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Stability over time of immature platelet fraction and comparison between EDTA and citrated whole blood samples
Marc Michel Noel1, Guillaume Feugray2,3, Fiston Kasonga1
1CHU Rouen, Vascular Hemostasis Unit, Rouen, France.
Insights
Immature platelet (IP) measurements are stable up to 24 hours in EDTA and 6 hours in citrate samples. This research supports the clinical utility of immature platelet fraction (IPF) analysis in diagnosing thrombocytopenia.
Area of Science:
- Hematology
- Clinical Pathology
- Diagnostic Research
Background:
- Immature platelets (IP) are young, active platelets crucial for diagnosing thrombocytopenia.
- Understanding IP variability and stability is essential for reliable clinical application.
Purpose of the Study:
- To compare immature platelet (IP) variability in citrate versus EDTA anticoagulant samples.
- To determine the stability of IP measurements over time in both sample types.
Main Methods:
- Fifty-six patients, including 28 with thrombocytopenia, were analyzed.
- Platelet counts and immature platelet fraction (IPF) were measured using Sysmex XN-9000 (impedancemetry and fluorimetry).
- IPF and absolute immature platelet count (A-IPC) were determined via fluorescent methods.
Main Results:
- No significant difference in IPF was found between EDTA (7.74±6.68%) and citrate (8.45±7.37%) samples.
- IPF measurements showed stability up to 24 hours in EDTA and 6 hours in citrate samples.
- Bland-Altman analysis confirmed stability within specified timeframes for both anticoagulants.
Conclusions:
- IP measurements are reliable up to 24 hours in EDTA and 6 hours in citrate samples.
- These findings support the potential clinical utility of IPF analysis.
- Further standardization is needed to fully define IPF's role in clinical practice.
Background:
Immature platelets (IP) are the youngest circulating platelets, released from megakaryocytes, and demonstrating increased dimensions, significant RNA content, and enhanced activity. Immature platelet research focuses on a differential diagnostic help in patients with thrombocytopenia. The objectives of this study were to compare the variability of IP in citrate and EDTA samples, and to determine stability over time.
Methods:
Fifty-six patients were included for comparison between EDTA and citrate whole blood sample collection. Among the patients, 28 had thrombocytopenia (platelet count < 150G/L). Platelet measurement impedancemetry and fluorimetry were performed with Sysmex XN-9000. The immature platelet fraction (IPF) and absolute immature platelet count (A-IPC) were determined with a fluorescent method.
Results:
The mean value of platelet count with fluorescence was, in EDTA sample, 215 ± 171 and, in citrate sample, 153 ± 118 G/L. No significant difference was observed between IPF between EDTA and citrate (7.74 ± 6.68% vs. 8.45 ± 7.37%, p = 0.69), respectively. With the Bland-Altman analysis, the mean difference in the EDTA sample, between 1 and 24 h, was 8.06 ± 6.96% and 8.73 ± 7.12% for IPF, whereas in the citrate sample, between 1 and 6 h, it was 8.60 ± 7.29% and 7.54 ± 6.97%, for IPF. Comparing 1 h EDTA sample with 6 h citrate sample, the variance ratio was 0.974 (95% CI: 0.864-1.084) in IPF.
Conclusions:
We confirmed the potential to conduct IP measurements up to 24 h in the EDTA sample and IPF measurements in the citrate sample for up to 6 h. These results may be useful for the use of IPF, which is a promising parameter whose interest in clinical practice and standardization is not yet well defined.
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