Immature Platelet Fraction Research Articles

Evaluation of immature platelet fraction as a marker of dengue fever progression

Progression of dengue is often associated with thrombocytopenia resulting from viral-induced bone marrow suppression and immune-mediated peripheral platelet consumption. Immature platelet fraction (IPF), which can be measured using a haematology analyser, is a precursor indicating platelet formation in the bone marrow. This study evaluated the trend of IPF as an early recovery indicator of platelets in dengue patients with thrombocytopenia, and its relationship with severe dengue in conjunction with reticulocyte count. Hospitalized patients with dengue were enrolled and followed-up daily until discharge. Blood investigations included daily full blood counts and IPF measured using a haematology analyser. In total, 287 patients with confirmed dengue were enrolled in this study, 25 of whom had severe dengue. All patients had a decreasing trend in platelet count in the first week of illness, concomitant with an increasing trend in the percentage of immature platelets to total platelets (IPF%) for more than 3 days prior to platelet recovery. IPF% was significantly increased in patients with severe dengue compared with patients with non-severe dengue on days 3-5 after the onset of fever. Reticulocyte count increased significantly in patients with severe dengue on day 5. IPF can be utilized as an early recovery indicator of platelets in patients with dengue and thrombocytopenia.

Immature platelet fraction: is a novel early predictive marker for disease severity in patients with Covid-19 pneumonia?

Abstract Objectives In many diseases, immature platelet fraction (IPF%) is related to coagulopathy and poor outcome. This study aimed to investigate the predictive value of IPF% for the severity of pneumonia in patients with Coronavirus Disease 2019 (COVID-19). Methods A total of 154 patients with COVID‐19 infections were included. The patients were divided into two groups according to the severity of pneumonia (severe and non-severe) regarding their oxygen demand. Results Given laboratory parameters, the median IPF% was significantly higher in the severe group (11.9 vs. 3.9%, p<0.001). Mean platelet volume (p<0.001), platelet-large cell ratio (p=0.001), platelet distribution width (p=0.001), D-Dimer (p<0.001), INR (p=0.003), and aPTT (p=0.007) were also found to be significantly higher in the severe group. Moreover, IPF (p=0.014, Odds ratio = 2.000, 95%CI: 1.149-3.482) was an independent predictor for the severity. The curve value from receiver operating characteristics was 0.879 (p<0.001, 95%CI: 0.784-0.943) for determining the severity of pneumonia. IPF% had a sensitivity and specificity value of 69.5 and 92.4% to detect the disease’s severity. Conclusions IPF% is an independent predictor for the severity of COVID-19 pneumonia. Assessment of IPF% may both help to early determine high-risk patients with COVID-19 and to alert the physicians.

Relationship between Plasma Vascular Endothelial Growth Factor (VEGF) and Ovarian Cancer Staging

Ovarian cancer is the 8th most common cancer that occurs in most women. In a 2018 survey by Global Cancer Statistics in 185 countries of all cancer cases, 3.4% were caused by ovarian cancer. Vascular endothelial growth factor is a multifunctional cytokine that stimulates angiogenesis and increases microvascular permeability by binding to receptors located in endothelial cells in blood vessels. Immature platelet fraction (% IPF) is a modern parameter that measures young platelets and reticulation in peripheral blood. The purpose of this study was to look at differences in plasma VEGF and IPF levels between ovarian cancer sufferers and staging of ovarian cancer. This type of research is a cross sectional observational study of VEGF and Ovarian Cancer stage. A total of 18 people with ovarian cancer were sampled before surgery and after surgery an anatomy pathology examination was performed to assess early stage and advanced cancer staging. From 18 patients with ovarian cancer obtained from the early stage ovarian cancer group and advanced stage group. Obtained a median age of 50 (42-63), whereas in the advanced stage group a median age of 51 (19-68) was obtained. There is a significant difference between VEGF levels in early and advanced stage ovarian cancer with a value of p = 0,000. Using the Spearman Correlation test to assess the correlation between tumor size and VEGF levels, p values <0.001 with r = 0.742 were obtained. The conclusion of this research are advanced stage ovarian cancer VEGF is significantly higher P = 0.001 compared to early stage. Keywords: VEGF, Ovarian Cancer.

