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Frelinger AL, Rivera J, Connor DE, et al. Consensus recommendations on flow cytometry for the assessment of inherited and acquired disorders of platelet number and function: Communication from the ISTH SSC Subcommittee on Platelet Physiology. J Thromb Haemost. 2021;19(12):3193-3202doi: 10.1111/jth.15526.
Frelinger, A. L., Rivera, J., Connor, D. E., Freson, K., Greinacher, A., Harrison, P., Kunishima, S., Lordkipanidzé, M., Michelson, A. D., Ramström, S., & Gresele, P. (2021). Consensus recommendations on flow cytometry for the assessment of inherited and acquired disorders of platelet number and function: Communication from the ISTH SSC Subcommittee on Platelet Physiology. Journal of thrombosis and haemostasis : JTH, 19(12), 3193-3202. https://doi.org/10.1111/jth.15526
Frelinger, Andrew L, et al. "Consensus recommendations on flow cytometry for the assessment of inherited and acquired disorders of platelet number and function: Communication from the ISTH SSC Subcommittee on Platelet Physiology." Journal of thrombosis and haemostasis : JTH vol. 19,12 (2021): 3193-3202. doi: https://doi.org/10.1111/jth.15526
Frelinger AL, Rivera J, Connor DE, Freson K, Greinacher A, Harrison P, Kunishima S, Lordkipanidzé M, Michelson AD, Ramström S, Gresele P. Consensus recommendations on flow cytometry for the assessment of inherited and acquired disorders of platelet number and function: Communication from the ISTH SSC Subcommittee on Platelet Physiology. J Thromb Haemost. 2021 Dec;19(12):3193-3202. doi: 10.1111/jth.15526. Epub 2021 Sep 27. PMID: 34580997.
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J Thromb Haemost. 2021 Dec;19(12):3193-3202. doi: 10.1111/jth.15526. Epub 2021 Sep 27.

Consensus recommendations on flow cytometry for the assessment of inherited and acquired disorders of platelet number and function: Communication from the ISTH SSC Subcommittee on Platelet Physiology.

Journal of thrombosis and haemostasis : JTH

Andrew L Frelinger, José Rivera, David E Connor, Kathleen Freson, Andreas Greinacher, Paul Harrison, Shinji Kunishima, Marie Lordkipanidzé, Alan D Michelson, Sofia Ramström, Paolo Gresele

Affiliations

  1. Division of Hematology/Oncology, Center for Platelet Research Studies, Boston Children's Hospital, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA.
  2. Harvard Medical School, Boston, Massachusetts, USA.
  3. Centro Regional de Hemodonación, IMIB-Arrixaca, CB15/00055-CIBERER, Universidad de Murcia, Murcia, Spain.
  4. Haematology Research Laboratory, St Vincent's Centre for Applied Medical Research, Darlinghurst, New South Wales, Australia.
  5. University of New South Wales, Sydney, New South Wales, Australia.
  6. Department of Cardiovascular Sciences, Center for Molecular and Vascular Biology, University of Leuven, Leuven, Belgium.
  7. Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany.
  8. Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
  9. Department of Advanced Diagnosis, Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
  10. Faculté de Pharmacie, Research Center & The Montreal Heart Institute, Université de Montréal, Montréal, Quebec, Canada.
  11. Department of Clinical Chemistry and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
  12. Cardiovascular Research Centre, School of Medical Sciences, Örebro University, Örebro, Sweden.
  13. Department of Medicine and Surgery, University of Perugia, Perugia, Italy.

PMID: 34580997 DOI: 10.1111/jth.15526

Abstract

Flow cytometry is increasingly used in the study of platelets in inherited and acquired disorders of platelet number and function. However, wide variation exists in specific reagents, methods, and equipment used, making interpretation and comparison of results difficult. The goal of the present study was to provide expert consensus guidance on the use of flow cytometry for the evaluation of platelet disorders. A modified RAND/UCLA survey method was used to obtain a consensus among 11 experts from 10 countries across four continents, on the appropriateness of statements relating to clinical utility, pre-analytical variables, instrument and reagent standardization, methods, reporting, and quality control for platelet flow cytometry. Feedback from the initial survey revealed that uncertainty was sometimes due to lack of expertise with a particular test condition rather than unavailable or ambiguous data. To address this, the RAND method was modified to allow experts to self-identify statements for which they could not provide expert input. There was uniform agreement among experts in the areas of instrument and reagent standardization, methods, reporting, and quality control and this agreement is used to suggest best practices in these areas. However, 25.9% and 50% of statements related to pre-analytical variables and clinical utility, respectively, were rated as uncertain. Thus, while citrate is the preferred anticoagulant for many flow cytometric platelet tests, expert opinions differed on the acceptability of other anticoagulants, particularly heparin. Lack of expert consensus on the clinical utility of many flow cytometric platelet tests indicates the need for rigorous multicenter clinical outcome studies.

© 2021 International Society on Thrombosis and Haemostasis.

Keywords: RAND/UCLA survey; SSC Platelet Physiology; flow cytometry; platelet

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