Immature platelet fraction and bone marrow findings: diagnostic and prognostic value in hematology
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Bone marrow examination (BME) and the assessment of the immature platelet fraction (IPF) are crucial diagnostic tools in hematology. The IPF is the proportion of young, newly released platelets in the peripheral circulation. We performed a retrospective study of 1,552 patients with various hematologic disorders in which we evaluated the relationships between BME findings and IPF. Bone marrow aspirates and biopsies were assessed for their cellularity, the characteristics of the megakaryocytes, and the presence of dysplasia or malignant cells. The IPF was associated with BME findings and the final diagnoses made. Results showed IPF significantly correlated with megakaryocyte count in myelodysplastic syndrome (MDS) patients, though weakly (R²=0.251, p < 0.001). Immune thrombocytopenia patients exhibited markedly higher median IPF (14.8% vs. 3.0%, p < 0.001) compared to others. MDS patients displayed wide IPF variability (median: 6.8%, range: 0.40–43.5%), with IPF demonstrating high specificity for megakaryocyte abnormalities ( p < 0.001). The study highlights IPF's diagnostic utility alongside BME, particularly in distinguishing immune thrombocytopenia and identifying megakaryocyte-related pathologies in MDS, suggesting combined use could enhance diagnostic accuracy and inform treatment strategies for hematologic disorders.
