Clinical significance of IPF% or RP% measurement in distinguishing primary immune thrombocytopenia from aplastic thrombocytopenic disorders

The diagnosis of primary immune thrombocytopenia (ITP) is based on differential diagnosis. Although the measurement of percentages of reticulated platelets (RP%) by flow cytometry is useful as a supportive diagnostic test, this method is nonetheless a time-consuming, laboratory-based assay. To ident...

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Bibliographic Details
Published in:International journal of hematology 2015-04, Vol.101 (4), p.369-375
Main Authors: Sakuragi, Mikiko, Hayashi, Satoru, Maruyama, Miho, Kabutomori, Osamu, Kiyokawa, Tomoko, Nagamine, Keisuke, Kato, Hisashi, Kashiwagi, Hirokazu, Kanakura, Yuzuru, Tomiyama, Yoshiaki
Format: Article
Language:English
Subjects:
Adult
Aged
Blood Platelets - pathology
Diagnosis, Differential
Female
Hematology
Hemoglobinuria, Paroxysmal - blood
Hemoglobinuria, Paroxysmal - diagnosis
Hemoglobinuria, Paroxysmal - pathology
Hemolysis
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Oncology
Original Article
Purpura, Thrombocytopenic, Idiopathic - blood
Purpura, Thrombocytopenic, Idiopathic - diagnosis
Purpura, Thrombocytopenic, Idiopathic - pathology
Thrombocytopenia - blood
Thrombocytopenia - diagnosis
Thrombocytopenia - pathology
Thrombopoietin - blood
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Summary:The diagnosis of primary immune thrombocytopenia (ITP) is based on differential diagnosis. Although the measurement of percentages of reticulated platelets (RP%) by flow cytometry is useful as a supportive diagnostic test, this method is nonetheless a time-consuming, laboratory-based assay. To identify alternative assays that are useful in daily practice, we compared three methods in parallel, IPF% measured by XE-2100 [IPF% (XE), Sysmex Corp.], IPF% measured by new XN-1000 [IPF% (XN)], and RP%. We examined 47 patients with primary ITP, 28 patients with aplastic thrombocytopenia (18 aplastic anemia and 10 chemotherapy-induced thrombocytopenia) and 80 healthy controls. In a selected experiment, we examined 16 patients with paroxysmal nocturnal hemoglobinuria (PNH) to examine the effect of hemolysis. As compared with IPF% (XE), IPF% (XN) showed better within-run reproducibility. The sensitivity and specificity for the diagnosis of ITP were 83.0 and 75.0 % for IPF% (XE), 85.1 and 89.3 % for IPF% (XN), and 93.6 and 89.3 % for RP%, respectively. Examination of PNH patients revealed that hemolysis and/or red blood cell fragments interfered with IPF% (XE) values, but not with IFP % (XN) values. Our results suggest that IPF% measured by XN-1000 may be of comparable value with RP% as a supportive diagnostic test for ITP.
ISSN:0925-5710
1865-3774
DOI:10.1007/s12185-015-1741-0