Immature platelet fraction measured on the Sysmex XN hemocytometer predicts thrombopoietic recovery after autologous stem cell transplantation

Noreen van der Linden*, Lieke J. J. Klinkenberg, Steven J. R. Meex, Erik A. M. Beckers, Norbert C. J. de Wit, Lenneke Prinzen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objectives: A period of thrombocytopenia is common after stem cell transplantation (SCT). To prevent serious bleeding complications, prophylactic platelet transfusions are administered. Previous studies have shown that a rise in immature platelets precedes recovery of platelet count. Our aim was to define a cutoff value for immature platelets predicting thrombopoietic recovery within 2 d. Methods: Hematological parameters were measured on the Sysmex XN hemocytometer. We calculated reference change values (RCV) for platelets in eight healthy individuals as marker for platelet recovery. To define a cutoff value, we performed ROC analysis using data from 16 autologous SCT patients. Results: RCV for platelet concentration was 14.1%. Platelet recovery was observed 13 (median; range 9-31) days after SCT. Increase in immature platelet fraction (IPF) before platelet recovery was seen in all autologous SCT patients. Optimal cutoff IPF was found to be 5.3% for platelet recovery within 2 d (specificity 0.98, sensitivity 0.47, positive predictive value 0.93). Conclusions: We identified an optimal cutoff value for IPF 5.3% to predict platelet recovery after autologous SCT within 2 d. Implementing this cutoff value in transfusion strategy may reduce the number of prophylactic platelet transfusions.
Original languageEnglish
Pages (from-to)150-156
JournalEuropean Journal of Haematology
Issue number2
Publication statusPublished - Aug 2014


  • immature platelet fraction
  • stem cell transplantation
  • thrombopoiesis
  • platelets
  • transfusion

Cite this