Low Platelet Count Group Research Articles

Evaluation of Platelet Count by Different Methods in Hyperlipidemia Specimens.

Changes in platelet count are associated with a variety of diseases and treatments. Measuring it gives better insight into the expected outcome. Our aim was to evaluate the accuracy of three methods for platelet count in hyperlipidemia samples. Sixty non-lipid whole bloods from 60 individuals were included: 20 in low platelet count group, 20 in medium platelet count group, and 20 in high platelet count group. Then, 400 μL plasma was exchanged with 400 μL fat emulsion. Platelet count was measured after replacement by three methods, impedance method (Plt-I), optical method (Plt-O), and fluorescence method (Plt-F). In the low platelet count group with fat emulsion plasma exchange, except for Plt-O, other methods showed the predefined acceptance criterion (± 10%) covered the mean bias and 95% CI of proportional bias (slope) which were obtained from Bland-Altman plot and Passing-Bablok algorithm, respectively. In medium and high platelet count group with fat emulsion plasma exchange, the predefined acceptance mean bias and criterion of 95% CI of proportional bias (slope) and intercept were met only in Plt-F. In the medium platelet count group, the mean bias was -1.600% and the 95%CI of slope and intercept were 1.000 (0.815 to 1.071) and -0.500 (-12.831 to 23.907), respectively. In the high platelet count group, the mean bias was -2.250% and the 95%CI of slope and intercept were 1.071 (0.974 to 1.225) and -33.8142 (-113.703 to 8.339), respectively. Our results show that the Plt-F can more accurately reflect the true platelet count of lipemia specimens compared with Plt-I or Plt-O.

Preoperative platelet count predicts posttransplant portal vein complications in orthotopic liver transplantation: a propensity score analysis

BackgroundThe role of platelets on the prognosis of patients with liver transplantation remains unclear. Thus, we aimed to evaluate the influence of preoperative platelet count on postoperative morbidity after liver transplantation.MethodsClinical data of the patients who received liver transplantation from January 2015 to September 2018 were evaluated.ResultsOf the 329 patients included, the average age was 46.71 ± 0.55 years, and 243 were men (75.2%). The incidence of posttransplant portal vein complication was significantly higher in the high platelet count group (> 49.5 × 109/L; n = 167) than in the low platelet count group (≤ 49.5 × 109/L, n = 162, 12.6% vs. 1.9%). After multivariable regression analysis, high platelet count was independently associated with postoperative portal vein complication (odds ratio [OR]: 8.821, 95% confidence interval [CI]: 2.260 to 34.437). After the inverse probability of treatment weighting analysis, patients in the high platelet count group had significantly higher risk of portal vein complication (OR: 9.210, 95%CI: 1.907 to 44.498, p = 0.006) and early allograft dysfunction (OR: 2.087, 95%CI: 1.131 to 3.853, p = 0.019).ConclusionsPreoperative platelet count > 49.5 × 109/L was an independent risk factor for posttransplant portal vein complication and early allograft dysfunction. High preoperative platelet count could be an adverse prognostic predictor for liver transplantation recipients.

The Significance of Platelet Count in Short-Term Prognosis of Type B Acute Aortic Dissection Patients

<i>Background</i>: The lower number of platelet (PLT) has been found to be a risk factor in patients with type A acute aortic dissection (AAD) In admission. However prognostic implications of the PLT count in the type B AAD patients has not yet been elucidated. <i>Methods</i>: We consecutively enrolled 81 patients which confirmed with type B. Patients were divided into survival group and death group and PLT count were measured on admission. Univariate analysis and multiple logistic regression analysis were used to identify the predictors of in-hospital mortality. <i>Results</i>: Compared with the survival group, the death group PLT count was significant lower (172.07±57.38×10⁹/L vs. 227.13±75.97×10⁹/L, P<0.05). The results showed PLT count (HR: 0.993, 95% CI: 0.987-0.997, P=0.043), the area under the ROC curve of PLT count was 0.717, the best cut off was 179.5 × 10⁹ / L, the sensitivity was 72.5%, the specificity was 63.3%, P=0.001; Log Rang test results showed that there was a statistically significant difference in cumulative survival between the high PLT count group (>179.5 × 10⁹ / L) and the low PLT count group (<179.5 × 10⁹ / L) (P=0.001). <i>Conclusions</i>: Low PLT on admission count is one of the specific dead risk factors for type B AAD in-hospital patients.

