Predictive Value of Immature Reticulocyte and Platelet Fractions in Hematopoietic Recovery of Allograft Patients
Predictive Value of Immature Reticulocyte and Platelet Fractions in Hematopoietic Recovery of Allograft Patients
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DOI：
10.1016/j.transproceed.2010.12.030
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发表时间：
2011-01-01
影响因子：
0.9
通讯作者：
Mendes, C.
中科院分区：
文献类型：
--
作者：
Goncalo, A. P.;Barbosa, I. L.;Mendes, C.
造血祖细胞移植是治疗恶性血液病的首选方法。中性粒细胞（NEUT）和血小板（PLT）计数用于评估移植患者的血液学植入。新一代血液分析仪提供了一种替代方法来评估未成熟的外周血（PB）细胞组分，这也可以给出造血恢复的指示。PB样本中的未成熟网织红细胞分数（IRF）和未成熟血小板分数（IPF）可提供移植成功的早期指标。我们评估了IRF和IPF对46例接受异基因PB祖细胞移植的成人患者血液学恢复的预测价值。我们观察到，与NEUT恢复（11 vs 15 d）相比，IRF恢复预期时间为4 d，与PLT（10 vs 12 d）相比，IPF恢复预期时间为2 d。接受非清髓性方案（NMA）的患者的恢复情况不同;我们观察到IRF提前5天恢复，而NEUT（10 vs 15 d）和IPF提前2天恢复，而PLT提前2天恢复（9 vs 11 d）。我们还观察到NEUT和PLT回收率与新参数IRF和IPF的回收率之间存在显著相关性。我们得出结论，IRF和IPF预测造血恢复。对于接受NMA治疗的同种异体移植患者，预测更具有临床意义。这些未成熟的部分打开了新的视角，通过移植后恢复监测患者输血支持。
Hematopoietic progenitor cell transplantation is the treatment of choice for patients with malignant hematologic diseases. Neutrophil (NEUT) and platelet (PLT) counts are used to evaluate hematologic engraftment of transplanted patients. Recent-generation hematology analyzers offer an alternative way to evaluate immature peripheral blood (PB) cell fractions, which may also give an indication of hematopoietic recovery. The immature reticulocyte fraction (IRF) and immature platelet fraction (IPF) in PB samples may provide early indicators of transplant success. We evaluated the predictive value of IRF and IPF for the hematologic recovery of 46 adult patients undergoing allogeneic PB progenitor cell transplantation. We observed that IRF recovery anticipated by 4 days compared with NEUT recovery (11 vs 15 d) and IPF by 2 days compared with PLT (10 vs 12 d). The recovery was different for patients undergoing a nonmyeloablative regimen (NMA); we observed an early IRF recovery by 5 days compared with NEUT (10 vs 15 d) and a IPF compared with PLT recovery by 2 days (9 vs 11 d). We also observed significant correlations between NEUT and PLT recovery with recoveries of the new parameters IRF and IPF. We concluded that IRF and IPF predicted hematopoietic recovery. For allografted patients after NMA regimens, prediction was even more clinically relevant. These immature fractions open new perspectives for monitoring patient transfusion support through the posttransplantation recovery.