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Reticulated platelets and immature platelet fraction: Clinical applications and method limitations
Mauro Buttarello1, Giacomo Mezzapelle2, Francesca Freguglia3
1Department of Laboratory Medicine, Azienda Ospedaliera-Università di Padova, Padova, Italy.
International Journal of Laboratory Hematology
|March 12, 2020
Summary
Reticulated platelets, also known as immature platelets, are more reactive and contain more RNA than mature ones. Measuring these young platelets presents challenges due to technological limitations and a lack of standardization, impacting clinical interpretation.
Area of Science:
- Hematology
- Clinical Pathology
- Biomedical Engineering
Background:
- Reticulated platelets (immature platelets) are newly released, more reactive cells containing higher RNA content.
- Current methods for counting immature/reticulated platelets (RP) include flow cytometry and automated hematology analyzers, but with numerical disagreements.
- These young platelets have potential diagnostic and prognostic value in various clinical conditions.
Purpose of the Study:
- To review the current technologies for measuring immature/reticulated platelets (RP).
- To analyze the preanalytical, analytical, and postanalytical limitations of RP measurement.
- To explore the clinical utility of immature/RP in diverse medical settings.
Main Methods:
- Review of existing literature and technologies for immature/reticulated platelet (RP) quantification.
- Analysis of preanalytical factors (stability, variation), analytical methods (imprecision), and postanalytical aspects (reference ranges).
- Evaluation of clinical applications of immature/RP in thrombocytopenia, transplantation, cardiovascular diseases, and antiplatelet therapy response.
Main Results:
- Significant limitations exist in current immature/reticulated platelet (RP) measurement technologies, including method-dependent results and lack of universal standards.
- Clinical applications of immature/RP are identified, particularly in differential diagnosis of thrombocytopenia and monitoring transplantation recovery.
- Discrepancies between measurement techniques hinder inter-study comparisons, necessitating method-specific reference intervals.
Conclusions:
- Standardization of immature/reticulated platelet (RP) measurement is crucial for reliable clinical application.
- Development of specific RNA dyes and consideration of platelet size are needed for improved accuracy.
- A harmonized nomenclature, such as 'young platelets,' is proposed to better reflect the characteristics and functionality of this cell population.