Immature platelets in COVID-19 infection.

Immature platelets in COVID-19 infection.

Immature platelets as a biomarker for disease severity and mortality in COVID-19 patients.

SummaryCOVID‐19, caused by SARS‐CoV‐2, is a contagious life‐threatening viral disease that has killed more than three million people worldwide to date. Attempts have been made to identify biomarker(s) to stratify disease severity and improve treatment and resource allocation. Patients with SARS‐COV‐2 infection manifest with a higher inflammatory response and platelet hyperreactivity; this raises the question of the role of thrombopoiesis in COVID‐19 infection. Immature platelet fraction (IPF, %) and immature platelet counts (IPC, ×109/l) can be used to assess thrombopoiesis. This study investigates whether the level of thrombopoiesis correlates with COVID‐19 severity. A large cohort of 678 well‐characterized COVID‐19 patients was analyzed, including 658 (97%) hospitalized and 139 (21%) admitted to the intensive care unit (ICU). Elevated percentage IPF at presentation was predictive of length of hospitalization (P < 0·01) and ICU admission (P < 0·05). Additionally, percentage IPF at the peak was significantly higher among ICU patients than non‐ICU patients (6·9 ± 5·1 vs 5·3 ± 8·4, P < 0·01) and among deceased patients than recovered patients (7·9 ± 6·3 vs 5·4 ± 7·8, P < 0·01). Furthermore, IPC at the peak was significantly higher among ICU patients than non‐ICU patients (18·5 ± 16·2 vs. 13·2 ± 8·3, P < 0·05) and among patients on a ventilator than those not (22·1 ± 20·1 vs.13·4 ± 8·4, P < 0·05). Our study demonstrated that elevated initial and peak values of percentage IPF and IPC might serve as prognostic biomarkers for COVID‐19 progression to severe conditions.

The immature platelet fraction affects the efficacy of platelet rich plasma therapy for knee osteoarthritis.

IntroductionPlatelet-rich plasma (PRP) therapy is used to treat pathological conditions such as degenerative inflammatory diseases including osteoarthritis (OA) by enhancing tissue repair and promoting anti-inflammatory effects. Although PRP therapy for patients with knee OA improved pain and functional scores, the association of clinical outcomes and quality of PRP including cell composition and concentration is unclear.MethodsTherefore, this study analyzed blood cell counts, including the immature platelet fraction (IPF), in peripheral blood and PRP of 144 patients with knee OA who underwent PRP therapy. The mean leukocyte and platelet concentrations in whole blood and PRP were analyzed using an XN-1000 automated hematology analyzer. Visual analogue scale (VAS) scores and knee injury and osteoarthritis outcome scores (KOOS) before and 1 month after a single PRP injection were also determined.ResultsHigher platelet and lower leukocyte concentration rates were observed in PRP compared with whole blood. The platelet concentration in whole blood was negatively correlated with VAS improvement. The percentage of IPF (IPF%) in whole blood was positively correlated with VAS improvement and KOOS (pain) improvement, whereas the IPF% in PRP tended to correlate with VAS improvement. Furthermore, multivariate logistic regression demonstrated the high IPF% in whole blood was significantly associated with VAS improvement. The low percentage of neutrophil (neutrophil%) in PRP was significantly associated with the VAS improvement and KOOS (ADL) improvement.ConclusionsTherefore, PRP efficacy for OA might depend on the patient's biological status.

Development of gates to measure the immature platelet fraction in C57BL/6J mice using the Sysmex XN-V series multispecies hematology analyzer.

