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Reticulated platelets
P Harrison1, M S Robinson, I J Mackie
1Department of Haematology, University College Hospital, London, UK.
Abstract:
Young or reticulated platelets contain some residual mRNA, which is rapidly degraded after platelet release into the circulation. They can be easily detected either with supravital dye staining (e.g. new methylene blue) on blood films, or more commonly with fluorescent dyes (e.g thiazole orange) and flow cytometry. Using the latter technique many different groups have demonstrated that the measurement of reticulated platelets has much clinical potential. It is apparent that the level of reticulated platelets gives a relatively simple and non-invasive measurement of the rate of thrombopoiesis in an analogous fashion to the red cell reticulocyte count. Many research groups are currently measuring reticulated platelets but with wide variation in data and methods. An international platelet panel has begun to develop protocols and between laboratory comparisons, which will result in the standardization of the procedure. Platelet reticulocyte analysis should thus become part of accepted haematological practice and provide useful clinical information for the investigation and monitoring of platelet production in various thrombocytopenic conditions. In particular, measurement of reticulated platelets will provide an excellent and simple means for monitoring the response of chemotherapy and transplant patients to growth factors (e.g. thrombopoietin) resulting in a decrease in the demand for platelet transfusion.
Insights
Reticulated platelets, young circulating platelets, offer a simple, non-invasive measure of thrombopoiesis, or platelet production. Standardizing their measurement will enhance clinical use in managing thrombocytopenic conditions and monitoring treatment responses.
Area of Science:
- Hematology
- Clinical Pathology
Background:
- Young platelets, termed reticulated platelets, contain residual mRNA.
- Their detection is possible via supravital dye staining or fluorescent dyes with flow cytometry.
- Reticulated platelet counts reflect thrombopoiesis rates, similar to reticulocyte counts for red blood cells.
Purpose of the Study:
- To highlight the clinical potential of measuring reticulated platelets.
- To emphasize the need for standardized methods in reticulated platelet analysis.
- To establish reticulated platelet counts as a valuable tool in hematological practice.
Main Methods:
- Detection of reticulated platelets using fluorescent dyes and flow cytometry.
- Comparison of various methods and data across different research groups.
- Initiation of an international panel to develop standardized protocols.
Main Results:
- Reticulated platelet measurement provides a non-invasive assessment of thrombopoiesis.
- Current methods show significant variation, hindering widespread clinical adoption.
- Standardization efforts are underway to ensure reliable and reproducible results.
Conclusions:
- Reticulated platelet analysis holds significant clinical potential for diagnosing and monitoring thrombocytopenic disorders.
- Standardized measurement will facilitate its integration into routine hematological practice.
- This analysis can effectively monitor patient responses to growth factors, potentially reducing platelet transfusion needs.
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