Evaluation of the immature platelet fraction as a predictive marker of bone marrow regeneration after hematopoietic stem cell transplantation

IF 2.2 4区医学 Q3 HEMATOLOGY

International Journal of Laboratory Hematology Pub Date : 2024-09-04 DOI:10.1111/ijlh.14358

Kélian Steibel, Magalie Joris, Valentin Clichet, Amandine Charbonnier, Judith Desoutter, Jean-Pierre Marolleau, Loïc Garçon, Thomas Boyer

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引用次数: 0

Abstract

Introduction

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.

Methods

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.

Results

An optimized A-IPF (absolute number of IPF) threshold of 2.5 × 10⁹/L was predictive of a PC greater than 50 × 10⁹/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.

Conclusion

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.

Abstract Image

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评估作为造血干细胞移植后骨髓再生预测标志的未成熟血小板部分。

简介造血干细胞移植（HCST）是治疗血液恶性肿瘤的一种广泛应用的疗法，会导致需要短暂输血的细胞减少症。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。血小板未成熟率（IPF）是 Sysmex® XN 系列分析仪提供的一项研究参数，可在血小板减少时快速诊断定位。它也被描述为化疗或造血干细胞移植后 PR 的预测因素，并已提出了阈值：本研究旨在评估 IPF 对造血干细胞移植患者前瞻性队列中 PR 的预测能力，并评估其在指导血小板输注决策方面的效用：2.5×109/L的优化A-IPF（IPF绝对数）阈值可预测第30天PC大于50×109/L，灵敏度为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%。我们能够通过更早的 IPF 峰值百分比、更大的 IPF 恢复动力学和更快的中性粒细胞恢复速度来区分第 15 天前恢复 PC 的患者：结论：A-IPF有望作为造血干细胞移植后PR的预测指标。多中心研究有助于确认 A-IPF 和 IPF%（IPF）的临床实用性，然后再将其提供给临床医生。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Laboratory Hematology 医学-血液学

CiteScore

4.50

自引率

6.70%

发文量

211

审稿时长

6-12 weeks

期刊介绍： The International Journal of Laboratory Hematology provides a forum for the communication of new developments, research topics and the practice of laboratory haematology. The journal publishes invited reviews, full length original articles, and correspondence. The International Journal of Laboratory Hematology is the official journal of the International Society for Laboratory Hematology, which addresses the following sub-disciplines: cellular analysis, flow cytometry, haemostasis and thrombosis, molecular diagnostics, haematology informatics, haemoglobinopathies, point of care testing, standards and guidelines. The journal was launched in 2006 as the successor to Clinical and Laboratory Hematology, which was first published in 1979. An active and positive editorial policy ensures that work of a high scientific standard is reported, in order to bridge the gap between practical and academic aspects of laboratory haematology.