The immature platelet fraction (IPF) is a measure of newly released platelets, which has been used as a marker of platelet production in multiple human studies but is not widely available in multispecies analyzers. We developed gates to measure the IPF in diluted and undiluted murine blood samples on the Sysmex XN-1000V multispecies hematology analyzer. IPF gates were created using undiluted and diluted (1/10) blood samples obtained from adult and newborn (postnatal day 10, P10) C57BL/6J wild-type (WT) mice, and from 3 murine models of thrombocytopenia: c-MPL-/- mice, which lack the thrombopoietin receptor (hyporegenerative); antibody-mediated thrombocytopenia; and acute inflammation-induced thrombocytopenia. P10 mice were chosen because, at their size, we could consistently obtain (by terminal phlebotomy) the blood volume needed to run an undiluted sample. The undiluted blood IPF gate successfully differentiated between mechanisms of thrombocytopenia in both adult and P10 mice. For diluted samples, 2 IPF gates were generated: a thrombocytopenic (T) gate, which performed well in samples with platelet counts (PCs) <800 × 109/L in adult mice and <500 × 109/L in newborn mice, and a non-thrombocytopenic (NT) gate, which performed well in samples with PCs above these thresholds. PCs and IPFs measured in diluted blood using these gates agreed well with those measured in undiluted blood and had good reproducibility. These diluted gates allow for the accurate measurement of PCs and IPFs in small (10 µL) blood volumes, which can be obtained easily from adult and newborn mice as small as P1 to assess platelet production serially.

Immature Platelet Fraction and COVID-19: Maturing prognostic links!

AbstractPrompted by the combination of an ever-evolving comprehension of the platelet activation as a pivotal perpetuator of an ongoing systemic inflammatory process and an encouraging literature on the prognostic role of immature platelet fraction (IPF) in septic and prothrombotic settings, we present an elaborated account of the possible prognostic links between IPF and Coronavirus disease 2019 (COVID-19).

Lower Antiplatelet Effect of Aspirin in Essential Thrombocythemia than in Coronary Artery Disease.

Background Patients with essential thrombocythemia (ET) and coronary artery disease (CAD) have increased risk of thromboembolic complications. In addition, a reduced antiplatelet effect of aspirin has been demonstrated in both patient groups. As ET is a platelet disorder, platelets may be more important for the thromboembolic risk in ET than in CAD. We aimed to investigate the antiplatelet effect of aspirin and platelet turnover in ET versus CAD patients. Methods We included 48 ET patients and an age-matched group of 48 CAD patients. The effect of aspirin was evaluated by thromboxane B 2 (TXB 2 ) levels and platelet aggregation. Platelet turnover was assessed by immature platelet count (IPC) and immature platelet fraction (IPF). Results ET patients had reduced effect of aspirin compared with CAD patients, demonstrated by significantly higher TXB 2 levels (median of differences = 22.3 ng/mL, p < 0.0001) and platelet aggregation (median of differences = 131.0 AU*min, p = 0.0003). Furthermore, ET patients had significantly higher IPC ( p < 0.0001) and IPF ( p = 0.0004) than CAD patients. Conclusion ET patients have lower 24-hour antiplatelet effect of aspirin than CAD patients. This may be explained by an increased platelet production and turnover counteracting the antiplatelet effect of aspirin. These findings strengthen the rationale for exploring novel antiplatelet regimens in ET patients to reduce the risk of cardiovascular events.

Platelet Desialylation Is a Novel Mechanism of Thrombocytopenia during Mechanical Circulatory Assistance

Introduction: Although bleeding associated with thrombocytopenia often complicates mechanical circulatory assistance (MCA), the mechanisms of thrombocytopenia observed in this high shear stress situation remain poorly understood. Recent studies have highlighted that platelet desialylation, a process in which terminal sialic acids are cleaved from glycoconjugates on the platelet surface, leads to accelerate platelet clearance via asialoglycoprotein receptors on hepatocytes and subsequent thrombocytopenia. Moreover, it was demonstrated that platelet receptor GPIba occupancy by plasma protein von Willebrand factor (VWF) under physiological shear stress induces platelet desialylation. As MCA promotes, in the majority of patients, high shear-induced VWF/GPIba interactions, we aimed to investigate whether the thrombocytopenia observed during MCA depends on platelet desialylation.Methods: The effects of MCA on platelet desialylation were assessed i) in vitro using human whole blood or platelets rich plasma (PRP) and an Impella (Abiomed Europe GmbH, Aachen, Germany) circulatory assistance pump providing flow rate of 5 liters by minute and inserted in a loop and ii) in 11 adult patients requiring arteriovenous extracorporeal membrane oxygenation (ECMO) circulatory assistance. Platelet desialylation was measured by flow cytometry using fluorescent lectin, at baseline and after initiation (5, 30, 60, 120 and 180 minutes and 24 hours for patients) of MCA. The blood platelet count and the immature platelet fraction (IPF), a new parameter that reflects the activity of thrombopoiesis, were also determined in patients at baseline and daily after ECMO initiation.Results: In vitro, platelet desialylation levels in whole blood and in PRP increased after 5 minutes of circulatory assistance pump compared to baseline (+216%, p<0.05 and +132%, p<0.05, respectively) and the difference persists over time (at 180 minutes: +244%, p<0.05 in whole blood and +292%, p<0.05 in PRP). In all patients, platelet desialylation levels were higher after 5 minutes of ECMO compared to baseline (+197%, p<0.001) and as in vitro, the difference persist over time (at 180 minutes: +187%, p<0.05 and at 24 hours: +223%, p<0.05). In parallel, a decrease of platelet counts and an increase of IPF were observed in all these patients after 2 days under ECMO with a nadir at 4 days for platelet counts (73 G/L, range: 27-119 G/L) and a zenith at 3 days for IPF (13.75%, range: 5.5-22.0%).Conclusion: The present study is the first to show that MCA increases platelet desialylation within minutes after pump initiation. Thus, thrombocytopenia observed in this context seems dependent on platelet desialylation. Giving these results, further studies evaluating the potential beneficial effects of desialylation inhibitors to prevent or treat MCA associated thrombocytopenia could be valuable. DisclosuresNix:Abiomed: Employment.

