The role of platelet indices as predictive markers of immune thrombocytopenic purpura (itp) in bone marrow aspirate: a study in a tertiary care centre

Introduction: Thrombocytopenia is considered to be one of the most important causes of abnormal bleedings. It is necessary to ascertain whether the thrombocytopenia is due to hyperdestruction or hypoproduction. Hyperdestructive thrombocytopenias are caused by extramedullary destruction of platelets while hypoproductive thrombocytopenias are caused by a decreased production of platelets by the bone marrow. Platelet indices (PIs) can be used as predictive markers of ITP in thrombocytopenic patients, thus avoiding bone marrow aspirations.
Material and Methods: A total of 365 cases of thrombocytopenia (on automated analyser and peripheral blood film examination) with platelet counts <150 x 109/l in whom bone marrow aspiration was indicated were retrieved from the records over a period of one year and divided into two broad groups: cases of thrombocytopenia due to hyperdestruction (i.e. ITP, 68 patients) and cases of thrombocytopenia due to hypoproduction (i.e. Non-ITP , 297 patients). Platelet indices of these two groups were compared.
Results: Comparison between the two groups showed that platelet count (10^9/L) and PCT (%) were higher in patients in the hypoproductive group and this difference was found to be statistically significant. Comparison of the MPV (fl) and PDW between the two groups showed that both were higher in patients in the hyper destructive group (not statistically significant). P-LCC (10^9/L) was found to be higher in hypoproductive group and was statistically significant.
Conclusion: Patients with ITP had significantly lower platelet counts, PCT (%) and P-LCC and higher MPV than patients of non-ITP causes.