Diagnostic value of immature platelet fraction for detecting production disorders in thrombocytopenia

Abstract

Link of Video Abstract: https://youtu.be/FrXavnzSY3Q   Introduction: Impaired platelet production is one of the causes of thrombocytopenia. Immature platelet fraction (IPF) shows the proportion of young platelets in peripheral blood. A decrease in the number of young platelets reflects a decrease in the thrombopoiesis process. This suggests that young platelets can be a marker for measuring megakaryopoiesis activity. This study aimed to determine the diagnostic value of IPF. Methods: The sample will be divided into two groups; groups suspected of production disturbances and groups not suspected of production disturbances. In the group with suspected production disorders, bone marrow aspiration (BMA) will be carried out to determine a definitive diagnosis. Meanwhile, in the group not suspected of production disruption, bias work-up will be carried out. After that, descriptive statistical analysis, ROC analysis and diagnostic tests will be carried out. Result: This study used 81 cases of thrombocytopenia with a proportion of 49 (60.5%) in the production disorder group and 32 (39.5%) in the non-production disorder group. The IPF% value in the production disruption group is significantly lower than the non-production disruption group 3.1% (0.3-21.4) vs 13% (2.0-49.2) p value <0.001. The results of calculations using ROC analysis in this study showed an AUC of 0.917 (95% confidence interval (CI): 0.853-0.981, p<0.001). The results of the analysis set a cut-off value of 7.5% at sensitivity 83.7%, specificity 84.4%, PPV 89.1%, NPV 77.1%, LR+ 5.53, LR- 0.19, prevalence 60.4%, and 83.9% accuracy. Conclusion: The results of this study showed that IPF% AUC was 0.917, indicating that IPF% was very good for distinguishing production disorders from theombocytopenia with an accuracy of 83.9%.