Immature Platelet Fraction: Its Clinical Utility in Thrombocytopenia Patients

Objectives Etiology of thrombocytopenia is multifactorial and its pathogenesis should be distinguished for appropriate management. Newly formed immature platelets are called reticulated platelets (RPs) and can be estimated in peripheral blood using automated hematology analyzers, which express them as immature platelet fraction (IPF). In the present study we intend to assess and establish the clinical utility of IPF in differentiating the two major causes of thrombocytopenia—decreased production and increased destruction of platelets—along with determining its significance in monitoring patients with thrombocytopenia. Materials and Methods Sixty-one cases of thrombocytopenia and 101 healthy controls with normal platelet count were included in the study. IPF and all the other usual blood cell parameters were measured using a fully automated hematology analyzer. Based on the pathogenesis of thrombocytopenia, the cases were divided into groups and the difference in IPF value between the groups was evaluated. Results The reference range of IPF among healthy controls was estimated to be 0.7 to 5.7%. The mean IPF was significantly higher in patients with increased peripheral destruction of platelets (13.4%) as compared to patients with decreased production of platelets (4.6%). The optimal cutoff value of IPF for differentiating patients with increased peripheral destruction of platelets from patients with decreased production of platelets was 5.95% with a sensitivity of 88% and specificity of 75.9%. Conclusion Measurement of IPF is useful for detecting evidence of increased platelet production and helps in the initial evaluation of thrombocytopenia patients. It is a novel diagnostic method which can be used to differentiate patients with thrombocytopenia due to increased destruction of platelets from patients with thrombocytopenia due to bone marrow failure/suppression.

A Case Report, Suspected Megakaryoblastic Transformation In A Chronic Myeloid Leukemia Patient

Preliminary: Chronic myeloid leukaemia (CML) is a clonal hematopoiesis stem cell disorder, characterised by reciprocal translocation between chromosomes 9 and chromosomes 22, originally named the ‘Philadelphia chromosome’(Ph). The megakaryoblastic transformation of a CML is extremely rare, consisting <3% of transformed cases. Case description: A 68-year-old male presented with a CML history since 2000 and received Imatinib therapy. The patient currently showed anemia and splenomegaly. Laboratory results showed hemoglobin 8.1 g/dL, leukocyte count 31,740/?L, platelet count 7,000/?L, Immature Platelet Fraction (IPF) 29.2%, BCR-ABL gene fusion is positive. Bone marrow examination showed CML blastic crisis phase with 45% blasts which had megakaryoblast morphology so it was concluded as a CML that underwent a transformation into megakaryoblastic. The results of bone marrow aspirate using Sysmex-XN1000 showed a very high IPF value which indicated an increased megakaryopoietic proliferative activity. Immunophenotyping examination showed blast population with CD45 dim, low side scatter, with the expression of CD34+, CD33+, CD13+ corresponding to the megakaryoblast area. Examination of the CD41 and CD61 specific megakaryoblast markers was not performed due to reagent limitations. Discussion: Clinical features, morphology, immunophenotyping and molecular findings help the identification of CML with suspected megakaryoblastic transformation. Conclusion: A CML patient has been reported with suspected megakaryoblastic transformation based on the bone marrow morphology, immunophenotyping, molecular and elevated IPF examination.

