity of thrombocytopoiesis until recently was possible only after examining the bone marrow, but modern laboratory diagnostic capabilities make it possible to evaluate thrombocytopoiesis by a comprehensive clinical blood test performed on a hematological analyzer using a fluorescent optical method (PLT-F). At the same time, in addition to the number of platelets in peripheral blood, information is available on the number of immature platelets (IPF) in absolute and relative terms. Objective: to evaluate the possibility of using the PLT-F channel and IPF parameters in the differential diagnosis of thrombocytopenia. We reviewed three clinical cases with different pathogenetic variants of thrombocytopenia (immune thrombocytopenia, thrombocytopenia in DIC and thrombocytopenia associated with bone marrow damage). In all cases, a clinical blood test was performed on a Sysmex XN 1000 hematological analyzer using the PLT-F channel. When using the PLT-F channel, parameters are available to differentiate thrombocytopenia according to the mechanism of pathogenesis. The absolute value of IPF is a criterion for the activity of thrombocytopoiesis in the bone marrow, while the relative value of IPF, namely the increase in this parameter, is a criterion for the loss of platelets in the peripheral bloodstream (destruction or increased consumption of platelets). The availability of obtaining diagnostic information about the activity of thrombocytopoiesis and loss of platelets in the peripheral bloodstream using a clinical blood test using the PLT-F channel on Sysmex XN hematological analyzers is of great clinical importance, since a clinical blood test, being a routine study, does not require special conditions for sampling biomaterial, and can be performed not only at the stage of diagnosis, but also during therapy monitoring.