Usefulness of immature platelet fraction measurement in predicting hematologic recovery in patients with acute leukemias undergoing high-intensity chemotherapy and stem cell transplantation.
Ana Beatriz Sánchez López, Rolando Humberto Martínez Cordero, Gloria Patricia Duarte Luque, Rose Mary Jaramillo Calle, Melody Mary Lever Hawkins, Lina María Sopó Martínez, Alexandra Porras Ramírez, Alejandro Rico Mendoza
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Abstract
Background and objectives: The immature platelet fraction (IPF) count is a parameter that quantifies young and reticulated platelets in peripheral blood, which reflects platelet production in the bone marrow. It has been used as a predictive model for bone marrow recovery in patients with acute leukemia after high-intensity chemotherapy and/or stem cell transplantation. This study aimed to evaluate IPF as a predictor of hematologic recovery in these patients.
Materials and methods: A retrospective analysis of patients with acute leukemias after high-intensity chemotherapy or undergoing stem cell transplantation, treated at the Instituto Nacional de Cancerología (INC) (Bogotá, Colombia) between October 2020 and March 2021.The variables studied included age, sex, type of leukemia, type of treatment, type of chemotherapy, treatment duration, peripheral blood platelet count, percentage of IPF (IPF%), and peripheral blood neutrophil count. Univariate and multivariate analyses were carried out to evaluate the relationship between the IPF behavior and hematologic recovery. Statistical analysis was performed using the R package version 4.2.0® (free license).
Results: Between October 2020 and March 2021, 32 patients were analyzed, with a median age of 26 years; the male population was 59.4%. Acute lymphoid leukemia was the most frequent type in 62.5%; 43.7% of patients received chemotherapy, while the others underwent allogeneic stem cell transplantation. Hematologic recovery occurred between days 15 and 30. Spearman's correlation was 0.27 with a p=0.13 for recovery day and IPF% (weak correlation).
Conclusion: There is limited information regarding the usefulness of IPF% in hematology. The IPF% was not found to be a predictor of hematologic recovery in patients with acute leukemia after chemotherapy and/or allogeneic stem cell transplantation. The lack of correlation does not allow for assuming a reliable cut-off point. Further studies with a larger sample size are needed.
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