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Estimation of a cut-off value for immature platelet fraction (IPF) in predicting platelet recovery in dengue patients with thrombocytopenia

Ahmad J, Md Noor S, Mustapha SZ, Idris F

Malays J Pathol, 2022 Dec;44(3):499-508.
PMID: 36591717

INTRODUCTION: Thrombocytopenia is a common complication in dengue that sometimes necessitates platelet transfusion. Immature platelet fraction (IPF) measures immature platelets that indirectly reflect thrombopoiesis and is helpful in predicting platelet recovery.
OBJECTIVES: This study aimed to evaluate the role of IPF% and identify its cut-off value in predicting platelet recovery in dengue patients with thrombocytopenia.
MATERIALS AND METHODS: Serial platelet count and IPF results were obtained from fifty-four confirmed dengue patients with platelet count <50x109 /L. Median peak IPF% and number of patients with platelet recovery were determined. Receiver operating characteristic (ROC) curve is generated to identify the IPF% cut-off value to predict platelet recovery.
RESULTS: Median peak IPF% among dengue patients was 12.15% with 83.3% of them achieving platelet recovery after reaching the peak IPF%. There was a significant difference between median IPF% on day one of admission with peak IPF% among dengue patients. ROC curve analysis showed IFP% of 10.55% can be used to predict platelet recovery with a sensitivity of 69% and a specificity of 67%.
CONCLUSION: IPF% is a reliable and useful parameter in predicting platelet recovery in dengue patients. This would assist the clinician in managing dengue patients especially those with severe thrombocytopenia without giving unnecessary platelet transfusion.

Matched MeSH terms: Platelet Transfusion/adverse effects
Fulltext Disseminated fusariosis and endogenous fungal endophthalmitis in acute lymphoblastic leukemia following platelet transfusion possibly due to transfusion-related immunomodulation

Kah TA, Yong KC, Rahman RA

BMC Ophthalmol, 2011;11:30.
PMID: 22044440 DOI: 10.1186/1471-2415-11-30

To report a case of disseminated fusariosis with endogenous endophthalmitis in a patient with acute lymphoblastic leukemia. Transfusion-associated immune modulation secondary to platelet transfusion could play an important role in the pathophysiology of this case.

Matched MeSH terms: Platelet Transfusion/adverse effects*
Acute hemolytic transfusion reaction following ABO-mismatched platelet transfusion: Two case reports

Zulkeflee RH, Hassan MN, Hassan R, Saidin NIS, Zulkafli Z, Ramli M, et al.

Transfus Apher Sci, 2023 Jun;62(3):103658.
PMID: 36805153 DOI: 10.1016/j.transci.2023.103658

Acute hemolytic transfusion reaction following ABO-incompatible platelet transfusion: two case reports An ideal platelet transfusion should provide ABO identical platelet concentrate, and cross match compatibility is not routinely performed in the standard practices. However, ABO non identical platelet transfusions are not uncommon with the limited resources and short shelf life of platelet concentrate. Though rare, acute hemolytic transfusion reaction (AHTR) may occur following minor ABO-incompatible platelet transfusion. Here, we report two cases of thrombocytopenic patients (one child and one adult) type as Group B RhD positive and received Group O RhD positive platelet transfusions. Both patients experienced an AHTR evidenced by a drop in hemoglobin level, spherocytosis and small agglutinations on the blood film, and positive direct Coombs test. They were treated symptomatically, recovered and discharged well post-event without any morbidity. No anti-B isohemagglutinins titer were done to confirm the high titer of the antibody in the platelet donors. Our cases highlighted the importance of ABO-compatible platelet transfusion, especially to children and those vigilant groups of patients.

Matched MeSH terms: Platelet Transfusion/adverse effects

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