Department of Pediatrics, Hualien Buddhist Tzu-Chi General Hospital, Hualien, Taiwan.
Transfusion. 2010 May;50(5):1088-95. doi: 10.1111/j.1537-2995.2009.02546.x. Epub 2009 Dec 29.
The hematopoietic progenitor cell (HPC) count measured by the Sysmex hematology analyzer can determine the timing for leukapheresis in autologous peripheral blood stem cell (PBSC) harvest. We evaluated whether a HPC count could predict CD34+ cell yield in healthy, unrelated donors after granulocyte-colony-stimulating factor mobilization.
A total of 117 healthy donors underwent 161 PBSC leukapheresis procedures in our institution. The HPCs and CD34+ cells were identified by an automated hematology analyzer and flow cytometry, respectively. Using Spearman's rank test, we evaluated the relationships between preharvest HPCs, CD34+ cell counts, and CD34+ cell yields in the apheresis product. A receiver operating characteristic (ROC) curve analysis was used to identify the cutoff value of HPC for adequate mobilization and harvest yield.
The HPC count had a moderate correlation with the preharvest CD34+ cell count (r = 0.502, p < 0.001), and an HPC count of more than 21.3 x 10(6)/L could exclude poor mobilization (<20 x 10(6) CD34+ cells/L) with sensitivity and specificity of 89.2 and 83.3%. However, the relationship between HPC count and CD34+ cell yield was not marked (r = 0.321, p < 0.001). The area under the curve for HPCs was significantly smaller than the preharvest CD34+ cell count on the ROC curve for predicting adequate harvest yield (>10 x 10(6) CD34+ cells/L of processed blood volume, 0.678 vs. 0.850, p = 0.001).
Although the preapheresis HPC count could predict mobilization in healthy donors before leukapheresis, it may not be a superior index for predicting CD34+ cell yield compared with the preharvest CD34+ cell count.
Sysmex 血液分析仪检测到的造血祖细胞 (HPC) 计数可确定自体外周血造血干细胞 (PBSC) 采集时进行白细胞分离术的时间。我们评估了在粒细胞集落刺激因子动员后,HPC 计数是否可以预测健康无关供者采集后的 CD34+ 细胞产量。
共有 117 名健康供者在我们机构接受了 161 次 PBSC 白细胞分离术。HPC 与 CD34+细胞分别通过自动血液分析仪和流式细胞术鉴定。采用 Spearman 秩检验评估了收获前 HPC 与 CD34+细胞计数和收获产物中 CD34+细胞产量之间的关系。采用受试者工作特征 (ROC) 曲线分析确定 HPC 的截止值,以评估充分动员和收获产量。
HPC 计数与收获前 CD34+细胞计数呈中度相关(r = 0.502,p < 0.001),HPC 计数>21.3 x 10(6)/L 可排除动员不良(<20 x 10(6) CD34+细胞/L),其敏感性和特异性分别为 89.2%和 83.3%。然而,HPC 计数与 CD34+细胞产量之间的关系并不显著(r = 0.321,p < 0.001)。HPC 曲线下面积显著小于 ROC 曲线中预测收获产量的 CD34+细胞计数(收获后每处理血容量中>10 x 10(6) CD34+细胞,0.678 与 0.850,p = 0.001)。
尽管收获前的 HPC 计数可预测白细胞分离术前健康供者的动员情况,但与收获前 CD34+细胞计数相比,它可能不是预测 CD34+细胞产量的更好指标。