An observational study to see the correlation between trends of platelet counts and immature platelet fraction in dengue infection.

Dengue, a common tropical viral disease, often has complications of thrombocytopenia causing bleeding and warranting blood transfusion. This is costly in low-income settings. We conducted an observational study using a relatively new parameter called immature platelet fraction which indicates regeneration of platelets by the bone marrow. Our study on 124 dengue patients showed a strong correlation between platelet count and immature platelet fraction and we observed that 96.1% and 97.4% patients showed rise in platelet count at 24 and 48 h, respectively. In the absence of bleeding, platelet transfusion was prevented in 64% of patients with an IPF level of 10% or more.

Haematological parameters associated with postpartum haemorrhage after vaginal delivery: Results from a French cohort study

BackgroundImmediate postpartum haemorrhage (PPH) is a major, feared and often unpredictable issue. Besides many clinical risk factors, some biological parameters could also be predictive of PPH. ObjectiveTo study simple and easily accessible haematological parameters as potential risk factors for PPH after vaginal delivery. MethodsAll women who had a vaginal delivery between April 1, 2013 and May 29, 2015 in the maternity ward of Brest University Hospital (France) were included, after oral informed consent obtained. Clinical data were collected by obstetricians or midwives during antenatal care visits, labour and delivery, and recorded by trained research assistants. Haematological variables, including immature platelet fraction, were measured from a blood sample systematically collected at the entrance in the delivery room. PPH, measured with a graduated collector bag, was defined as blood loss of at least 500 ml. Results2742 women were included. PPH occurred in 141 (5%) women. Seven clinical factors were independently associated with PPH: pre-eclampsia (OR 5.85, 95%CI 2.02, 16.90), multiple pregnancy (OR 3.28, 95%CI 1.21, 8.91), assisted reproduction (OR 2.75, 95%CI 1.45, 5.20), antepartum bleeding (OR 2.15, 95%CI 1.24,3.73), post-term delivery (OR 1.93, 95%CI 1.17, 3.17), obesity (OR 2.95, 95%CI 1.76, 4.93) and episiotomy (OR 2.51, 95%CI 1.63, 3.74). Three haematological factors were additionally identified as independent risk factors for PPH: platelets < 150 Giga/L (OR 2.98, 95%CI 1.63, 5.46), fibrinogen < 4.5 g/l (OR 1.86, 95%CI 1.21, 2.87) and APTT ratio ≥ 1.1 (OR 2.16, 95%CI 1.31, 3.57). Immature platelet fraction was not associated with PPH. ConclusionBesides classical clinical risk factors, this study identifies simple haematological parameters as risk factors for PPH.

Immature Platelet Fraction in Patients with Chronic Liver Disease, A Marker for Evaluating Cirrhotic Changes.

Objective: To evaluate the role of Immature platelet fraction in patients with chronic liver disease, a marker for evaluating cirrhotic changes.&#x0D; Methodology: This case control study was conducted at department of Pathology, Aziz Fatima Medical and Dental College, Faisalabad, over a period of Seven months from June 2020 to January 2021. A total of 126 participants were included in the study consisting of 63 patients with chronic liver disease in group A and 63 participants without any known disease in group B as control. The IPF master program in combination with XE-2100 multiparameter automatic hematology analyzer was used to measure the immature platelet fraction. Ethylene diamine tetraacetic acid was used to collect the blood sample for IPF measurement and was maintained till analysis on room temperature. Ten repeated analyses, immediately and after 24 hours were done for reproducibility of IPF%.&#x0D; Results: The mean age of liver disease patients was 52.35 ± 13.64 years and in control group the mean age was 51.62 ± 11.27 years. There was no significant (p-value &gt; 0.05) difference between both groups based on age and gender. The hemoglobin level and red cell count was found to be significantly (p-value &lt; 0.05) reduced in cases group. While white blood cells count was comparable in both groups. The mean platelet count was significantly (p-value &lt; 0.05) less in cases group (163.5 ± 90.4 vs 233.4 ± 54.5 (x10*3/µl). The mean value of immature platelet fraction (IPF%) was significantly (p-value &lt; 0.05) raised in cases group (5.62 ± 2.92 vs 3.06 ± 1.87). The multivariate discriminant analysis (MDA) score showed a significant (p-value &lt; 0.05) association with chronic hepatis as compared to other liver related diseases.&#x0D; Conclusions: In chronic liver disease patients, there is an inverse relationship between platelet count and IPF% with decreased platelet count and increased IPF%. The proposed MDA function can be used to identify the cirrhotic changes in liver disease patients.

