The number of CD34+CD38+CD117+HLA-DR+CD13+CD33+ cells indicates post-chemotherapy hematopoietic recovery in patients with acute myeloid leukemia.
The number of CD34+CD38+CD117+HLA-DR+CD13+CD33+ cells indicates post-chemotherapy hematopoietic recovery in patients with acute myeloid leukemia.
复制标题
CD34 CD38 CD117 HLA-DR CD13 CD33细胞数量提示急性髓系白血病患者化疗后造血功能恢复情况
DOI：
10.1371/journal.pone.0180624
复制
发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Wang J
中科院分区：
文献类型：
--
作者：
Gu R;Wei H;Wang Y;Lin D;Liu B;Zhou C;Liu K;Gong B;Wei S;Zhang G;Gong X;Liu Y;Li Y;Zhao X;Qiu S;Wang H;Wang M;Mi Y;Wang J
造血恢复被认为与骨髓中多能造血干细胞的数量相关，如在涉及干细胞移植的功能测定中所观察到的。然而，很少有证据表明，在非移植环境中，造血恢复是由内源性造血细胞完成的。最近的一项研究表明，祖细胞是这种稳态造血过程中的主要贡献者，这与外源性移植不同。我们假设内源性祖细胞支持化疗后造血恢复。为了探讨这些祖细胞百分比对造血恢复的潜在影响，我们回顾性分析了223例初治急性髓系白血病患者完全缓解后接受两个疗程巩固化疗期间CD 34 + CD 38 + CD 117 +HLA-DR+ CD 13 + CD 33+细胞（P细胞）的百分比和造血恢复。我们发现，较低的P细胞百分比与第一和第二疗程巩固化疗后中性粒细胞减少恢复时间延长显著相关（分别为p = 0.001; p = 0.045）。我们还观察到了巩固化疗第一个疗程后血小板恢复时间的相似结果（p = 0.000）。单因素分析显示P细胞百分比和巩固化疗方案与化疗后中性粒细胞恢复相关，而性别、年龄、诱导化疗方案、感染分级、WHO分类和NCCN危险度分类与化疗后中性粒细胞恢复无关。多变量分析表明，P细胞百分比是一个独立的因素，影响中性粒细胞恢复能力的第一和第二个疗程（p = 0.008，p = 0.032，分别）。我们的研究结果表明，每个疗程化疗前的CD 34 + CD 38 + CD 117 +HLA-DR+ CD 13 + CD 33+细胞与化疗相关的造血重建能力独立相关。这些发现可能有助于根据祖细胞百分比修改未来的化疗方案。
Hematopoietic recovery is considered to be associated with the number of multipotent hematopoietic stem cells in the bone marrow, as observed in functional assays involving stem cell transplantation. However, there is little evidence related to hematopoietic recovery in non-transplantation settings, which is accomplished by endogenous hematopoietic cells. A recent study suggested that progenitors are the main contributors during this steady-state hematopoiesis, which differs from exogenous transplantation. We hypothesized that endogenous progenitor support post-chemotherapy hematopoietic recovery. To investigate the potential impact of these progenitor cell percentage on hematopoietic recovery, we retrospectively analyzed the percentage of CD34+CD38+CD117+HLA-DR+CD13+CD33+ cells (P cells) and hematopoietic recovery in 223 newly diagnosed acute myeloid leukemia patients during two courses of consolidation chemotherapy after complete remission. We found that a lower P cell percentage was significantly associated with prolonged neutropenia recovery time after the first and second courses of consolidation chemotherapy (p = 0.001; p = 0.045, respectively). We also observed similar results with regard to platelet recovery time after the first course of consolidation chemotherapy (p = 0.000). Univariate analysis showed that P cell percentage and consolidation chemotherapy regimens, and not gender, age, induction chemotherapy regimens, infection grade, WHO classification and NCCN risk category, were associated with neutrophil recovery after chemotherapy. Multivariate analysis demonstrated that P cell percentage is an independent factor affecting neutrophil recovery capacity for both the first and second courses (p = 0.008; p = 0.032, respectively). Our results indicate that CD34+CD38+CD117+HLA-DR+CD13+CD33+ cells before each course of chemotherapy is independently associated with chemotherapy-related hematopoietic reconstitution capacity. These findings may help modify future chemotherapy regimens based on progenitor cell percentages.