Introduction
A successful bone marrow transplant requires a minimum of 2‐4 × 106 cells/kg patient body weight of CD 34+ cells to be transfused, where peripheral blood CD34+ cell count being and ideal predictor. We compared the correlation and predictive capacity of both hematopoietic progenitor cell count (HPC) determined on the Sysmex XN‐9000 and flow cytometric CD34 in autologous and allogenic donors.
Methods
Autologous and allogenic donors were taken as per criteria. TLC (Total Leukocyte Count), MNC (Mononuclear cell count), HPC, and CD34 assay were done in both the peripheral blood prior to apheresis, and the harvest product postapheresis. Sysmex XN‐9000 was used for TLC, MNC, and HPC tests, and a modified ISH‐AGE protocol was used to enumerate CD34 by flow cytometry. Statistical analysis was done using SPSS 16.0.
Results
Sixty‐seven allogenic and 35 autologous donors were enrolled. 45% were females, and 55% were males. Correlation between HPC and CD34 was found to be 0.887 with P value < .01 in peripheral blood and 0.847 with P value < .01 in the harvested product. On the other hand, TLC had a correlation of 0.424 and 0.520 in peripheral blood and harvested, respectively. MNC had a weak association. The cutoff value for a target dose of 2 × 106 CD34 cells/kg was 37 × 106/L for pre‐HPC. For a target of 4 × 106 CD34 cells/kg, the cutoff value calculated to be 54 × 106/L (Sensitivity: 85%, Specificity: 89%) for peripheral blood HPC.
Conclusion
We conclude that HPC is comparable to CD34 in predicting harvest product's adequacy.
BackgroundEarly T cell precursor‐acute lymphoblastic leukemia (ETP‐ALL) is a hematolymphoid malignancy where the blasts demonstrate T cell differentiation markers along with stem cell and myeloid antigen expression. The differential diagnosis of ETP‐ALL from non‐ETP ALL and mixed phenotype acute leukemia is often challenging due to its overlapping immunophenotypic picture with co‐expression of myeloid antigens. In this study, we endeavored to describe the immune‐phenotype profile of ETP‐ALL in our patients and compared the utility of four different scoring systems for better discrimination of these entities.MethodsThis retrospective analysis included 31 ETP‐ALL out of 860 acute leukemia cases consecutively diagnosed at the two tertiary care centers. Flowcytometry‐based immunophenotype was reviewed for all the cases, and the utility of four flow‐based objective scorings was assessed for the diagnosis of ETP‐ALL. Receiver operating curves were drawn to compare the different flow‐based scoring systems.ResultsThe prevalence of ETP‐ALL was 40% (n = 31/77 T‐ALL) in our study group, comprised mainly of adults with a median age of 20 years. The five‐marker scoring system had the maximum area under the curve, followed by the seven‐marker scoring system. A cut‐off of ≥2.5 was more specific (sensitivity: 91%; specificity: 100%), while a score of ≥1.5 was more sensitive but slightly less specific (sensitivity: 94%, specificity: 96%).ConclusionThe WHO criteria for the diagnosis of ETP‐ALL should be followed across all laboratories to avoid confusion and for better treatment stratification. Flow‐based scoring systems can be objectively employed for better detection of cases.
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