Tanaka Hiroaki, Ishii Akihiro, Sugita Yasumasa, Shimizu Ryo, Sato Fumi, Sakuma Yukie, Iwai Rie, Kakuta Shinichiro
Department of Hematology, Asahi General Hospital.
J Clin Exp Hematop. 2017;56(3):150-159. doi: 10.3960/jslrt.56.150.
For optimizing CD34+ cell collection, appropriately timing peripheral blood stem cell harvest (PBSCH) initiation is crucial. Automatic cell analyzers with the immature myeloid information channel provide hematopoietic progenitor cell (HPC) count, a surrogate marker of CD34+ cells, which can be obtained within a few minutes without requiring monoclonal antibodies. The final decision on PBSCH initiation can be made using the HPC count obtained on the morning of the harvest day. Herein, we evaluated the impact of the HPC count as an indicator for the optimal timing of PBSCH in clinical practice over 9 years. One hundred and eighteen aphereses from 72 cases had a definite number of CD34+ cells/kg in the PBSC yield. A correlation was found between the HPC count in the PB and the CD34+ cell count (R = 0.563, p < 0.001), whereas no correlation existed between the white blood cell and CD34+ cell counts (R = 0.0418, p = 0.65). We defined > 2.0 × 10/kg of CD34+ cells in a single apheresis as good mobilization. Multivariate analysis demonstrated that an HPC count of > 21/μL, myeloblast count of > 12/μL, and age at PBSCH of < 50 years were independently associated with good mobilization (p = 0.001, p < 0.001, and p = 0.005, respectively). Our findings suggest that the HPC count is a good indicator for the optimal timing of PBSCH.
为优化CD34+细胞采集,适时启动外周血干细胞采集(PBSCH)至关重要。具有未成熟髓系信息通道的自动细胞分析仪可提供造血祖细胞(HPC)计数,这是CD34+细胞的替代标志物,无需单克隆抗体即可在几分钟内获得。可根据采集日早晨获得的HPC计数做出PBSCH启动的最终决定。在此,我们评估了9年多来HPC计数作为临床实践中PBSCH最佳时机指标的影响。72例患者的118次单采中,PBSC产量中每千克CD34+细胞数量明确。发现外周血中的HPC计数与CD34+细胞计数之间存在相关性(R = 0.563,p < 0.001),而白细胞计数与CD34+细胞计数之间无相关性(R = 0.0418,p = 0.65)。我们将单次单采中CD34+细胞>2.0×10/kg定义为良好动员。多变量分析表明,HPC计数>21/μL、原始粒细胞计数>12/μL以及PBSCH时年龄<50岁与良好动员独立相关(分别为p = 0.001、p < 0.001和p = 0.005)。我们的研究结果表明,HPC计数是PBSCH最佳时机的良好指标。