Abstract
Platelet regeneration represents an important and separate element in the engraftment process for allogeneic stem cell transplantation. Fully automated flow cytometry using blood cell counters now allows reliable quantification of reticulated platelets, expressed as the immature platelet fraction (IPF). We studied the kinetics of IPF in six patients grafted with allogeneic peripheral blood stem cell transplantation (PBSCT), 12 patients with bone marrow transplantation (BMT) and seven patients with cord blood transplantation (CBT). Preconditioning therapy caused an immediate and rapid fall in tri-lineage hematopoiesis. IPF rose transiently above 3% after a mean duration of 11 days post-PBSCT, 18 days post-BMT and 19 days post-CBT. This was 1, 4 and 13 days earlier than platelet engraftment, respectively. A linear correlation model showed a close association between the rise of IPF and tri-lineage engraftment after transplantation. IPF counting may thus provide an accessible measure of thrombopoietic activity, leading to early evaluation of marrow function and allowing monitoring of platelet regeneration.
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References
Diaconescu R, Storb R . Allogeneic hematopoietic cell transplantation: from experimental biology to clinical care. J Cancer Res Clin Oncol 2005; 131: 1–13.
Arcese W, Rocha V, Labopin M, Sanz G, Iori AP, de Lima M et al. Unrelated cord blood transplants in adults with hematologic malignancies. Haematologica 2006; 91: 223–230.
Rocha V, Wagner Jr JE, Sobocinski KA, Klein JP, Zhang MJ, Horowitz MM et al. Graft-versus-host disease in children who have received a cord-blood or bone marrow transplant from an HLA-identical sibling. Eurocord and International Bone Marrow Transplant Registry Working Committee on Alternative Donor and Stem Cell Sources. N Engl J Med 2000; 342: 1846–1854.
Davis BH, Bigelow N, Ball ED, Mills L, Cornwell III GG . Utility of flow cytometric reticulocyte quantification as a predictor of engraftment in autologous bone marrow transplantation. Am J Hematol 1989; 32: 81–87.
Greinix HT, Linkesch W, Keil F, Kalhs P, Schwarzinger I, Schneider B et al. Early detection of hematopoietic engraftment after bone marrow and peripheral blood stem cell transplantation by highly fluorescent reticulocyte counts. Bone Marrow Transplant 1994; 14: 307–313.
Davies SV, Cavill I, Bentley N, Fegan CD, Poynton CH, Whittaker JA . Evaluation of erythropoiesis after bone marrow transplantation: quantitative reticulocyte counting. Br J Haematol 1992; 81: 12–17.
Nakao S, Zeng W, Yamazaki H, Wang H, Takami A, Sugimori N et al. Early establishment of hematopoietic chimerism following allogeneic peripheral blood stem cell transplantation in comparison with allogeneic bone marrow transplantation. Eur J Haematol 1999; 62: 265–270.
Abe Y, Wada H, Tomatsu H, Sakaguchi A, Nishioka J, Yabu Y et al. A simple technique to determine thrombopoiesis level using immature platelet fraction (IPF). Thromb Res 2006; 118: 463–469.
Briggs C, Kunka S, Hart D, Oguni S, Machin SJ . Assessment of an immature platelet fraction (IPF) in peripheral thrombocytopenia. Br J Haematol 2004; 126: 93–99.
Kurata Y, Hayashi S, Kiyoi T, Kosugi S, Kashiwagi H, Honda S et al. Diagnostic value of tests for reticulated platelets, plasma glycocalicin, and thrombopoietin levels for discriminating between hyperdestructive and hypoplastic thrombocytopenia. Am J Clin Pathol 2001; 115: 656–664.
Koh KR, Yamane T, Ohta K, Hino M, Takubo T, Tatsumi N . Pathophysiological significance of simultaneous measurement of reticulated platelets, large platelets and serum thrombopoietin in non-neoplastic thrombocytopenic disorders. Eur J Haematol 1999; 63: 295–301.
