Clinical significance of immature platelet fraction in immune thrombocytopenia patients

Background and Aims:Immune thrombocytopenia (ITP) is an acquired isolated immune-mediated thrombocytopenia that affects both children and adults,with platelet count <100×109/L.It is mainly diagnosed by exclusion of other causes of thrombocytopenia.Immature platelet fraction (IPF%)is an automated parameter which measures the percentage of immature platelets that are newly released from the bone marrow to the peripheral blood.It’s calculated as a proportion of the total number of platelets.The aim of this study was to investigate the diagnostic performance and clinical implications of IPF% in ITP patients. Subjects and Methods:A total of 82 patients with ITP were assigned into 3 groups:28 newly diagnosed ITP (ND-ITP),30 chronic ITP (C-ITP),24 refractory ITP (R-ITP),in addition to 48 healthy volunteers who served as age and sex matched control group.IPF% was assessed using automated cell counter,ADVIA 2120i Siemens Healthcare, Germany, and compared among the different groups of the study,the relation between platelet count and IPF% was also studied. Results:IPF% was significantly higher among ITP cases compared to healthy controls. It was significantly higher in ND-ITP patients when compared to healthy controls (p=0.001),C-ITP patients (p=0.01)and R-ITP patients (p=0.03) as well.There was a significant negative fair correlation between platelet count and IPF%(r= -0.34;p=.001).ROC curve analysis for IPF% showed that IPF% had AUC of 0.91(95%CI=0.86-0.96;p=0.001)at a cut-off value of 1.97% that yielded a sensitivity,specificity,PPV,NPV and diagnostic accuracy of 94%,53%,77%,83.3%and78.5% respectively. Conclusion:IPF% proved its role as a potential diagnostic marker for prediction of ITP patients. Due to its non-invasive nature,it could be helpful in quickening the management of thrombocytopenia joined with enhanced IPF%.