Differentiation of platelets from red cell fragments using laser technology: comparison between splenectomized and nonsplenectomized thalassemic patients.

Platelets from 59 beta-thalassemia/hemoglobin E (beta-thal/HbE) patients (19 were splenectomized) and 97 normal individuals were studied using laser and computer analysis. Fragmented red cells of similar platelet volume were differentiated from platelets using laser inspection of the intracellular hemoglobin of the fragmented red cell. The patients had increased platelet count than normal cases at p < 0.0001 (nonsplenectomized, mean +/- SE = 32.4 +/- 21.9; splenectomized, 617.5 +/- 64.2; normal, 264.7 +/- 6.4 x 10(3) cells/dl). Splenectomized patients had greater platelet counts than nonsplenectomized cases (p < 0.0001). Numbers of small red cells, probably red cell fragments, markedly increased in nonsplenectomized patients. Increased heterogeneity in platelet size was demonstrated in the patients of both groups. The nonsplenectomized patients had significantly higher mean platelet volume than normal (p < 0.02) and splenectomized cases (p < 0.01). Increased platelet number and heterogeneity in platelet population may involve in pulmonary thrombosis in splenectomized patients.