engleski

Accuracy of low platelet count in routine laboratory diagnosis

An accurate laboratory method for low platelet count is necessary for prophylactic platelet transfusion in acute thrombocytopenias (Trb<10x109/L). The gold standard, i.e. the method of platelet count in a chamber under phase microscope, is time-consuming, subjective and imprecise to be used for low platelet count. Modern hematology analysers in routine diagnostic use employ a variety of technologies to count platelets including impedance change, optical light scatter and optical fluorescent staining methods. The precision achieved by these methods is inadequate for a sample with low platelet number due to their inability to distinguish platelets from other similar-sized cell fragments, and results in falsely elevated platelet number. A major advance has been attained through the development of immunologic methods using flow cytometry. This method is proposed now by the International Society of Laboratory Hematology as International Reference Method. It uses two specific monoclonal antibodies, CD41 and CD61, for platelet labeling, and the platelet number is derived from the platelet/erythrocyte ratio. This method replaces the manual phase microscopy method and improves calibration of hematologic counters, the quality of control blood samples and accuracy of platelet count in thrombocytopenia. The method based on monoclonal antibodies has partially been applied in a new generation of hematology analysers (Abbott Cell-Dyn CD61 immunologic method), which has promoted the accuracy of low platelet count in routine laboratory diagnosis.

thrombocytopenia; platelet transfusion

nije evidentirano