Interest of Immature Platelet Fraction (IPF) in the Etiological Diagnosis of Thrombocytopenia.

Background: Thrombocytopenia is a common hematological abnormality with diverse etiologies, including peripheral platelet destruction and central production failure. The Immature Platelet Fraction (IPF) is a new parameter that quantifies reticulated platelets and provides an indication of the quality of thrombopoiesis. Objective: This study aimed to evaluate the diagnostic utility of IPF in distinguishing thrombocytopenia etiologies. Methods: A prospective cross-sectional study was conducted on 120 thrombocytopenic patients for over two months at the Hematology Laboratory of Arrazi Hospital, Marrakesh. IPF was measured using a Sysmex XE-5000 analyzer. Statistical analyses included the Mann-Whitney U test, Kolmogorov-Smirnov test, and Receiver Operating Characteristic (ROC) curves to determine the IPF cutoff values and diagnostic accuracy. Results: The cohort included 46,7% males and 53,3% females, with a median age of 44 years. The median IPF was 8,0% [1.5–40,6%], with significantly higher values for peripheral thrombocytopenia (9,5%) than for central thrombocytopenia (6,0%; p = 0.019). ROC analysis yielded an Area Under the Curve (AUC) of 0,65, with a cutoff value of 8,1% (sensitivity, 65,9%; specificity, 78,6%). The Kolmogorov-Smirnov test confirmed significant differences in distribution between the groups (p = 0,003). Conclusion: IPF provides significant insights into thrombocytopenia etiologies, with higher levels observed in peripheral cases. While its moderate discriminatory capacity suggests the need for complementary diagnostic tools such as bone marrow aspiration in central thrombocytopenia. IPF remains a promising marker for improving the diagnostic accuracy in thrombocytopenia management. Standardization of cutoff values and larger studies are needed to refine its clinical application.