Immature Platelet Fraction as a useful marker in the aetiological determination of Thrombocytopenia

Abstract The aetiology of thrombocytopenia is important in treatment and management of the condition. Most platelet parameters that are routinely analysed in the diagnostic laboratory have not proven useful in identifying the aetiology while specialised assays suffer from poor standardisation and lack of agreement between laboratories. The immature platelet fraction (IPF), which indirectly provides a measure of bone marrow function is showing promise as a valuable marker of thrombopoietic responses. This study set out determine whether the IPF could effectively identify specific underlying aetiologies of thrombocytopenia in a large thrombocytopenic cohort, to allow for quicker, more effective management of the condition. The IPF was analysed in a large cohort of 637 thrombocytopenic patients and 171 healthy control patients on the Sysmex XN 10 haematology analyser using the specialised fluorescence optical analysis. The thrombocytopenic patients were divided into six cohorts based on aetiology. The IPF%, was significantly higher in cases of increased platelet consumption (median=9.55, min=1.1, max= 77.9), or pseudothrombocytopenia (median=13.1, min=0.4, max=28.8) compared with control (median=4.2, min=1.3, max=12.8). Furthermore, the IPF% was also able to identify idiopathic thrombocytopenic purpura (ITP) (P