Influence of Anticoagulants on Platelet Counts: A Study and Recommendations From the French Speaking Cellular Hematology Group (GFHC)

IF 2.2 4区医学 Q3 HEMATOLOGY

International Journal of Laboratory Hematology Pub Date : 2025-01-16 DOI:10.1111/ijlh.14430

Soraya Wuilleme, Sandrine Girard, Michel Soulard, Bernard Chatelain, Elodie Etienne, Eric Guiheneuf, Franck Geneviève, Aurélie Vedrenne, Jean François Lesesve, Véronique Baccini, Valérie Bardet

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引用次数: 0

Abstract

Introduction

For complete blood count, ethylenediaminetetraacetic acid (EDTA) is universally used and has been recognized as the most robust anticoagulant. However, it may lead to pseudothrombocytopenia (PTCT), due to the formation of platelet clumps, which is currently followed by resampling on sodium citrate. Other possible anticoagulants are citrate theophylline adenosine dipyridamole (CTAD) and MgSO₄. These anticoagulants were compared here for resolution of PTCT and platelet count values and stability.

Methods

Paired blood samples were used to compare the four anticoagulants. First, samples containing clumps on EDTA were compared to samples collected on sodium citrate (335), CTAD (31), or MgSO₄ (160). For platelet counts, compared series were of respectively, 168, 191, and 87, paired to PTCT-free EDTA samples. Finally, platelet count stability was evaluated over 2–24 h.

Results

MgSO₄, followed by CTAD, was the most efficient to avoid platelet clump formation, while sodium citrate performed poorly. Regarding platelet count, significantly lower values were obtained with sodium citrate (p < 0.0001), with more samples (35% vs. 6.5%) below the 150 × 10⁹/L threshold. Conversely, CTAD yielded similar values as EDTA, while higher counts were observed with MgSO₄ (p = 0.008). Finally, platelet count stability began to decrease at 4 h for sodium citrate, while the other anticoagulants were stable for at least 8 h, up to 12 h for MgSO4 and 24 h for EDTA.

Conclusions

This real-life study confirms that sodium citrate should no longer be used to improve platelet counts in patients with platelet clumps, CTAD, if available, and MgSO₄ being much better alternatives.

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抗凝剂对血小板计数的影响：法语细胞血液学组（GFHC）的研究和建议。

简介：对于全血细胞计数，乙二胺四乙酸（EDTA）被普遍使用，并已被认为是最强大的抗凝剂。然而，由于血小板团块的形成，它可能导致假性血小板减少症（PTCT），目前在柠檬酸钠上重新采样。其他可能的抗凝血剂有柠檬酸儿茶碱腺苷双嘧达莫（CTAD）和MgSO4。本文比较了这些抗凝剂的PTCT分辨率和血小板计数值及其稳定性。方法：采用配对血液标本对四种抗凝剂进行比较。首先，将EDTA上含有团块的样品与柠檬酸钠（335）、CTAD（31）或MgSO4（160）上收集的样品进行比较。对于血小板计数，比较系列分别为168,191和87，配对到不含ptct的EDTA样品。最后，在2-24 h内评估血小板计数稳定性。结果：MgSO4，其次是CTAD，对避免血小板团块形成最有效，而柠檬酸钠效果较差。在血小板计数方面，柠檬酸钠的阈值显著降低（p9 /L）。相反，CTAD与EDTA产生相似的值，而MgSO4的计数更高（p = 0.008）。最后，柠檬酸钠的血小板计数稳定性在4小时开始下降，而其他抗凝剂至少稳定8小时，MgSO4稳定12小时，EDTA稳定24小时。结论：这项现实生活中的研究证实，枸橼酸钠不应再用于改善血小板结块、CTAD患者的血小板计数，如果有的话，MgSO4是更好的选择。

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.