Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
J Clin Apher. 2021 Oct;36(5):737-749. doi: 10.1002/jca.21924. Epub 2021 Jul 7.
An automated hematopoietic progenitor cell count measurement in Sysmex XN analyzer (XN-HPC) has been developed to assist flow cytometry CD34 cell count measurement, which requires technical expertise and a long turnaround time. Here, we evaluated the correlation between XN-HPC count and flow cytometric CD34 cell count in pre-harvest peripheral blood (PB) samples from patients undergoing autologous peripheral blood stem cell (PBSC) transplantation according to diagnosis and investigated the possible cause of the decreased correlation in plasma cell neoplasm patients.
We retrospectively included 399 patient data that had matched PB XN-HPC count and CD34 cell count of PB and apheresis product from Samsung Medical Center (SMC) and the Hematopoietic Stem Cell (HSC) registry. We assessed the diagnostic accuracy and the potential cutoff values of XN-HPC count for predicting adequate PBSC collection.
The PB XN-HPC count was 1.6 and 1.3-fold higher than the CD34 cell count in SMC (25.0 vs 15.9/μl) and the HSC registry (20.0 vs 15.2/μl), respectively. Overall the correlation between the PB XN-HPC and CD34 cell count was moderate (SMC, r = 0.71; HSC registry, r = 0.66). A significant proportional and systemic bias with overestimation of XN-HPC count were noted in the plasma cell neoplasm patients in both SMC and the HSC registry. However, no significant difference in correlation was observed according to myeloma-related laboratory parameters in plasma cell neoplasm patients.
Our results suggest that XN-HPC count should be interpreted cautiously in cancer patients undergoing autologous PBSC transplantation, especially in those with plasma cell neoplasm.
为了辅助流式细胞术 CD34 细胞计数的检测,希森美康 XN 分析仪(XN-HPC)开发了一种自动化造血祖细胞计数测量方法,该方法需要专业技术和较长的周转时间。在这里,我们根据诊断评估了接受自体外周血造血干细胞(PBSC)移植的患者采集前外周血(PB)样本中 XN-HPC 计数与流式细胞术 CD34 细胞计数之间的相关性,并研究了浆细胞瘤患者相关性降低的可能原因。
我们回顾性纳入了 399 例患者的数据,这些患者均在三星医疗中心(SMC)和造血干细胞(HSC)登记处的 PB 和单采产品中匹配了 PB XN-HPC 计数和 CD34 细胞计数。我们评估了 XN-HPC 计数对预测足够 PBSC 采集的诊断准确性和潜在截止值。
PB XN-HPC 计数分别比 SMC(25.0 比 15.9/μl)和 HSC 登记处(20.0 比 15.2/μl)的 CD34 细胞计数高 1.6 倍和 1.3 倍。总体而言,PB XN-HPC 与 CD34 细胞计数之间的相关性为中度(SMC,r=0.71;HSC 登记处,r=0.66)。在 SMC 和 HSC 登记处的浆细胞瘤患者中,均发现 XN-HPC 计数存在显著的比例和系统偏差,存在高估。然而,浆细胞瘤患者的骨髓瘤相关实验室参数与相关性无显著差异。
我们的研究结果表明,在接受自体 PBSC 移植的癌症患者中,尤其是在浆细胞瘤患者中,应谨慎解释 XN-HPC 计数。