Reticulated Platelets-Which Functions Have Been Established by In Vivo and In Vitro Data?

Reticulated platelets (RP) are the youngest platelet fraction released into the circulation. These immature platelets have increased RNA content, a larger cell volume, more dense granules, higher levels of surface activation markers and are thought to be more reactive compared to their mature counterparts. RP have been associated with cardiovascular disease, diabetes and increased mortality. Yet only a few animal studies investigating RP have been conducted so far and further investigations are warranted. Established methods to count RP are flow cytometry (staining with thiazole orange or SYTO13) or fully automated hematology analyzers (immature platelet fraction, IPF). IPF has been established as a diagnostic parameter in thrombocytopenia, cardiovascular disease and, in particular, the response to antiplatelet therapy. This review seeks to provide an overview of the key features of RP as well as preanalytical and analytical aspects that need to be considered when working with this platelet population.

Impact of anemia on platelet production and function in acute coronary syndrome: results of long-term single-center registry

Abstract Funding Acknowledgements Type of funding sources: None. Anemia is the most common clinical condition known to increase both ischemic and hemorrhagic risks in patients with acute coronary syndrome (ACS). Despite it"s high frequency there are certain gaps in evidence on how to choose appropriate antiplatelet regimen in anemia, for anemia was among exclusion criteria in almost all randomized clinical trials on efficacy and safety of antiplatelet agents. Purpose of the study to evaluate prevalence of anemia and it"s impact on platelet production and function in patients admitted to ICU with ACS. Methods. To determine the prevalence and characteristics of anemia we analyzed data from the local single-center long-term registry of coronary heart disease (n total= 4776, n ACS = 765). To evaluate platelet production and function we used data obtained from those patients with ACS in whom platelet function, immature platelet fraction (IPF), thrombopoietin (TPO), stromal cell-derived factor 1 (SDF1), TPO receptors (MPL) and platelet derived microparticles (PDMP) were measured serially at admission, on the second and on the 7th day since ACS manifestation (n = 321). Results. Anemia on admission was verified in 12.5% of ACS, and there were no significant differences in antiplatelet therapy at first medical contact and on admission. Anemia in patients with ACS was accompanied with decreased platelet count, therefore TPO level at admission was higher: 336.23 (141.35; 429.85) ng/mL vs 266.04 (199.16; 341.20) pg/mL, p = 0.050. PDMP level at admission was minimal in anemic patients: 6.75 (5.31; 7.81) vs 26.45 (16.05; 39.35) ng/mL (p = 0.027). There were no significant differences in TPO levels measured on the 2nd and the 7th days, as well as SDF and MPL. IPF was also comparable in anemic patients and those with normal Hb levels. Despite similar platelet function on admission in patients with anemia there was significant increase in platelet ADP-induced aggregation and secretion with maximal level at the 7th day since ACS manifestation: 2 (1; 4) vs 0 (0; 1) Ohm, p = 0.02. Anemia in ACS was characterized with unfavorable myocardial stress and injury biomarkers dynamics: BNP at the 7th day – 1155 (867; 2251) vs 73.4 (40.3; 148.5) pg/mL, and with increase in risk of early adverse (ischemic, but not hemorrhagic) events OR 8.6 CI 1.1; 19.4, p = 0.038. Conclusion. Anemia is a common comorbidity in acute coronary syndrome increasing risk of early complications. Anemia on admission in ACS is characterized by increase of platelet aggregation and secretion despite antiplatelet therapy, and this activation does not result from possible associated changes in platelet production and turnover. Received results underline the risk of early discontinuation of antiplatelet therapy in ACS with anemia, and possible benefits of platelet function monitoring in these patients.