Prevalence of Low Platelet Count and Identification of Associating Determinants and Genetic Polymorphism in Healthy Individuals of Upper Assam, India.

The purpose of the study was to assess the prevalence of low platelet count among the healthy population of upper Assam, India. The impact of socio-demographic features was moreover pointed to evaluate. Additionally, Mean platelet volume (MPV) and Interleukin-6 gene polymorphism (-174 G > C) were also determined to speculate their effect on the basal platelet count. For determination of hematological indices, CBC was done and genetic polymorphism was identified by ARMS-PCR technique. Out of 510 study subjects, 25.3% (n = 129) had low platelet count, and females were recorded with significantly higher mean platelet count as compared to their male counterpart (p < 0.001). A progressive decline in platelet count was observed with ageing and more significantly noticed in females across the various age groups (p < 0.001). The mean MPV was significantly higher in low platelet count group as compared to the normal group (p < 0.001). Both platelet count and MPV differed significantly among the individuals with varied ethnicity. An inverse correlation between platelet count and its volume was reported, and such observation was continued to persist in every age-group under the study. However, no significant differences were observed for other hematological indices between the studied groups except for platelet indices and RBC count. Moreover, the peripheral blood smear examined for cellular morphology and in vitro platelet clumping did not report any significant aberrancy. No significant penetrance of the risk allele was revealed in the studied groups. However, ARMS-PCR confirmed 6% (n = 8/129) of the low platelet count subjects with heterozygous for G allele. This happens to be the first description of low platelet count among the healthy population of upper Assam, where age, gender, ethnicity, and MPV are significantly associated with platelet count variation. Heterozygosity of the risk allele does not contribute to the low platelet count condition.

Laparoscopic splenectomy for immune thrombocytopenia in patients with a very low platelet count.

IntroductionLaparoscopic splenectomy (LS) is the gold standard in treating immune thrombocytopenia (ITP). However, there are still some problems in decision-making when considering LS in patients with a very low platelet count (PLT).AimTo evaluate safety outcomes of LS in patients with severe ITP and very low PLT in comparison to those with higher PLT.Material and methodsWe retrospectively analyzed consecutive patients who underwent LS in a single institution between April 1998 and December 2017. Perioperative care was based on an algorithm developed at our department which takes into consideration the patient’s PLT level. Patients were divided into 2 groups depending on the PLT level (cut-off point 50,000/mm3).ResultsThe mean operative time in the low PLT group and high PLT group was 90 ±42.1 min and 95 ±45 min, respectively (p = 0.59). Intraoperative blood loss was 144 ±226.1 ml in the low PLT group and 83 ±161.24 ml in the high PLT group (p = 0.23). Complications occurred in 5 (9.09%) patients in the low PLT group and 16 (11.51%) in the high PLT group (p = 0.67). There were no conversions in the group with lower PLT, while 2 patients in the group with higher PLT had to be converted to open surgery (p = 0.38). Patients with low PLT preoperatively more often required perioperative platelet transfusions (13 vs. 1, p < 0.001).ConclusionsLaparoscopic splenectomy is safe and feasible treatment in patients with ITP regardless of the PLT level. Still, patients with critical ITP and marginally low PLT require special awareness.

The Results of Chemotherapy for the Elderly Acute Myelogenous Leukemia Patients

AbstractAbstract 4346 BackgroundDespite of advances in the treatment for acute myelogenous leukemia (AML), the response of chemotherapy for the elderly is still poor and there is no definite guideline for the elderly AML patients. MethodsThe retrospective analysis with medical chart review was taken to the 82 patients over 65 years old and treated with AML from January 2003 to April 2012 at the Korea University Medical Center. The efficacy of chemotherapy for the elderly patients was evaluated and subgroup analysis was taken to determine which conditions are more effective to the chemotherapy. ResultsMedian overall survival period of 82 patients were 3.9 months. 52 patients were treated with chemotherapy (33 patients were standard dose idarubicin plus cytarabine, 19 patients were low dose cytarabine) and 30 patients received best supportive care only. Among the standard chemotherapy group, there were 16 cases of remission (48.5%) after induction chemotherapy. The treatment related mortality was 24.2% and the most common cause was pneumonia sepsis. Median overall survival period of standard chemotherapy group was 7.9 months. In a multivariate analysis, significant factors for longer overall survival were performance status, no underlying heart disease, no fever at diagnosis, high platelet count, low blast count and standard induction chemotherapy. In the subgroup analysis, the efficacy of chemotherapy was observed in the relatively younger patients group (HR 0.437, P =.022), De novo AML group (HR 0.421, P =.025), no underlying heart disease group (HR 0.421, P =.031), high WBC count group (HR 0.306, P =.026), Low platelet count group (HR 0.12, P <.001), high blast counts group (HR 0.233, P =.005), high LDH group (HR 0.21, P=.001). ConclusionThe result of chemotherapy in the elderly AML patients is poor. However the results of the chemotherapy will be better if the patients are selected appropriately through subgroup analysis. Disclosures:Choi:the korean society of hematology: Membership on an entity's Board of Directors or advisory committees.

