Department of Laboratory Haematology, Royal Melbourne Hospital, Melbourne, Vic, Australia; Department of Haematology, Alfred Hospital, Melbourne, Vic, Australia.
Department of Haematology, Alfred Hospital, Melbourne, Vic, Australia.
Pathology. 2021 Jun;53(4):493-497. doi: 10.1016/j.pathol.2020.09.031. Epub 2021 Mar 22.
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.
未成熟血小板比率（IPF）是血小板生成增加的标志物。IPF 的增加与骨髓生成增加有关；因此，骨髓移植受者在全血细胞减少期后的后续增加可能与血小板恢复和植入相关。我们进行了一项回顾性队列研究，评估了 32 名接受异基因骨髓移植的患者。患者的血小板计数、中性粒细胞计数、血小板输注和 IPF 记录从干细胞输注日（第 0 天）延伸至第 30 天。分析的结果是血小板计数与时间的关系和 IPF 与时间的关系，以确定 IPF 对血小板计数恢复的预测能力。进一步的分析用于确认相关性的强度和 IPF 在预测第 30 天血小板计数大于 50 的敏感性。结果显示，IPF 在血小板计数增加前 5 天上升。IPF 的上升也与移植第 30 天更高的平均血小板计数相关。在第 11 天至第 15 天之间，IPF 在预测第 30 天血小板计数大于 50 方面的预测价值最强，曲线下面积（AUC）为 0.79。IPF 为 2.0 或更高时，预测第 30 天血小板计数大于 50 的灵敏度为 69%，特异性为 85%。在异基因骨髓移植中，IPF 是血小板恢复的可靠预测因子。在预测第 30 天血小板计数大于 50 方面，第 11 天至第 15 天之间的平均 IPF 最敏感。