Takubo T, Yamane T, Hino M, Tsuda I, Tatsumi N . Usefulness of determining reticulated and large platelets in idiopathic thrombocytopenic purpura. Acta Haematol 1998; 99: 109–110.
Ault KA, Rinder HM, Mitchell J, Carmody MB, Vary CP, Hillman RS . The significance of platelets with increased RNA content (reticulated platelets). A measure of the rate of thrombopoiesis. Am J Clin Pathol 1992; 98: 637–646.
Briggs C, Hart D, Kunka S, Oguni S, Machin SJ . Immature platelet fraction measurement: a future guide to platelet transfusion requirement after haematopoietic stem cell transplantation. Transfus Med 2006; 16: 101–109.
Richards EM, Baglin TP . Quantitation of reticulated platelets: methodology and clinical application. Br J Haematol 1995; 91: 445–451.
Rinder HM, Munz UJ, Ault KA, Bonan JL, Smith BR . Reticulated platelets in the evaluation of thrombopoietic disorders. Arch Pathol Lab Med 1993; 117: 606–610.
Zucker ML, Murphy CA, Rachel JM, Martinez GA, Abhyankar S, McGuirk JP et al. Immature platelet fraction as a predictor of platelet recovery following hematopoietic progenitor cell transplantation. Lab Hematol 2006; 12: 125–130.
Torres A, Sanchez J, Lakomsky D, Serrano J, Alvarez MA, Martin C et al. Assessment of hematologic progenitor engraftment by complete reticulocyte maturation parameters after autologous and allogeneic hematopoietic stem cell transplantation. Haematologica 2001; 86: 24–29.
Lacombe F, Lacoste L, Vial JP, Briais A, Reiffers J, Boisseau MR et al. Automated reticulocyte counting and immature reticulocyte fraction measurement. Comparison of ABX PENTRA 120 Retic, Sysmex R-2000, flow cytometry, and manual counts. Am J Clin Pathol 1999; 112: 677–686.
Ingram M, Coopersmith A . Reticulated platelets following acute blood loss. Br J Haematol 1969; 17: 225–229.
Kienast J, Schmitz G . Flow cytometric analysis of thiazole orange uptake by platelets: a diagnostic aid in the evaluation of thrombocytopenic disorders. Blood 1990; 75: 116–121.
O'Malley CJ, Rasko JE, Basser RL, McGrath KM, Cebon J, Grigg AP et al. Administration of pegylated recombinant human megakaryocyte growth and development factor to humans stimulates the production of functional platelets that show no evidence of in vivo activation. Blood 1996; 88: 3288–3298.
Yamazaki R, Kuwana M, Mori T, Okazaki Y, Kawakami Y, Ikeda Y et al. Prolonged thrombocytopenia after allogeneic hematopoietic stem cell transplantation: associations with impaired platelet production and increased platelet turnover. Bone Marrow Transplant 2006; 38: 377–384.
Spanish Multicentric Study Group for Hematopoietic Recovery. Flow cytometric reticulocyte quantification in the evaluation of hematologic recovery. Eur J Haematol 1994; 53: 293–297.
Acknowledgements
This work was supported in part by Grants-in-Aid for Scientific Research from the Ministry of Education, Science, Technology, Sports and Culture (KAKENHI 18591049) and from the Ministry of Health, Labor and Welfare, Japan. We are indebted to the patients and their families, the Japan Bone Marrow Donor Program, the Japan Cord Blood Network, the staff at the Division of Hematology and Oncology at Kanazawa University Medical Center, and Kayo Goto and Rie Ohmi for excellent technical assistance.
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Takami, A., Shibayama, M., Orito, M. et al. Immature platelet fraction for prediction of platelet engraftment after allogeneic stem cell transplantation. Bone Marrow Transplant 39, 501–507 (2007). https://doi.org/10.1038/sj.bmt.1705623
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DOI: https://doi.org/10.1038/sj.bmt.1705623
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