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Consensus on Aggregometry for platelet function testing in thrombocytopenic patients: Communication from the SSC of
Ruchika Sharma1, Georges Jourdi2, Ishac Nazy3
1Pediatric Hematology and Oncology, University of Texas Southwestern Medical Center and Children's Health, Dallas, Texas, USA.
Background:
There is an unmet need for improving platelet function testing methods in patients with low platelet count. Platelet aggregometry is recommended for platelet function testing; however, no specific guidelines on technical and performance aspects do hitherto exist for aggregometry in patients with low platelet counts.
Objectives:
The goal of this joint project between the International Society on Thrombosis and Haemostasis (ISTH) Scientific Standardization Committees on platelets in health and disease and immune-mediated platelet disorders is to provide an expert consensus on the use of aggregometry (light transmission and impedance based) for the evaluation of platelet function in patients with low platelet counts.
Methods:
A literature review was performed to identify relevant questions and areas of uncertainty. An electronic expression of interest form was announced on the ISTH webpage, followed by a survey encompassing 38 questions regarding preanalytical, analytical, postanalytical, and performance aspects. Areas of disagreement or uncertainty were identified and formed the basis for 2 focus group discussions.
Results:
Considerations relative to patient sample collection, preanalytical variables, sample type, platelet count cutoff, and potential specific modification of the standard aggregometry protocol are proposed based on the current practices, as identified in the literature and consensus of experts in the field.
Conclusions:
The proposed considerations would facilitate standardization of laboratory practices. Large multicenter studies are still needed to test some of the proposed technical considerations and compare the clinical utility of aggregometry with other methods such as flow cytometry assays for platelet function testing to identify platelet-associated defects and/or predict bleeding risk in patients with thrombocytopenia.
