Evaluation of a diagnostic platelet aggregation test strategy for platelet rich plasma samples with low platelet counts.

Autor:	Altahan, Rahaf Mahmoud, Mathews, Natalie, Bourguignon, Alex, Tasneem, Subia, Arnold, Donald M., Lim, Wendy, Hayward, Catherine P. M.
Předmět:	BLOOD platelet aggregation PLATELET count BLOOD coagulation disorders RESEARCH funding BLOOD collection PLATELET-rich plasma DESCRIPTIVE statistics THROMBOCYTOPENIA PLATELET function tests BLOOD platelet disorders GENETIC disorders ELECTRONIC health records COMPARATIVE studies HEMOSTASIS VON Willebrand disease CONFIDENCE intervals SENSITIVITY & specificity (Statistics) VASCULAR diseases
Zdroj:	International Journal of Laboratory Hematology; Apr2024, Vol. 46 Issue 2, p362-374, 13p
Abstrakt:	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. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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