Diagnostic and clinical relevance of the number of circulating CD34+ cells in myelofibrosis with myeloid metaplasia
Diagnostic and clinical relevance of the number of circulating CD34+ cells in myelofibrosis with myeloid metaplasia
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DOI：
10.1182/blood.v98.12.3249
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发表时间：
2001-12-01
期刊：
影响因子：
20.3
通讯作者：
Frassoni, F
中科院分区：
文献类型：
--
作者：
Barosi, G;Viarengo, G;Frassoni, F
对84例骨髓纤维化伴髓样化生（MMM）和23例其他Ph阴性慢性骨髓增生性疾病（CMD）患者外周血CD 34（+）细胞绝对含量进行了检测。在MMM中，循环CD 34（+）细胞的中位绝对数量始终较高（91.6 x 10（6）/L;范围，0-2460 x 10（6）/L）。受试者工作特征曲线分析显示，以CD 34（+）细胞15 × 10（6）/L作为判定标准，几乎可以完全区分未接受治疗的MMM患者和其他Ph-CMD患者（阳性预测值，98.4%;阴性预测值，85.0%）。CD 34+细胞数量较高的MMM患者的病程明显较长（P = .019），脾脏体积指数（P = .014）、肝脏体积（P = .000）、循环未成熟髓系细胞百分比（P = .020）和髓系原始细胞百分比（P = .000）较高。当CD 34（+）细胞与使用Dupriez危险分层相关时，CD 34（+）细胞从低风险（中位数，68.1 × 10（6）/L）显著增加到中风险（中位数，112.8 × 10（6）/L）和高风险患者（中位数666.1 × 10（6）/L）（F = 4.95; P = 0.009）。当CD 34（+）细胞与基于骨髓增生和骨髓耗竭特征的疾病严重程度评分相关时，只有骨髓增生指数与CD 34（+）细胞水平显著相关（F = 5.7; P = .000）。CD 34（+）细胞超过300 × 10（6）/L的患者的总生存期和从CD 34（+）细胞分析开始的母细胞转化间隔显著较短（分别为P = 0.005和0.0005）。总之，CD 34（+）循环细胞的绝对数量使MINIM与其他Ph-CMD区分开来;它与骨髓增殖的程度密切相关，并预测向母细胞转化的演变。（血。2001;98：3249-3255）（C）2001由美国血液学学会。
The absolute content of CD34(+) cells in the peripheral blood of 84 patients with myelofibrosis with myeloid metaplasia (MMM) and 23 patients with other Philadelphia-negative (Ph-) chronic myeloproliferative disorders (CMDs) was investigated. In MMM, the median absolute number of circulating CD34(+) cells was consistently high (91.6 x 10(6)/L; range, 0-2460 x 10(6)/L). Receiver operating characteristic curve analysis showed that 15 x 10(6)/L as a decision criterion for CD34(+) cells produced an almost complete discrimination between MMM patients out of therapy and other Ph- CMDs (positive predictive value, 98.4%; negative predictive value, 85.0%). MMM patients with higher numbers of CD34+ cells had a significantly longer disease duration (P = .019) and higher spleen volume index (P = .014), liver volume (P = .000), percentage of circulating immature myeloid cells (P = .020), and percentage of myeloid blasts (P = .000). When CD34(+) cells were correlated with the use of Dupriez risk stratification, CD34(+) cells increased significantly from low-risk (median, 68.1 x 10(6)/L) to intermediate-risk (median, 112.8 x 10(6)/L) and high-risk patients (median 666.1 x 10(6)/L) (F = 4.95; P = .009). When CD34(+) cells were correlated with a severity score on the basis of both myeloproliferative and myelodepletive characteristics of the disease, only the myeloproliferation index was significantly associated with CD34(+) cell level (F = 5.7; P = .000). Overall survival and interval to blast transformation from the time of CD34(+) cell analysis were significantly shorter in patients with more than 300 x 10(6)/L CD34(+) cells (P = .005 and .0005, respectively). In conclusion, the absolute number of CD34(+) circulating cells allows MINIM to be distinguished from other Ph- CMDs; it is strongly associated with the extent of myeloproliferation and predicts evolution toward blast transformation. (Blood. 2001;98:3249-3255) (C) 2001 by The American Society of Hematology.