title: Immature platelet fraction measured on the Sysmex XN hemocytometer predicts thrombopoietic recovery after autologous stem cell transplantation.
abstract: OBJECTIVE
  A period of thrombocytopenia is common after stem cell transplantation (SCT). To prevent serious bleeding complications, prophylactic platelet transfusions are administered. Previous studies have shown that a rise in immature platelets precedes recovery of platelet count. Our aim was to define a cutoff value for immature platelets predicting thrombopoietic recovery within 2 d.
  
  
  METHODS
  Hematological parameters were measured on the Sysmex XN hemocytometer. We calculated reference change values (RCV) for platelets in eight healthy individuals as marker for platelet recovery. To define a cutoff value, we performed ROC analysis using data from 16 autologous SCT patients.
  
  
  RESULTS
  RCV for platelet concentration was 14.1%. Platelet recovery was observed 13 (median; range 9-31) days after SCT. Increase in immature platelet fraction (IPF) before platelet recovery was seen in all autologous SCT patients. Optimal cutoff IPF was found to be 5.3% for platelet recovery within 2 d (specificity 0.98, sensitivity 0.47, positive predictive value 0.93).
  
  
  CONCLUSIONS
  We identified an optimal cutoff value for IPF 5.3% to predict platelet recovery after autologous SCT within 2 d. Implementing this cutoff value in transfusion strategy may reduce the number of prophylactic platelet transfusions.
authors.affiliation: Central Diagnostic Laboratory, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Noreen
authors.initials: N
authors.lastname: van der Linden
authors.forename: Lieke J J
authors.initials: LJ
authors.lastname: Klinkenberg
authors.forename: Steven J R
authors.initials: SJ
authors.lastname: Meex
authors.forename: Erik A M
authors.initials: EA
authors.lastname: Beckers
authors.forename: Norbert C J
authors.initials: NC
authors.lastname: de Wit
authors.forename: Lenneke
authors.initials: L
authors.lastname: Prinzen
mesh_terms: D000328:Adult; D000368:Aged; D057205:Automation, Laboratory; D001792:Blood Platelets / Q000166:cytology*; D002454:Cell Differentiation; D005260:Female; D019337:Hematologic Neoplasms / Q000473:pathology / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D017713:Platelet Transfusion; D012372:ROC Curve; D012016:Reference Values; D013921:Thrombocytopenia / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D013997:Time Factors; D014182:Transplantation, Autologous
keywords: immature platelet fraction; platelets; stem cell transplantation; thrombopoiesis; transfusion