比較Sysmex XN-9000與流式細胞技術在預測CD34+細胞劑量並探討臨床應用價值

Comparing Sysmex XN-9000 with Flow Cytometry in Predicting CD34+ Cells Dose and Exploring their Clinical Application Value

周邊造血幹細胞（PBSC）移植由於其恢復快，成本低而成為治療血液系統疾病的重要方法。而幹細胞移植的成效則受到CD34+細胞劑量的影響。因此，在PBSC收集前必須預測CD34+細胞的劑量。該研究納入了37例自體造血幹細胞移植的患者。藉由Sysmex XN-9000檢測造血祖細胞及白血球濃度，並透過流式細胞技術檢測CD34+細胞。隨後，使用接收者操作特徵曲線（ROC曲線）和曲線下面積（AUC）值來計算這三種方法的預測準確性。收集前WBC濃度與收集後CD34+細胞劑量不具相關性（R＝-0.107，p＝0.53）。收集前造血祖細胞量（R＝0.721，p＜0.001）和收集前CD34+細胞濃度（R＝0.807，p＜0.001）均與收集後CD34+細胞劑量呈正相關。此外，在ROC曲線分析中，收集前WBC濃度的AUC值為0.21，不具統計意義。收集前CD34+細胞濃度的AUC值為0.968（p＜0.001），檢測收集前造血祖細胞計數的AUC值為0.903（p＝0.002）。這兩種預測方法的正相關性非常強，並且在ROC曲線分析中具有出色的區別力。然而，依據成本，檢測時間和人員培訓的綜合評估，使用Sysmex XN-9000檢測造血組細胞值更能符合臨床效益。

Peripheral hematopoietic stem cell (PBSC) transplantation is an important method for treating hematologic diseases, owing to the faster recovery and lower cost. Moreover, the effectiveness of the transplantation would be affected by the CD34+ cell dose. Hence, the dose of CD34+ cells must be predicted before harvesting PBSC. The 37 patients receiving autologous hematopoietic stem cell transplantation were enrolled in this study. The count of WBCs and hematopoietic progenitor cells(HPCs) were detected by Sysmex XN-9000.CD34+ cells were detected by flow cytometry. Subsequently, receiver operating characteristic (ROC)curve and area under the curve (AUC) value were used to calculate the prediction accuracy of thesethreetests. The pre-harvest WBC count(R=-0.107, p=0.53)was non-significant correlation with harvested CD34+ cell dose. Both the pre-harvest HPC count (R=0.721, p<0.001) and pre-harvest CD34+ cell concentration (R=0.807, p<0.001) were strongly positively correlated with harvested CD34+ cell dose. Moreover, in ROC curve analysis, the AUC value of detected pre-harvest WBC count was 0.21, which had no statistical significance. The AUC value of detecting pre-harvest CD34+ cell concentration was 0.968 (p<0.001) , and AUC value of detecting pre-harvest HPC count was 0.903 (p=0.002) . The positive correlation of these two predicted methods wasvery strong, and they had outstanding discrimination in ROC curve analysis. However, according to the comprehensive evaluation of cost, test time and personnel training, it was considered that detecting HPCs by Sysmex XN-9000 was more in line with clinical benefits.