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预处理未成熟血小板分数可作为网织血小板的替代物,预测成人免疫性血小板减少症对皮质类固醇的反应。

Pretreatment Immature Platelet Fraction as a Surrogate of Reticulated Platelets Predicts the Response to Corticosteroids in Adults with Immune Thrombocytopenia.

机构信息

Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan,

Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.

出版信息

Acta Haematol. 2021;144(3):345-349. doi: 10.1159/000510460. Epub 2020 Sep 17.

Abstract

OBJECTIVES

Reticulated platelets circulating in the blood reflect megakaryopoietic activity and platelet turnover and can be automatically and low-invasively measured as the immature platelet fraction (IPF) using a Sysmex XN hematocytometer. The present study retrospectively investigated whether or not the IPF can predict the treatment response to corticosteroids in adult patients with primary immune thrombocytopenia (ITP).

METHODS

Forty-six patients who had been newly diagnosed with primary treatment-naïve ITP and started treatment with corticosteroids were analyzed.

RESULTS

Among the 46 primary ITP patients, 33 (72%) responded to the treatment and 13 (28%) did not. The percentage of IPF (IPF%) among the nonresponders was significantly lower than that of the responders (6.6 vs. 16.0%; p < 0.001). In the receiver operating characteristics analysis, the optimum IPF% cut-off value for predicting the treatment response was 12%, with a specificity of 85% and a sensitivity of 76%.

CONCLUSIONS

Our findings thus suggest that measuring the IPF% as a surrogate of reticulated platelets is useful to identify patients likely to respond to corticosteroids.

摘要

目的

循环血液中的网织血小板反映巨核细胞生成活性和血小板更新,可使用希森美康 XN 血细胞计数器自动且微创地测量为未成熟血小板分数(IPF)。本研究回顾性调查了 IPF 是否可以预测成人原发性免疫性血小板减少症(ITP)患者对皮质类固醇治疗的反应。

方法

分析了 46 名新诊断为原发性初治 ITP 并开始皮质类固醇治疗的患者。

结果

在 46 名原发性 ITP 患者中,33 名(72%)对治疗有反应,13 名(28%)无反应。无反应者的 IPF%(IPF%)明显低于有反应者(6.6%比 16.0%;p<0.001)。在受试者工作特征分析中,预测治疗反应的最佳 IPF%截断值为 12%,特异性为 85%,敏感性为 76%。

结论

因此,我们的研究结果表明,测量 IPF%作为网织血小板的替代物有助于识别可能对皮质类固醇有反应的患者。

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