Evaluation of a diagnostic platelet aggregation test strategy for platelet rich plasma samples with low platelet counts.
Int J Lab Hematol
; 46(2): 362-374, 2024 Apr.
Article
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| MEDLINE
| ID: mdl-38148642
ABSTRACT
INTRODUCTION:
Light transmission aggregometry (LTA) is important for diagnosing platelet function disorders (PFD) and von Willebrand disease (VWD) affecting ristocetin-induced platelet aggregation (RIPA). Nonetheless, data is lacking on the utility of LTA for investigating thrombocytopenic patients and platelet rich plasma samples with low platelet counts (L-PRP). Previously, we developed a strategy for diagnostic LTA assessment of L-PRP that included (1) acceptance of referrals/samples, regardless of thrombocytopenia severity, (2) tailored agonist selection, based on which are informative for L-PRP with mildly or severely low platelet counts, and (3) interpretation of maximal aggregation (MA) using regression-derived 95% confidence intervals, determined for diluted control L-PRP (C-L-PRP).METHODS:
To further evaluate the L-PRP LTA strategy, we evaluated findings for a subsequent patient cohort.RESULTS:
Between 2008 and 2021, the L-PRP strategy was applied to 211 samples (11.7% of all LTA samples) from 192 unique patients, whose platelet counts (median [range] × 109 /L) for blood and L-PRP were 105 [13-282; 89% with thrombocytopenia] and 164 [17-249], respectively. Patient-L-PRP had more abnormal MA findings than simultaneously tested C-L-PRP (p-values <0.001). Among patients with accessible electronic medical records (n = 181), L-PRP LTA uncovered significant aggregation abnormalities in 45 (24.9%), including 18/30 (60%) with <80 × 109 platelets/L L-PRP, and ruled out PFD, and VWD affecting RIPA, in others. The L-PRP LTA strategy helped diagnose VWD affecting RIPA, Bernard Soulier syndrome, familial platelet disorder with myeloid malignancy, suspected ITGA2B/ITGB3-related thrombocytopenia, and acquired PFD.CONCLUSION:
Diagnostic LTA with L-PRP, using a strategy that considers thrombocytopenia severity, is feasible and informative.Palabras clave
Texto completo:
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Bases de datos:
MEDLINE
Asunto principal:
Trombocitopenia
/
Enfermedades de von Willebrand
/
Trastornos de las Plaquetas Sanguíneas
/
Plasma Rico en Plaquetas
Límite:
Humans
Idioma:
En
Revista:
Int J Lab Hematol
Asunto de la revista:
HEMATOLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Canadá