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

 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+34 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+34 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+34 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+34 计数＝-0.829+0.648×外周血HPC计数；非化疗组外周血CD+34 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+34 细胞量呈线性相关（r＝0.602，P＝0.001），采集物CD+34 计数＝1.106+0.046×外周血HPC计数。以HPC≥85／μl预测采集物CD+34 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CD+34 计数预测采集效果，HPC≥85／μl为较好的预测阈值。

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

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 CD+34 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+34 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+34 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 CD+34 cell in apheresis concentrate. Results　CD+34 cell counts in peripheral blood samples can be estimated by HPC counts (r = 0.711, P = 0.000, r = 0.656, P = 0.004). CD+34 cell counts = －0.829+0.648×HPC 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 CD+34 cell yield (r = 0.602, P = 0.001), CD+34 cell counts = 1.106+0.046×HPC counts. When HPC in peripheral blood was ≥85/μl, the prediction of adequate CD+34 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.