Immature platelet fraction

The immature platelet fraction (IPF) is a rapid automated measure of the least mature component of the platelet population and is thought to correlate with thrombopoietic activity of the marrow.

Immature Platelet Fraction

Useful test in the evaluation of thrombocytopenia.

It allows quantification of immature platelets, and may be used as an index of bone marrow thrombopoietic activity, analogous to the red cell reticulocyte count in the evaluation of anemia.

Newly released platelets contain residual RNA and were originally termed reticulated platelets.

Measurement of reticulated platelets can help differentiate whether thrombocytopenia is secondary to decreased production or peripheral destruction of platelets.

Hematology analyzers use flow cytometry and a fluorescent RNA binding dye to quantitate immature platelets, and this is called the immature platelet fraction (IPF).

This automated IPF assay is useful in differentiating aplastic from peripheral consumptive causes of thrombocytopenia.

Patients with immune thrombocytopenia purpura (ITP) demonstrate the highest IPF values of all the patients studied.

High IPF indicates active platelet production in the setting of peripheral platelet destruction.

Raised IPF values are seen in 73% of patients with ITP, and 100% of ITP patients with a platelet count below 50 th/uL.

Patients with active thrombotic thrombocytopenic purpura (TTP) also have high IPF values.

Patients with ITP and TTP in remission generally had low IPF values.

Patients with thrombocytopenia secondary to chemotherapy had low IPF values, indicative of decreased platelet production.

Patients with peripheral platelet destruction (ITP and DIC) have significantly higher IPF values than those with marrow suppression due to aplastic anemia and cancer.

An elevated level is indicative of peripheral platelet destruction, for example ITP, TTP, or DIC, whereas a normal level is suggestive of decreased platelet production, for example drug-induced marrow suppression or aplastic anemia.

IPF is a predictor of platelet recovery following peripheral blood hematopoietic progenitor cell (HPC) transplantation.

Monitoring IPF may guide and possibly limit the use of prophylactic platelet transfusions, in view of anticipated imminent recovery of the platelet count.

Reference range is 1.1-7.1%.

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