Gu Runxia, Wei Hui, Wang Ying, Lin Dong, Liu Bingcheng, Zhou Chunlin, Liu Kaiqi, Gong Benfa, Wei Shuning, Zhang Guangji, Gong Xiaoyuan, Liu Yuntao, Li Yan, Zhao Xingli, Qiu Shaowei, Wang Huijun, Wang Min, Mi Yingchang, Wang Jianxiang
Department of Leukemia, Institute of Hematology, Hospital of Blood Diseases, Chinese Academy of Medical Sciences, Tianjin, China.
Department of Pathology and Lab Medicine, Institute of Hematology, Hospital of Blood Diseases, Chinese Academy of Medical Sciences, Tianjin, China.
PLoS One. 2017 Jul 5;12(7):e0180624. doi: 10.1371/journal.pone.0180624. eCollection 2017.
Hematopoietic recovery is considered to be associated with the number of multipotent hematopoietic stem cells in the bone marrow, as observed in functional assays involving stem cell transplantation. However, there is little evidence related to hematopoietic recovery in non-transplantation settings, which is accomplished by endogenous hematopoietic cells. A recent study suggested that progenitors are the main contributors during this steady-state hematopoiesis, which differs from exogenous transplantation. We hypothesized that endogenous progenitor support post-chemotherapy hematopoietic recovery. To investigate the potential impact of these progenitor cell percentage on hematopoietic recovery, we retrospectively analyzed the percentage of CD34+CD38+CD117+HLA-DR+CD13+CD33+ cells (P cells) and hematopoietic recovery in 223 newly diagnosed acute myeloid leukemia patients during two courses of consolidation chemotherapy after complete remission. We found that a lower P cell percentage was significantly associated with prolonged neutropenia recovery time after the first and second courses of consolidation chemotherapy (p = 0.001; p = 0.045, respectively). We also observed similar results with regard to platelet recovery time after the first course of consolidation chemotherapy (p = 0.000). Univariate analysis showed that P cell percentage and consolidation chemotherapy regimens, and not gender, age, induction chemotherapy regimens, infection grade, WHO classification and NCCN risk category, were associated with neutrophil recovery after chemotherapy. Multivariate analysis demonstrated that P cell percentage is an independent factor affecting neutrophil recovery capacity for both the first and second courses (p = 0.008; p = 0.032, respectively). Our results indicate that CD34+CD38+CD117+HLA-DR+CD13+CD33+ cells before each course of chemotherapy is independently associated with chemotherapy-related hematopoietic reconstitution capacity. These findings may help modify future chemotherapy regimens based on progenitor cell percentages.
正如在涉及干细胞移植的功能试验中所观察到的，造血恢复被认为与骨髓中多能造血干细胞的数量有关。然而，在非移植环境下，由内源性造血细胞完成的造血恢复方面的证据很少。最近的一项研究表明，祖细胞是这种稳态造血过程中的主要贡献者，这与外源性移植不同。我们假设内源性祖细胞支持化疗后的造血恢复。为了研究这些祖细胞百分比对造血恢复的潜在影响，我们回顾性分析了223例新诊断的急性髓系白血病患者在完全缓解后的两个巩固化疗疗程中CD34+CD38+CD117+HLA-DR+CD13+CD33+细胞（P细胞）的百分比与造血恢复情况。我们发现，较低的P细胞百分比与第一个和第二个巩固化疗疗程后中性粒细胞恢复时间延长显著相关（分别为p = 0.001；p = 0.045）。我们还观察到在第一个巩固化疗疗程后血小板恢复时间方面有类似结果（p = 0.000）。单因素分析表明，P细胞百分比和巩固化疗方案与化疗后中性粒细胞恢复相关，而与性别、年龄、诱导化疗方案、感染分级、世界卫生组织分类和美国国立综合癌症网络风险类别无关。多因素分析表明，P细胞百分比是影响第一个和第二个疗程中性粒细胞恢复能力的独立因素（分别为p = 0.008；p = 0.032）。我们的结果表明，每个化疗疗程前的CD34+CD38+CD117+HLA-DR+CD13+CD33+细胞与化疗相关的造血重建能力独立相关。这些发现可能有助于根据祖细胞百分比调整未来的化疗方案。
