基于多种外周血标志物的多发性骨髓瘤和淋巴瘤患者造血干细胞采集效率预测模型。

IF 2.2 4区 医学 Q3 HEMATOLOGY International Journal of Laboratory Hematology Pub Date : 2024-07-03 DOI:10.1111/ijlh.14337
Longrong Ran, Yu Peng, Mingyu Zhao, Xin Luo, Shuang Chen, Xinyi Tang, Yakun Zhang, Lian Li, Liangmei Li, Wei Zhang, Tingting Jiang, Xuelian Wu, Renzhi Hu, Yao Liu, Zailin Yang
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引用次数: 0

摘要

导言:自体造血干细胞移植(ASCT)已广泛应用于淋巴瘤和多发性骨髓瘤(MM)的治疗。大量研究表明,外周血指标可被视为造血干细胞采集效率的潜在预测生物标志物,包括白细胞计数(WBC)、单核细胞计数(Mono)、血小板计数(PLT)、血细胞比容和血红蛋白水平。目前,还缺乏基于这些外周检测指标的临床实用预测模型,以快速、方便、准确地预测采集效率:方法:回顾性研究了 139 名接受动员和 ASCT 采集的 MM 和淋巴瘤患者。研究终点是成功采集自体造血干细胞。我们分析了临床特征和外周血标志物对采集成功率的影响,并筛选变量建立了预测模型。我们确定了预测干细胞成功采集的最佳外周血标志物截断值,以及多标志物预测方法的临床价值。我们还建立了一个采集疗效预测模型:单变量和多变量逻辑回归分析表明,动员方案、Mono、PLT、单核细胞计数(MNC)和外周血CD34+细胞计数(PB CD34+计数)是成功采集外周血干细胞(PBSC)的重要预测指标。根据多变量逻辑分析结果构建了两个预测模型。模型1包括动员方案、Mono、PLT和MNC,而模型2包括动员方案、Mono、PLT、MNC和PB CD34+计数。接收者操作特征曲线(ROC)分析表明,PB CD34+ 计数、模型 1 和模型 2 可预测造血干细胞的成功采集,其临界值分别为 26.92 × 106/L、0.548 和 0.355。模型 1 预测造血干细胞采集成功的灵敏度为 84.62%,特异度为 75.73%,曲线下面积(AUC)为 0.863。模型 2 预测造血干细胞采集成功的灵敏度为 83.52%,特异性为 94.17%,曲线下面积(AUC)为 0.946;因此,它优于单纯的 PB CD34+ 计数:我们的研究结果表明,采集前动员方案、Mono、PLT、MNC 和 PB CD34+ 计数的组合对 MM 和淋巴瘤患者自体造血干细胞采集的疗效具有预测价值。使用基于这些预测指标的模型可能有助于避免过度采集并改善患者预后。
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Predictive model of the efficiency of hematopoietic stem cell collection in patients with multiple myeloma and lymphoma based on multiple peripheral blood markers

Introduction

Autologous hematopoietic stem cell transplantation (ASCT) has gained extensive application in the treatment of lymphoma and multiple myeloma (MM). Plenty of studies demonstrate that peripheral blood indicators could be considered potential predictive biomarkers for hematopoietic stem cells (HSCs) collection efficiency, including white blood cell count (WBC), monocyte count (Mono), platelet count (PLT), hematocrit, and hemoglobin levels. Currently, clinically practical predictive models based on these peripheral detection indicators to quickly, conveniently, and accurately predict collection efficiency are lacking.

Methods

In total, 139 patients with MM and lymphoma undergoing mobilization and collection of ASCT were retrospectively studied. The study endpoint was successful collection of autologous HSCs. We analyzed the effects of clinical characteristics and peripheral blood markers on collection success, and screened variables to establish a prediction model. We determined the optimal cutoff value of peripheral blood markers for predicting successful stem cell collection and the clinical value of a multi-marker prediction approach. We also established a prediction model for collection efficacy.

Results

Univariate and multivariate logistic regression analyses showed that the mobilization regimen, Mono, PLT, mononuclear cell count (MNC), and peripheral blood CD34+ cell count (PB CD34+ counts) were significant predictors of successful collection of peripheral blood stem cells (PBSC). Two predictive models were constructed based on the results of multivariate logistic analyses. Model 1 included the mobilization regimen, Mono, PLT, and MNC, whereas Model 2 included the mobilization regimen, Mono, PLT, MNC, and PB CD34+ counts. Receiver operating characteristic (ROC) curve analysis showed that the PB CD34+ counts, Model 1, and Model 2 could predict successful HSCs collection, with cutoff values of 26.92 × 106/L, 0.548, and 0.355, respectively. Model 1 could predict successful HSCs collection with a sensitivity of 84.62%, specificity of 75.73%, and area under the curve (AUC) of 0.863. Model 2 could predict successful HSCs collection with a sensitivity of 83.52%, specificity of 94.17%, and AUC of 0.946; thus, it was superior to the PB CD34+ counts alone.

Conclusion

Our findings suggest that the combination of the mobilization regimen, Mono, PLT, MNC, and PB CD34+ counts before collection has predictive value for the efficacy of autologous HSCs collection in patients with MM and lymphoma. Using models based on these predictive markers may help to avoid over-collection and improve patient outcomes.

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来源期刊
CiteScore
4.50
自引率
6.70%
发文量
211
审稿时长
6-12 weeks
期刊介绍: The International Journal of Laboratory Hematology provides a forum for the communication of new developments, research topics and the practice of laboratory haematology. The journal publishes invited reviews, full length original articles, and correspondence. The International Journal of Laboratory Hematology is the official journal of the International Society for Laboratory Hematology, which addresses the following sub-disciplines: cellular analysis, flow cytometry, haemostasis and thrombosis, molecular diagnostics, haematology informatics, haemoglobinopathies, point of care testing, standards and guidelines. The journal was launched in 2006 as the successor to Clinical and Laboratory Hematology, which was first published in 1979. An active and positive editorial policy ensures that work of a high scientific standard is reported, in order to bridge the gap between practical and academic aspects of laboratory haematology.
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