Steibel Kélian, Joris Magalie, Clichet Valentin, Charbonnier Amandine, Desoutter Judith, Marolleau Jean-Pierre, Garçon Loïc, Boyer Thomas
Laboratory of Hematology, Amiens-Picardie University Hospital, Amiens, France.
Department of Hematology, Amiens-Picardie University Hospital, Amiens, France.
Int J Lab Hematol. 2025 Feb;47(1):41-50. doi: 10.1111/ijlh.14358. Epub 2024 Sep 4.
Hematopoietic stem cell transplantation (HCST) is a widely used therapy in the management of hematological malignancies, leading to cytopenias that require transient transfusions. Platelet recovery (PR) following HSCT is assessed by monitoring platelet count (PC). Immature platelet fraction (IPF) is a research parameter offered by Sysmex® on XN series analyzers, enabling rapid diagnostic orientation in the event of thrombocytopenia. It has also been described as a predictive factor for PR after chemotherapy or HSCT, and thresholds have been proposed.
The objective of this study was to assess the predictive capability of IPF for PR in a prospective cohort of patients undergoing HSCT and to evaluate its utility in guiding platelet transfusion decision.
An optimized A-IPF (absolute number of IPF) threshold of 2.5 × 10/L was predictive of a PC greater than 50 × 10/L at day 30 with a sensitivity of 78.9%, specificity of 78.6%, positive predictive value (PPV) of 83.3% and negative predictive value (NPV) of 73.3%. We were able to distinguish patients recovering PC before day 15 with an earlier %IPF peak, greater IPF recovery kinetics and faster neutrophil recovery.
A-IPF shows promise as a predictor of PR following HSCT. A multicenter study could help confirm both A-IPF and %IPF (IPF) clinical utility before it is made available to clinicians.
造血干细胞移植（HCST）是血液系统恶性肿瘤治疗中广泛应用的一种疗法，会导致血细胞减少，需要进行短期输血。异基因造血干细胞移植后的血小板恢复（PR）通过监测血小板计数（PC）来评估。未成熟血小板比率（IPF）是Sysmex® XN系列分析仪提供的一项研究参数，可在血小板减少时实现快速诊断定位。它也被描述为化疗或异基因造血干细胞移植后血小板恢复的预测因素，并已提出相关阈值。
本研究的目的是评估未成熟血小板比率对接受异基因造血干细胞移植患者血小板恢复的预测能力，并评估其在指导血小板输血决策中的效用。
优化后的A-IPF（未成熟血小板绝对数）阈值为2.5×10⁹/L，可预测第30天时血小板计数大于50×10⁹/L，敏感性为78.9%，特异性为78.6%，阳性预测值（PPV）为83.3%，阴性预测值（NPV）为73.3%。我们能够区分在第15天前血小板计数恢复的患者，这些患者的%IPF峰值出现更早，IPF恢复动力学更好，中性粒细胞恢复更快。
A-IPF有望成为异基因造血干细胞移植后血小板恢复的预测指标。在向临床医生推广之前，多中心研究有助于证实A-IPF和%IPF（未成熟血小板比率）的临床效用。
