Reticulated platelets

Abstract

Young or reticulated platelets contain some residual mRNA, which is rapidly degraded after platelet release into the circulation. They can be easily detected either with supravital dye staining (e.g. new methylene blue) on blood films, or more commonly with fluorescent dyes (e.g thiazole orange) and flow cytometry. Using the latter technique many different groups have demonstrated that the measurement of reticulated platelets has much clinical potential. It is apparent that the level of reticulated platelets gives a relatively simple and non-invasive measurement of the rate of thrombopoiesis in an analogous fashion to the red cell reticulocyte count. Many research groups are currently measuring reticulated platelets but with wide variation in data and methods. An international platelet panel has begun to develop protocols and between laboratory comparisons, which will result in the standardization of the procedure. Platelet reticulocyte analysis should thus become part of accepted haematological practice and provide useful clinical information for the investigation and monitoring of platelet production in various thrombocytopenic conditions. In particular, measurement of reticulated platelets will provide an excellent and simple means for monitoring the response of chemotherapy and transplant patients to growth factors (e.g. thrombopoietin) resulting in a decrease in the demand for platelet transfusion.