Department of Pathology and Laboratory Medicine, University of Pennsylvania Health System, Philadelphia, USA.
Biol Blood Marrow Transplant. 2012 Dec;18(12):1867-75. doi: 10.1016/j.bbmt.2012.07.002. Epub 2012 Jul 13.
The CXCR4 antagonist plerixafor is increasingly used in the mobilization regimens for autologous peripheral blood stem cell (PBSC) transplantation. This agent may mobilize a different subset of the stem cell population than traditional regimens, such as growth factors (with and without chemotherapy). Thus, it is important to determine whether plerixafor has an effect on the utility of measurements used to predict the yield of CD34(+) cells, usually either preharvest peripheral blood CD34(+) enumeration by flow cytometry or hematopoietic precursor cell (HPC) enumeration by automated hematology analysis. Although HPC enumeration has a weaker correlation with first-harvest CD34(+) cell yield, this parameter still plays an important role in the timing of apheresis procedures for autologous PBSC transplantation because of its technical simplicity and low cost. In the present study, we retrospectively examined the correlation of HPC measurements with CD34(+) cell yields in patients with multiple myeloma and lymphoma undergoing autologous PBSC transplantation, and investigated how the mobilization regimen affected these results. We found that the correlation coefficients ranged from 0.5877 to 0.7668 and were not significantly impacted by differences in diagnosis or inclusion of plerixafor in the mobilization regimen. The predictive ability of HPC enumeration for various target yields was also examined, and receiver-operating characteristic curves were generated. An HPC cutoff of 20 should result in adequate initial CD34(+) cell yields (>2.5 × 10(6) cell/kg) in >80% of autologous donors with or without plerixafor. This study confirms the utility of HPC enumeration in prediction of adequate initial cell yields, and demonstrates that this utility is maintained regardless of whether or not plerixafor is included in the mobilization regimen.
趋化因子受体 4 拮抗剂培利昔洛韦越来越多地用于自体外周血造血干细胞（PBSC）移植的动员方案。该药物可能会动员不同于传统方案（如生长因子[联合或不联合化疗]）的干细胞亚群。因此，确定培利昔洛韦是否会影响用于预测 CD34+细胞产量的测量值的实用性非常重要，这些测量值通常是通过流式细胞术进行收获前外周血 CD34+细胞计数，或者通过自动化血液学分析进行造血前体细胞（HPC）计数。尽管 HPC 计数与首次收获 CD34+细胞产量的相关性较弱，但由于其技术简单且成本低廉，该参数在自体 PBSC 移植的采集程序时间方面仍起着重要作用。在本研究中，我们回顾性地检查了多发性骨髓瘤和淋巴瘤患者接受自体 PBSC 移植时 HPC 测量值与 CD34+细胞产量的相关性，并研究了动员方案如何影响这些结果。我们发现，相关系数范围为 0.5877 至 0.7668，且不受诊断差异或动员方案中是否包含培利昔洛韦的影响。还检查了 HPC 计数对各种靶产量的预测能力，并生成了接收者操作特性曲线。HPC 截断值为 20 时，无论是否使用培利昔洛韦，都应使 >80%的自体供者产生足够的初始 CD34+细胞产量（>2.5×106 细胞/kg）。本研究证实了 HPC 计数在预测足够初始细胞产量方面的实用性，并表明无论是否使用培利昔洛韦，这种实用性都保持不变。
