Specchia Giorgina, Pastore Domenico, Mestice Anna, Liso Arcangelo, Carluccio Paola, Leo Manuela, Casanova Margherita, Sibilla Silvia, Giannoccaro Margherita, Liso Vincenzo
Hematology Section, Department DAP, University of Bari, Bari, Italy.
Acta Haematol. 2006;116(4):229-37. doi: 10.1159/000095872.
This study aimed to identify which subset of CD34+ cells might be the most predictive of early and long-term hematopoietic recovery following autologous peripheral blood stem cell (PBSC) transplantation (PBSCT) in adult acute myeloid leukemia (AML) patients. The relationships between the number of 'mature' subsets of CD34+ cells (CD34+/CD33+, CD34+/CD38+, CD34+/DR+ and CD34+/CD90-) and 'immature' subsets of CD34+ cells (CD34+/CD33-, CD34+/CD38-, CD34+/DR- and CD34+/CD90+) and early and long-term hemoglobin, neutrophil and platelet counts were studied in a homogeneous series (for disease, pre-transplant chemotherapy, mobilization chemotherapy, conditioning regimen) of 26 AML patients after autologous PBSCT. Cell counts were performed before and after cryopreservation, but only after thawing were the cell counts used for correlation with early and long-term engraftment. The number of CD34+/CD38- cells infused correlated with the neutrophil (r = 0.88, p < 0.005) and platelet counts (r = 0.67, p < 0.05) at 12 months after PBSCT. This correlation was better than that for the total CD34+ cell dose at 12 months (r = 0.36, p = 0.09 for neutrophil count and r = 0.48, p = 0.06 for platelets count). The number of CD34+/CD90+ cells was also correlated with the platelet counts at 6 (r = 0.70, p < 0.05) and 12 months (r = 0.80, p = 0.005) after PBSCT. This correlation was better than the total dose of CD34+ cells at 6 (r = 0.31, p = 0.3) and 12 months (r = 0.48, p = 0.06) for the platelet counts. CD34+ subset analysis suggests that for early engraftment the total number of CD34+ cells infused is more strongly correlated than the CD34+ subsets, whereas the CD34+/CD38- and CD34+/CD90+ subsets may be associated with sustained long-term neutrophil and platelet engraftment. These findings may help to predict the repopulating capacity of PBSCs in AML patients after autologous PBSCT, especially when a relatively low number of CD34+ cells is infused.
本研究旨在确定在成年急性髓系白血病（AML）患者自体外周血干细胞移植（PBSCT）后，哪一亚群的CD34+细胞最能预测早期和长期造血恢复情况。在26例接受自体PBSCT的AML患者组成的同质队列（疾病、移植前化疗、动员化疗、预处理方案）中，研究了CD34+细胞“成熟”亚群（CD34+/CD33+、CD34+/CD38+、CD34+/DR+和CD34+/CD90-）和“未成熟”亚群（CD34+/CD33-、CD34+/CD38-、CD34+/DR-和CD34+/CD90+）的数量与早期和长期血红蛋白、中性粒细胞及血小板计数之间的关系。细胞计数在冻存前后均进行，但仅解冻后的细胞计数用于与早期和长期植入情况进行相关性分析。输注的CD34+/CD38-细胞数量与PBSCT后12个月时的中性粒细胞计数（r = 0.88，p < 0.005）和血小板计数（r = 0.67，p < 0.05）相关。这种相关性优于12个月时总CD34+细胞剂量与中性粒细胞计数（r = 0.36，p = 0.09）及血小板计数（r = 0.48，p = 0.06）之间的相关性。CD34+/CD90+细胞数量也与PBSCT后6个月（r = 0.70，p < 0.05）和12个月（r = 0.80，p = 0.005）时的血小板计数相关。这种相关性优于6个月（r = 0.31，p = 0.3）和12个月（r = 0.48，p = 0.06）时总CD34+细胞剂量与血小板计数之间的相关性。CD34+亚群分析表明，对于早期植入，输注的CD34+细胞总数比CD34+亚群的相关性更强，而CD34+/CD38-和CD34+/CD90+亚群可能与持续的长期中性粒细胞和血小板植入有关。这些发现可能有助于预测AML患者自体PBSCT后PBSC的再填充能力，尤其是在输注相对较少数量的CD34+细胞时。
