Immature Platelet Fraction Fact Sheet

Immature Platelet Fraction Fact Sheet

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What is the Immature Platelet Fraction?

The Immature Platelet Fraction (IPF) is a parameter available on Sysmex XN-Series™ analyzers that can help clinicians assess bone marrow platelet production. As the bone marrow generates more platelets, IPF levels rise, providing a measure of platelet production. The IPF is an index of thrombopoiesis, and access to this result can help clinicians determine the underlying pathophysiologic mechanism of the patient’s platelet activity.

Normal patients:

  • The bone marrow constantly produces platelets to accommodate normal turnover.
  • Normal patients have a small percentage of circulating immature platelets.

Patients with low platelet counts (thrombocytopenia):

  • The bone marrow should increase platelet production, leading to an elevated immature platelet fraction (IPF).
  • In some cases, the bone marrow is unable to generate new platelets, resulting in a low or normal IPF.

Stages of Platelet Maturation

Platelets originate from large, nucleated cells called megakaryocytes which are located in the bone marrow. Platelets are continuously released by megakaryocytes into the bloodstream, where they undergo final maturation. Automated platelet counts typically include both mature and immature platelets, as many hematology analyzers cannot distinguish between the two platelet forms.

Sysmex Hematology Analyzers and IPF Measurement

When the IPF parameter is ordered, the XN’s Fluorocell™ PLT reagent stains the nucleic acids inside the platelets. The stained platelets are then detected in the flow cytometer’s Fluorescent Platelet channel. Platelets with increased nucleic acid concentration are considered immature, and the IPF is calculated based on this.

Key Advantages:

  • Detection point: The analyzer measures immature platelets that have been released into peripheral circulation from the bone marrow.
  • Cell Type Detected: Immature platelets containing increased amounts of nucleic acid.
  • Technology Used: Utilizing fluorescence flow cytometry and platelet-specific stains, the Sysmex XN-Series provides an accurate assessment of immature platelets without interference from WBC and RBC fragments.

Advantages of Sysmex IPF Measurement

  • Automated Analysis: IPF can be automatically performed through orders from the LIS or reflexed through on- board or middleware rules.
  • Direct Measurement: Fluorescent assessment of IPF provides a more direct measurement of immature platelets than Mean Platelet Volume (MPV), which solely reflects platelet size.
  • High Sensitivity: Fluorescent platelet counting using flow cytometry can accurately enumerate platelets in patients with very low platelet counts, especially in the presence of RBC or WBC fragments.
  • Comprehensive Reporting: IPF can be reported as a relative (%) or absolute (#) count. While the CPT code for this parameter is 85055, all billing and reimbursement decisions should be made in consultation with the site’s coding and billing departments.

Using Sysmex’s XN-Series analyzers, the IPF can be analyzed either by a direct order from the LIS or automatically based on predefined rules set up in the analyzer’s on-board software or middleware.

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