State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.
Tianjin Institutes of Health Science, Tianjin, China.
Clin Exp Med. 2024 Aug 24;24(1):197. doi: 10.1007/s10238-024-01467-0.
The Sysmex XN series haematopoietic progenitor cell (XN-HPC) is a novel tool for assessing stem cell yield before allogeneic haematopoietic stem cell transplantation. This study aimed to establish a reference interval (RI) for XN-HPC in peripheral blood allogeneic transplant donors following granulocyte colony-stimulating factor (G-CSF) stimulation and determine its clinical significance. All specimens were analysed using Sysmex XN-20. Samples were collected and analysed using non-parametric percentile methods to define the RIs. Quantile regression was used to explore the dependency of the RIs on sex and age. Samples were included in clinical decision limits for apheresis based on receiver operating characteristic curve analysis. The non-parametrically estimated RI for XN-HPC was 623.50 (90% confidence interval [CI90%] 510.00-657.00) to 4,144.28 (CI90% 3,761.00-4,547.00). The RIs for the XN-HPC were not age-dependent but were sex-dependent. The RI for males was 648.40 (CI90% 582.00-709.00)-4,502.60 (CI90% 4,046.00-5,219.00) and for females was 490.90 (CI90% 311.00-652.00)-3,096.90 (CI90% 2,749.00-3,782.00). Comparisons based on XN-HPC values between the poor and less-than-optimal groups, good and less-than-optimal groups, and good and non-good groups had areas under the curve of 0.794 (P < 0.001), 0.768 (P < 0.001), and 0.806 (P < 0.001), respectively, indicating a good predictive value for mobilisation effectiveness. XN-HPC data exceeding 3974 × 10/L suggested that a sufficient number of stem cells could be collected clinically. Values > 5318 < 10/L indicated 100% mobilisation effectiveness. We established an RI for XN-HPC in peripheral blood allogeneic transplant donors following G-CSF stimulation and determined clinical decision thresholds for mobilisation efficiency.
XN 系列造血祖细胞（XN-HPC）是一种评估异基因造血干细胞移植前干细胞产量的新工具。本研究旨在建立粒细胞集落刺激因子（G-CSF）刺激后外周血同种异体移植供者 XN-HPC 的参考区间（RI），并确定其临床意义。所有标本均采用 Sysmex XN-20 进行分析。采用非参数百分位法分析样本，确定 RI。采用分位数回归探索 RI 与性别和年龄的相关性。根据受试者工作特征曲线分析，将样本纳入基于采集的临床决策限。XN-HPC 的非参数估计 RI 为 623.50（90%置信区间[CI90%]510.00-657.00）至 4,144.28（CI90%3,761.00-4,547.00）。XN-HPC 的 RI 与年龄无关，但与性别有关。男性 RI 为 648.40（CI90%582.00-709.00）-4,502.60（CI90%4,046.00-5,219.00），女性 RI 为 490.90（CI90%311.00-652.00）-3,096.90（CI90%2,749.00-3,782.00）。基于 XN-HPC 值，在不良与欠佳组、良好与欠佳组和良好与非良好组之间进行比较，曲线下面积分别为 0.794（P<0.001）、0.768（P<0.001）和 0.806（P<0.001），提示对动员效果具有良好的预测价值。XN-HPC 数据超过 3974×10/L 提示临床上可采集足够数量的干细胞。值>5318<10/L 表示 100%动员有效。我们建立了 G-CSF 刺激后外周血同种异体移植供者 XN-HPC 的 RI，并确定了动员效率的临床决策阈值。
