外周血造血祖细胞检测对外周血干细胞动员采集的预测意义  

Hematopoietic progenitor cell counting for prediction of the yield of peripheral blood stem cell in mobilization and harvest

作　　者：魏征[1] 王志梅[1] 庄静丽[1] 李锋[1] 程韵枫[1] 邹善华[1] 

机构地区：[1]复旦大学附属中山医院血液科,上海200032

出　　处：《白血病．淋巴瘤》2013年第5期286-290,共5页Journal of Leukemia & Lymphoma

摘　　要：目的通过血细胞分析仪检测外周血造血祖细胞（HPC）含量，探寻一种快速预测采集物干细胞含量、判断外周血造血干细胞采集时机的手段，并评价其应用意义。方法对27例化疗联合粒细胞集落刺激因子（G．CSF）进行外周血造血干细胞动员采集者及17例单用G—CSF动员的采集者，利用血细胞分析仪检测外周血HPC计数，血液治疗和移植工程国际组织（ISHAGE）法检测外周血及采集物CD；细胞计数，并进行相关回归分析。对外周血HPC计数预测采集物CD；含量进行受试者工作曲线（ROC）分析。结果无论化疗组或非化疗组，外周血HPC计数与CD；计数均具有线性相关性（r=0．711，P=0．000及r=0．656，P=0．004）。化疗组外周血CD；计数=-0．829＋0．648×外周血HPC计数；非化疗组外周血CD；细胞计数=45．033＋0．460×外周血HPC计数。化疗组患者外周血HPC计数与采集物CD；细胞量呈线性相关（r=0．602，P=0．001），采集物CD；计数=1．106＋0．046×外周血HPC计数。以HPC≥85／μl预测采集物CD；计数≥5×106／kg的灵敏度为78％，特异度为82％。结论在自体干细胞移植动员患者中，外周血HPC计数可部分替代外周血CD5计数预测采集效果，HPC≥85／μl为较好的预测阈值。Objective To evaluate a method of fast detection of the hematopoietic progenitor cell （HPC） in peripheral blood samples and explore for an appropriate cutoff value in prediction of adequate CD3＋4 cell in apheresis concentrate. Methods Peripheral blood samples and apheresis concentrate samples were collected from 27 auto-PBSCT patients receiving chemotherapy plus G-CSF mobilization （chemo group） and 17 patients receiving G-CSF alone （non-chemo group）. CD;4 cell counts were determined by flow cytometry according to ISHAGE guideline and HPC counts were detected using Sysmex XE-2100 automatic hemocyte analyzer. The correlation between HPC and CD ;4 cell counts in peripheral blood samples and apheresis concentrates were analyzed. Receiver operating characteristic （ROC） curves was used to determine the cutoff value in prediction of adequate CD3＋4 cell in apheresis concentrate. Results CD3＋4 cell counts in peripheral blood samples can be estimated by HPC counts （r = 0.711, P = 0.000, r = 0.656, P = 0.004）. CD3＋4 cell counts = -0.829＋0.648xHPC counts （in chemo group） or 45.033＋0.460×HPC counts （in non-chemo group）. HPC counts in the peripheral blood of auto-PBSCT patients were highly correlated with the CD34 cell yield （r = 0.602, P = 0.001）, CD3＋4 cell counts = 1.106＋0.046×HPC counts. When HPC in peripheral blood was 85/1.d, the prediction of adequate CD3＋4 cells in the yield of apheresis （≥5×106/kg body weight） would have a sensitivity of 78 % and a specifity of 82 %. Conclusion HPC counts in peripheral blood samples in auto-PBSCT patients can be used to determine the optimal time of apheresis and be used as a good marker to predict the stem cell in the yield.

关 键 词：外周血干细胞移植 造血干细胞动员 预测 

分 类 号：R733[医药卫生—肿瘤] R4[医药卫生—临床医学]