Contributions
Abstract: PB2419
Type: Publication Only
Background
Allogeneic haematopoietic stem cells transplant provides the only chance of cure for various haematological disorders. Success of bone marrow transplant relies on the infusion of appropriate dose of haematopoietic progenitor cells (HPC) i.e. a minimum CD34+ cell count of >2x106 CD34+ cells/kg of recipient’s body weight. Enumeration of CD34+ cells by flowcytometry is a universally accepted reliable indicator of HPC. However, it is an operator-dependent costly procedure with a turnaround time of few hours. Sysmex automated haematology analyzers (XN-1000) segregate an immature myeloid population referred to as haematopoietic progenitor cells (XN-HPC).It is a non-operator dependent cost-effective procedure with a turnaround time of 90 seconds. Incipient statistics of various studies have suggested good correlation between XN-HPC and CD34+ cell count.
Aims
To elucidate the role of XN-HPC as a reliable and cost-effective surrogate of CD34+ cells in post-harvest products in allogeneic bone marrow transplant setting.
Methods
A cross sectional analytical study was conducted at the National Institute of Blood Disease & Bone Marrow Transplantation from Dec’2012 - Dec’2016. Eighty four patients, with various benign and malignant haematological diseases, and their matched related donors were recruited in the study. Donors were primed with injection GCSF 10ug/kg body weight subcutaneously for 4 days to mobilize stem cells. Peripheral blood apheresis was performed on day 5 to achieve the minimum target of >2x106 CD34+ cells/kg of recipient’s body weight. HPC, and CD34+ cell count of peripheral blood apheresis (post-harvest) product was performed by Sysmex XN-1000, and BD FACSCalibur respectively. Statistical analyses were performed using STATA version 11. Spearman’s rank correlation coefficient (ρ) and Receiver Operating Characteristic (ROC) curve were plotted to identify HPC value to optimally distinguish the cut-off of ≥2million CD34+ cells/kg of recipient’s body weight.
Results
Eighty-four healthy donors underwent peripheral blood stem cell harvest. Median age of the donors was 21 years. The most common benign and malignant diseases were Aplastic anemia (27%) and Acute myeloid leukemia (11%) respectively. Multiple XN-HPC cut-off values were computed for the CD34+ cell count of ≥2 × 106/kg of recipient’s body weight to establish evaluable sensitivity and specificity of XN-HPC. The XN-HPC cut-off of 0.049×103/ul has a sensitivity and specificity of 96.3% and 09% respectively, whereas the HPC cut-off of 0.87×103/ul has a sensitivity and specificity of 47.5% and 82% respectively. Despite a weak correlation between HPC and CD34 (ρ=0.18, p-value=0.104), the ROC curve analysis showed area under the curve (AUC) of 0.71 (95% CI; 0.58-0.84, p-value=0.023) highlighting the possible potential of XN-HPC to serve as a cost effective surrogate for CD34+ cell count.
Conclusion
Our results demonstrated a statistically significant p value of <0.05 that points towards the possible prognostication potential of XN-HPC for CD34+ cell count, in post-harvest products, in allogenic bone marrow transplant setting. A larger sample size will help in further elucidating the relationship of post-harvest product XN-HPC and CD34+ cell counts.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Allogeneic hematopoietic stem cell transplant, CD34+ cells, Hematopoietic stem and progenitor cells
Abstract: PB2419
Type: Publication Only
Background
Allogeneic haematopoietic stem cells transplant provides the only chance of cure for various haematological disorders. Success of bone marrow transplant relies on the infusion of appropriate dose of haematopoietic progenitor cells (HPC) i.e. a minimum CD34+ cell count of >2x106 CD34+ cells/kg of recipient’s body weight. Enumeration of CD34+ cells by flowcytometry is a universally accepted reliable indicator of HPC. However, it is an operator-dependent costly procedure with a turnaround time of few hours. Sysmex automated haematology analyzers (XN-1000) segregate an immature myeloid population referred to as haematopoietic progenitor cells (XN-HPC).It is a non-operator dependent cost-effective procedure with a turnaround time of 90 seconds. Incipient statistics of various studies have suggested good correlation between XN-HPC and CD34+ cell count.
Aims
To elucidate the role of XN-HPC as a reliable and cost-effective surrogate of CD34+ cells in post-harvest products in allogeneic bone marrow transplant setting.
Methods
A cross sectional analytical study was conducted at the National Institute of Blood Disease & Bone Marrow Transplantation from Dec’2012 - Dec’2016. Eighty four patients, with various benign and malignant haematological diseases, and their matched related donors were recruited in the study. Donors were primed with injection GCSF 10ug/kg body weight subcutaneously for 4 days to mobilize stem cells. Peripheral blood apheresis was performed on day 5 to achieve the minimum target of >2x106 CD34+ cells/kg of recipient’s body weight. HPC, and CD34+ cell count of peripheral blood apheresis (post-harvest) product was performed by Sysmex XN-1000, and BD FACSCalibur respectively. Statistical analyses were performed using STATA version 11. Spearman’s rank correlation coefficient (ρ) and Receiver Operating Characteristic (ROC) curve were plotted to identify HPC value to optimally distinguish the cut-off of ≥2million CD34+ cells/kg of recipient’s body weight.
Results
Eighty-four healthy donors underwent peripheral blood stem cell harvest. Median age of the donors was 21 years. The most common benign and malignant diseases were Aplastic anemia (27%) and Acute myeloid leukemia (11%) respectively. Multiple XN-HPC cut-off values were computed for the CD34+ cell count of ≥2 × 106/kg of recipient’s body weight to establish evaluable sensitivity and specificity of XN-HPC. The XN-HPC cut-off of 0.049×103/ul has a sensitivity and specificity of 96.3% and 09% respectively, whereas the HPC cut-off of 0.87×103/ul has a sensitivity and specificity of 47.5% and 82% respectively. Despite a weak correlation between HPC and CD34 (ρ=0.18, p-value=0.104), the ROC curve analysis showed area under the curve (AUC) of 0.71 (95% CI; 0.58-0.84, p-value=0.023) highlighting the possible potential of XN-HPC to serve as a cost effective surrogate for CD34+ cell count.
Conclusion
Our results demonstrated a statistically significant p value of <0.05 that points towards the possible prognostication potential of XN-HPC for CD34+ cell count, in post-harvest products, in allogenic bone marrow transplant setting. A larger sample size will help in further elucidating the relationship of post-harvest product XN-HPC and CD34+ cell counts.
Session topic: 23. Stem cell transplantation - Clinical
Keyword(s): Allogeneic hematopoietic stem cell transplant, CD34+ cells, Hematopoietic stem and progenitor cells