Diagnostic Accuracy of Immature Platelet Fraction (IPF) to Differentiate Between Thrombocytopenia due to Peripheral Destruction versus Bone Marrow Failure

To analyse the predictive value of immature platelet fraction (IPF) as an independent diagnostic marker to differentiate between hyperdestructive and hypoproductive thrombocytopenia.Cross-sectional observational study. Place and Duration of the Study: Armed Forces Institute of Pathology Rawalpindi, from February to July 2022.A total of 164 samples were included in the study by non-probability consecutive sampling. Among these, 80 were obtained from normal individuals serving as control; 43 were obtained from patients having hyperdestructive thrombocytopenia (idiopathic thrombocytopenia, thrombotic thrombocytopenic purpura, disseminated intravascular coagulation); and 41 were obtained from those hypoproductive thrombocytopenia (acute leukaemia, aplastic anaemia, chemotherapy). Sysmex automated haematology analyzer, XN-3000 was used to determine the immature platelet fraction (IPF) of the patients. ROC curves analysis was done to ascertain area under curve.Immature platelet fraction (IPF %) was significantly higher in consumptive / hyperdestructive thrombocytopenia group i.e. median (IQR), 21% (14.4-26.2) as compared to 6.5% (4.6-8.9) in hypoproductive thrombocytopenia, and 2.6% (1.3-4.1) in normal control group (p <0.001). Cut-off value with the highest sensitivity and specificity for IPF vs. normal population was 7.95% with sensitivity of 97.7% and specificity of 86%.Immature platelet fraction (IPF of 7.95%) possesses high diagnostic accuracy, sensitivity and specificity for differentiation between hyperdestructive vs. hypoproductive thrombocytopenia. It can be used as a reliable marker to differentiate between the two entities.Immature platelet fraction, Thrombocytopenia, Bone marrow failure, Peripheral destruction.