Immature platelet fraction as a predictor of platelet count recovery following allogeneic bone marrow transplantation

The immature platelet fraction (IPF) is a marker of increased platelet production. An increase in IPF is associated with increased marrow production; therefore, a subsequent increase in a bone marrow transplant recipient during the pancytopenic phase may correlate with platelet recovery and engraftment. We performed a retrospective cohort study and evaluated 32 patients who underwent allogeneic bone marrow transplantation. Patients had platelet count, neutrophil count, platelet transfusion and IPF recorded over a period extending from stem cell infusion, day 0, to day 30. The outcomes analysed were platelet count versus time and IPF versus time to establish the predictive ability of the IPF to determine platelet count recovery. Further analysis was performed to confirm the strength of the correlation and the sensitivity of the IPF in predicting a platelet count greater than 50 at day 30. The IPF was shown to rise 5 days prior to platelet count increase. An IPF rise was also shown to correlate with higher average platelet counts at day 30 of transplant. The utility of the IPF in predicting a platelet count of over 50 at day 30 was strongest between days 11 and 15 with an area under the curve (AUC) of 0.79. An IPF of 2.0 or above had 69% sensitivity and 85% specificity for predicting a platelet count of greater than 50 by day 30. In allogeneic bone marrow transplantation, the IPF is a reliable predictor of platelet recovery. The mean IPF between day 11 and day 15 is the most sensitive in predicting a robust platelet count of greater than 50 by day 30.

Role of Platelet Indices as a Potential Marker for Malaria Severity.

Platelet parameter alteration such as platelet count and platelet indices are more common than in other blood cell lines due to diverse causative pathophysiological mechanisms in severe malaria infection. In malaria patients, no more studies evaluated platelet indices in relation to disease severity and prognosis. Therefore, this review assessed the current scientific knowledge on the potential role of platelet indices for the diagnostic marker of severe malaria infection. Hence, after reviewing recent literatures, elevation of mean platelet volume and platelet distribution width in addition to decreased plateletcrit and platelet counts is the known potential risk factor associated with warning signs of severe malaria. Thus, thrombocytopenia < 150 × 109/L, MPV ≥ 9.05 fL, and PDW ≥ 14.550% as well as significantly higher P-LCR and decrease in PCT are shown significant sensitivity and specificity as they are used as diagnostic and prognostic values in severe malaria infection. Platelet indices are useful predictors of malaria severity. Immature platelet fraction (IPF%) is raised in the case of severe malaria, and it was significantly more useful than MPV. Advanced research will further investigate the platelet index abnormality associated with specific age and gender among specific malaria species.

Immature platelet fraction over time and clinical outcomes in patients with acute myocardial infarction.

Immature platelets in the circulation can be measured as immature platelet fraction (IPF). Limited data exist regarding IPF during the course of an acute myocardial infarction (AMI), the association between IPF and extent of cardiac damage, and the long-term prognostic implications of IPF in patients with AMI. To examine the temporal course of IPF during the first month after AMI, the association between IPF and extent of cardiac damage, and the long-term prognostic effect of IPF in AMI patients. Patients with AMI treated with percutaneous coronary intervention (PCI) were examined. IPF was evaluated by a Sysmex XN-3000 autoanalyzer, at 4 time points: baseline; one day post-PCI; 3days post-PCI, and 30days post-PCI. The association between peak troponin-T levels and IPF was evaluated. One-year clinical outcomes (cardiac hospitalization, urgent revascularization, or death) were assessed. One hundred patients were included, mean age was 59.5±11.3years, 82 were men, 27 had diabetes, and 54 were hospitalized with ST-segment elevation myocardial infarction (STEMI) and 46 with non-ST segment elevation myocardial infarction (NSTEMI). The levels of IPF modestly decreased a day after PCI but did not change in subsequent measurements. Peak troponin-T level was significantly associated with the levels of IPF at all 4 time points. IPF levels three days post-PCI were associated with the composite clinical outcome at 1year. The levels of IPF following AMI remain relatively stable over a one-month period. Higher levels of IPF during the acute phase of AMI appear to be associated with worse cardiac outcomes at 1year.