Mean platelet diameter measurements to classify inherited thrombocytopenias

Introduction Mean platelet volume (MPV) assists the differential diagnosis of inherited thrombocytopenia (IT) but lacks standardisation and varies between automated analysers. Classification of IT based on mean platelet diameter (MPD) has been proposed by an international collaborative study but has...

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Published in:	International journal of laboratory hematology Vol. 40; no. 2; pp. 187 - 195
Main Authors:	Fixter, K., Rabbolini, D. J., Valecha, B., Morel‐Kopp, M.‐C., Gabrielli, S., Chen, Q., Stevenson, W. S., Ward, C. M.
Format:	Journal Article
Language:	English
Published:	England Wiley Subscription Services, Inc 01-04-2018
Subjects:	Classification Differential diagnosis inherited thrombocytopenia macrothrombocytopenia mean platelet diameter mean platelet volume Platelets Runx1 protein Thrombocytopenia mean platelet diameter macrothrombocytopenia platelets inherited thrombocytopenia mean platelet volume
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Summary:	Introduction Mean platelet volume (MPV) assists the differential diagnosis of inherited thrombocytopenia (IT) but lacks standardisation and varies between automated analysers. Classification of IT based on mean platelet diameter (MPD) has been proposed by an international collaborative study but has not been validated. Methods To assess the applicability of MPD to classify forms of IT, digital images of blood films from patients with established genetic causes for IT were generated, and the MPD measured (ZEISS Axio‐scanner and Image J software) by a blinded reviewer. Comparison was made to the proposed classification system. Results Mean platelet volume was measured in thrombocytopenia with different genetic aetiologies, bilallelic BSS (bBSS) (n = 1), monoallelic BSS (mBSS) (n = 2), MYH9‐related disorders (MYH9‐RD) (n = 11), GFI1B‐related thrombocytopenia (RT) (n = 15), FLI1‐RT (n = 2), TUBB1‐RT (n = 3), ITGA2B/ITGB3‐RT (n = 1), RUNX1‐RT (n = 2) and controls (n = 54). bBSS and 82% of MYH9‐RD samples had MPD >4 μm which correlated with “IT with giant platelets.” Only 55% of samples expected in the “large platelet group” had MPD meeting the classification cut‐off (MPD >3.2 μm). FLI1‐RT MPD were significantly larger than expected whilst ITGA2B/ITGB3‐RT MPD were smaller than proposed. MPD in FPD/AML were “normal.” Conclusion Platelet MPD measurements are a useful guide to classify IT, but the time taken to record measurements may limit clinical applicability.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1751-5521 1751-553X
DOI:	10.1111/ijlh.12763