What is Immature platelet fraction(IPF)?


Recent advancements in laboratory diagnostics have introduced a new parameter known as Immature Platelet Fraction (IPF), offering valuable insights into platelet production dynamics and clinical utility.

Understanding Immature Platelet Fraction (IPF):

IPF represents the percentage of immature platelets in the total platelet population. These immature platelets, also known as reticulated platelets, are newly synthesized and released into circulation by the bone marrow. Unlike mature platelets, they retain remnants of RNA, allowing for their identification and quantification through specialized laboratory tests.

Test principle

Hematology analyzers can calculate the absolute numbers of immature platelets and their proportions relative to mature platelets. Fluorescent dye penetrates the cell membrane and stains the RNA in platelet, and stained cells are then passed through a semiconductor diode laser beam. the resulting forward light scatter denotes cell volume intensity of fluorescence denotes RNA content

The normal range of IPF is 1-7%

Clinical Applications of Immature Platelet Fraction:

  1. Differentiate the cause of thrombocytopenia : It helps in distinguishing between bone marrow failure or suppression vs increased peripheral destruction of platelet. IPF is decreased in bone marrow failure or suppression and increased in conditions with increased peripheral destruction like autoimmune thrombocytopenic purpura.
  2. Monitoring Response to Therapy: IPF can be utilized to assess the efficacy of platelet-enhancing therapies, such as thrombopoietin receptor agonists. Monitoring IPF levels over time helps evaluate treatment response, ensuring appropriate dosing and adjusting therapy if necessary.
  3. Predicting Platelet Recovery after Chemotherapy: chemotherapy  treatments often induce myelosuppression, resulting in reduced platelet counts. Monitoring IPF levels during chemotherapy can provide insights into bone marrow recovery and predict the return of normal platelet function.
  4. Prognostic Indicator in Cardiovascular Diseases: IPF has emerged as a potential prognostic marker in various cardiovascular diseases. Elevated IPF levels have been associated with increased risk of adverse outcomes in acute coronary syndromes, heart failure, and stroke. Monitoring IPF alongside other established risk factors can aid in risk stratification and guide therapeutic interventions.
  5. Early Diagnosis of Neonatal Thrombocytopenia: IPF has shown promise in the early diagnosis of neonatal thrombocytopenia. Detecting elevated IPF levels in newborns allows for timely interventions, such as platelet transfusions, to prevent bleeding complications.When platelet count platelet count drops below 50 x 103/L in an otherwise healthy appearing infant in the first 72 hours of life, neonatal alloimmune thrombocytopenia (NAIT) can be suspected.
  6. Dengue  can be used to predict the recovery of platelets in patients with dengue, so as to avoid unnecessary blood transfusions.The IPF% can predict the timing of platelet recovery which is 1-2 days of IPF increase

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