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Objectives  A period of thrombocytopenia is common after stem cell transplantation ( SCT ). To prevent serious bleeding complications, prophylactic platelet transfusions are administered. Previous studies have shown that a rise in immature platelets precedes recovery of platelet count. Our aim was to define a cutoff value for immature platelets predicting thrombopoietic recovery within 2 d.    Methods  Hematological parameters were measured on the  S ysmex  XN  hemocytometer. We calculated reference change values ( RCV ) for platelets in eight healthy individuals as marker for platelet recovery. To define a cutoff value, we performed  ROC  analysis using data from 16 autologous  SCT  patients.    Results   RCV  for platelet concentration was 14.1%. Platelet recovery was observed 13 (median; range 9–31) days after  SCT . Increase in immature platelet fraction (IPF) before platelet recovery was seen in all autologous  SCT  patients. Optimal cutoff  IPF  was found to be 5.3% for platelet recovery within 2 d (specificity 0.98, sensitivity 0.47, positive predictive value 0.93).    Conclusions  We identified an optimal cutoff value for  IPF  5.3% to predict platelet recovery after autologous  SCT  within 2 d. Implementing this cutoff value in transfusion strategy may reduce the number of prophylactic platelet transfusions.

Immature platelet fraction measured on the S ysmex XN hemocytometer predicts thrombopoietic recovery after autologous stem cell transplantation