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Immature Platelet Fraction – IPF

What is Immature Platelet Fraction counting?

The immature platelet fraction (%IPF) is a modern parameter that measures young and thereby reticulated platelets in peripheral blood. The reference range is approximately 1 to 5% of the total platelet count.

IPF levels rise as bone marrow production of platelets increases. Therefore its measurement provides an assessment of bone marrow platelet production from a peripheral blood sample, in a similar way to how a reticulocyte count could provide a measure of red cell production.

There is a high clinical utility of the %IPF in the laboratory diagnosis and treatment of thrombocytopenia due to the ability to relate raised %IPF levels with increased peripheral platelet destruction. It is particularly useful for supporting the diagnosis of autoimmune thrombocytopenic purpura, thrombotic thrombocytopenic purpura and for distinguishing these from bone marrow suppression or failure. In the case of the latter, the %IPF value would be low.

The %IPF can also be a sensitive measure for evaluating thrombopoietic recovery during aplastic chemotherapy. In some specialist haematology and cancer centres, for instance, %IPF is taken into consideration in platelet transfusions.  Transfusions may only be considered when the %IPF values are not rising as this would indicate poor intrinsic thrombopoietic activity.

Where to use IPF?

Since destruction-mediated thrombocytopenic diseases are fairly rare, IPF is most useful in environments that service a large number of patients. Good examples include laboratories of large hospitals with haemato-oncologic units, paediatric units / neonatology units for differential diagnosis of juvenile thrombocytopenia and/or monitoring of the course of thrombocytopenia.

 

 

Benefits

The IPF count supports clinicians in differentiating between consumptive versus productive reasons for thrombocytopenia and helps avoid a bone marrow biopsy with obvious benefits for the patient. This clinical utility in cases of thrombocytopenia is proven. Its usefulness in monitoring after chemotherapy and haematopoietic stem cell / bone marrow transplantation has been suggested.

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