Characteristics and surgical outcome of HCC patients with low platelet count.

Hepatocellular carcinoma (HCC) patients often have low platelet count (LPC). The aim of this study was to determine unique features of HCC patients with LPC. HCC patients who underwent surgery were divided into two groups: LPC group (platelet count ≤100,000/mm³, n=84) and control group (platelet count >100,000/mm³, n=240). Surgical outcomes, risk factors for postoperative complications and prognostic factors were retrospectively compared. HCC patients with LPC had poorer liver function, smaller tumors, less anatomical resection and more frequent postoperative liver failure than control group patients. Postoperative survival was not different between the two groups. Tumor invasion to the main branch or trunk of portal vein (Vp3, 4) was the only risk factor for postoperative substantial complications in the LPC group. Postoperative survival was worse in patients with tumor diameter ≥4 cm or multiple tumors and in those who underwent preoperative transcatheter arterial chemoembolization (TACE) in the LPC group by multivariate analysis. Among them, preoperative TACE were not prognostic factors in the control group. In HCC patients with LPC, Vp3, 4 patients should be carefully monitored after surgery and preoperative TACE is not recommended for long-term postoperative survival.

Effects of biological variations on platelet count in healthy subjects in China.

The effects of biological variations on platelet counts were investigated in 694 healthy subjects aged 18 to 60 years living in three cities including Chengdu (Sichuan Province), Suzhou (Jiangsu Province) and Harbin (Heilongjang Province) in China. Platelet counts in healthy subjects were significantly lower in Chengdu (52-202 x 10(9)/L) and Suzhou (60-259 x 10(9)/L) than in Harbin (154-348 x 10(9)/L) (p <0.0001), but the mean platelet volume (MPV) determined concurrently was negatively correlated with platelet count, the MPV values were significantly higher in Chengdu (11.8-15.6 fl) and Suzhou (10.9-15.8 fl) than in Harbin (9.5 approximately 12.9 fl) (p < 0.0001). Platelet counts were significantly higher in summer (73-289 x 10(9)/L) than in winter (52-202 x 10(9)/L) (p <0.0001), but the MPV values were lower in summer (11.2-14.7 fl) than in winter (11.8-15.6 fl) (p <0.05) in Chengdu. Platelet associated immunoglobulin (PA-IgG) in Chengdu was revealed to be significantly higher in the low platelet count group (<150 x 10(9)/L, 13.5 +/- 7.1 ng/10(7) PLT) than in the normal platelet count group (> or =150 x 10(9)/L, 8.3 +/- 2.7 ng/10(7) PLT) (p <0.0001). Similar results were observed in Suzhou for the reticulated platelet ratio, which was significantly higher in the low platelet count group (19.5 +/- 7.1%) than in the normal platelet count group (11.6 +/- 2.7%) (p <0.01). The bleeding time in Chengdu showed a significantly longer time in the low platelet count group (8.6 +/- 2.3 min) than in the normal platelet count group (6.0 +/- 1.2 min)(p <0.01). With regard to the effects of lipids on platelet counts, the HDL values were significantly higher in the normal platelet count group (1.60 +/- 0.76 mmol/L) than the low platelet count group (1.23 +/- 0.31 mmol/L) (p <0.01); but no significant differences in cholesterol and triglycerides values between the normal and low platelet count groups (p >0.05) were recorded. These findings suggest that the platelet counts could be greatly influenced in healthy subjects by biological variations such as geographical, seasonal, and lipid variations.