Evaluating the Performance of Flow Cytometric Method in Identification of Platelet Resistance in Patients with Acute Myeloid Leukemia (AML)

Immune platelet resistance is a condition in which antibodies are produced against platelet antigens and cause damage to injected platelets by phagocytes and macrophages. The aim of this study is to evaluate the efficacy of flow cytometry in predicting the results of platelet injections and platelet resistance and selecting compatible platelet for patients.
This case-control study was performed on 15 patients with acute myeloid leukemia (AML) with two or multiple injections of platelets and 15 healthy subjects without a history of platelet injection. After marking the platelets with 5-Chloromethylfluorescein diacetate (CMFDA) and their adjacency to the serum of patients, the amount of phagocytosis of platelets by monocytes was assessed in the two groups.
FINDINGS: The mean phagocytic power of platelets by monocyte was 18.27 ± 2.86% in the control group, 68.47 ± 10.40% in the group of patients with immune platelet resistance, and 36.73 ± 15.21 in the group of patients without immune platelet resistance (p = 0.001). In addition, there was a significant negative correlation between phagocytic power of platelets by monocyte and Corrected Count Increment (CCI) at 1 and 24 hours (p = - 0.001).
Based on the results of this study and considering the high sensitivity of the flow cytometric method, the use of CMFDA is highly appropriate for evaluating platelet studies, and it can also be used for platelet crossmatch by flow cytometry.