Stability and utility of flow cytometric platelet activation tests: A modality to bridge the gap between diagnostic demand and supply. (3rd October 2022)

• Record Type: Journal Article
• Authors: Dave, Rutvi Gautam; Geevar, Tulasi; Chellaiya, Gayathiri Kaduvetti; Mammen, Joy John; Vijayan, Ramya; Samuel, Ashok; Gowri, Mahasampath; Nair, Sukesh Chandran
• Is Part Of: Platelets. Volume 33:Number 7(2022)
• Page Start: 1043
• Page End: 1051
• Publication Date: 2022-10-03
• Subjects: Blood platelet disorders -- flow cytometry -- platelet activation -- platelet aggregation -- platelet function tests; Blood platelets -- Periodicals; Blood Platelets -- Periodicals; 615.39
• DOI: 10.1080/09537104.2022.2042232
• Languages: English
• ISSNs: 0953-7104

Abstract

Abstract: Light transmission aggregometry (LTA) is the gold standard for the diagnosis of platelet function disorders (PFDs). The requirement of customized aggregometer, large blood volume, normal platelet count and processing within 4 hours of venipuncture for LTA makes platelet function testing inaccessible to wider population. Flow cytometric platelet activation test (PACT) may overcome these limitations. This study compares the performance of PACT with LTA, characterizes diagnostic patterns of PFDs on PACT and assesses the stability of PACT beyond 4 hours of venipuncture in controls (n = 5) at different temperature conditions. LTA and PACT were performed in 121 healthy controls and 66 patients with suspected PFD. PACT had excellent agreement (kappa = 0.93) with LTA and 94.1% sensitivity, 98.5% specificity. PACT had distinct patterns in Bernard Soulier Syndrome (n = 10), Glanzmann Thrombasthenia (n = 24), δ-granule disorder (n = 7), and other PFDs (n = 12). PACT could assess platelet function in patients (14%) with thrombocytopenia/lipemia wherein LTA was inconclusive. PACT was stable up to 24 hours in samples stored/transported at 2–8◦C. The results of utility and stability are only valid for the specific markers, agonist concentrations, and conditions investigated in this paper. PACT is a useful modality for the diagnosis of PFD, especially in children, thrombocytopenia cases or in the setup where an aggregometer is not readily available.