EVALUATING THE ROLE OF IMMATURE PLATELET FRACTION IN PLATELET ENGRAFTMENT IN HEMATOPOIETIC STEM CELL TRANSPLANTATION

Background: Hematopoietic stem cell transplantation (HSCT) is a bone marrow condition in which platelet engraftment is a vital indicator of the condition. The immature platelet fraction (IPF) refers to the percentage composition of the recently formed platelets and could be used as a biomarker of prognosis of platelet recovery. The objective of this study was to conduct a test concerning the application of IPF in the measurement of the platelet engraftment in patients in the HSCT. Methods: The study was a descriptive one that took place within a 6 months time span in Shifa International Hospital. The consecutive sampling method was used to select the patients who underwent allogeneic or autologous transplantation of severe hematological disorders with the age of 30 between 15-60 years. Cases with grafted versus disease and other cases who were not of the age bracket were disqualified. To determine the relationship between platelet engraftment and IPF, as well as platelet count, on days 9 and 14 after the transplant, IPF and platelet counts were measured. Paired t-tests, ANOVA, and chi-square tests were used to perform the statistical analysis and the p-value below 0.05 was used to accept the significance. Results: It was revealed that IPF rose significantly in day 9 (4.35 ± 1.46%) to day 14 (5.68 ± 2.26) following HSCT (t = 3.21, p = 0.004) indicating that there was active platelet production in the early engraftment. The platelet measures were on an increasing trend and it was in agreement with increments of IPF. There were differences in age between the time of platelet engraftment (F = 5.48, p = 0.009) with the young patients (15-30 years old) having a higher platelet engraftment rate (9.2 ± 1.5 days) than the old patients. It further was discovered that, gender difference was critical, and the male engrafted far earlier (9.5 ± 1.6 days) in comparison to the female (10.8 ± 2.1 days) (t = 2.12, p = 0.043). Conclusion: IPF results are the basis of support that the platelet engraftment prediction and follow-up after HSCT are a useful biomarker. Platelet counts and IPF follow-up can potentially be used to improve clinical care, such as early detection of platelet recovery and transfusiveness. In other studies, the cohort size must be larger to confirm these findings.