Novel Markers of Early Neutrophilic and Monocytic Engraftment after Hematopoietic Stem Cell Transplantation
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Background: Numerous studies tried to find new markers that after hematopoietic stem cell transplantation predict engraftment earlier than the conventional marker, absolute neu- trophil count (ANC >500/µL). Early engraftment prediction can be achieved by a marker that reflects the release of neutrophils and monocytes into the leukopenic peripheral blood. Methods: We analyzed blood cell parameters, including cell population data such as vol- ume, conductivity, and light scatter in 77 patients who underwent HSCT (allogeneic, n= 63; autologous, n=11) to detect possible markers. Results: We identified 2 early engraftment markers of neutrophils (NEUTRO) and mono- cytes (MONO); a pair of mean-volume-neutrophils (MNV) and mean-conductivity-neutro- phils (MNC) for NEUTRO; and a pair of mean-volume-monocytes (MMV) and mean-con- ductivity-monocytes (MMC) for MONO. The new markers showed distinct patterns for early engraftment wherein 1) on the engraftment day, MNV peaked as MNC notched si- multaneously for every case, and 2) MMV peaked as MMC notched simultaneously in most cases. Engraftment was predicted 3.8±2.7 days earlier than by ANC in 74 success- ful engraftment cases by using NEUTRO and/or MONO: 1) 72 cases (97.3%), in which NEUTRO and/or MONO predicted earlier engraftment than ANC, 2) 1 case, in which the 3 markers predicted engraftment on the same day, and 3) 1 case, in which NEUTRO pre- dicted engraftment on the same day as ANC and MONO failed to predict engraftment. Conclusions: By analyzing the data from daily complete blood counts, engraftment can be predicted approximately 4 days earlier than ANC >500/µL using NEUTRO as a base marker and MONO as a supplementary marker.
Abstract
Background: Numerous studies tried to find new markers that after hematopoietic stem cell transplantation predict engraftment earlier than the conventional marker, absolute neu- trophil count (ANC >500/µL). Early engraftment prediction can be achieved by a marker that reflects the release of neutrophils and monocytes into the leukopenic peripheral blood. Methods: We analyzed blood cell parameters, including cell population data such as vol- ume, conductivity, and light scatter in 77 patients who underwent HSCT (allogeneic, n= 63; autologous, n=11) to detect possible markers. Results: We identified 2 early engraftment markers of neutrophils (NEUTRO) and mono- cytes (MONO); a pair of mean-volume-neutrophils (MNV) and mean-conductivity-neutro- phils (MNC) for NEUTRO; and a pair of mean-volume-monocytes (MMV) and mean-con- ductivity-monocytes (MMC) for MONO. The new markers showed distinct patterns for early engraftment wherein 1) on the engraftment day, MNV peaked as MNC notched si- multaneously for every case, and 2) MMV peaked as MMC notched simultaneously in most cases. Engraftment was predicted 3.8±2.7 days earlier than by ANC in 74 success- ful engraftment cases by using NEUTRO and/or MONO: 1) 72 cases (97.3%), in which NEUTRO and/or MONO predicted earlier engraftment than ANC, 2) 1 case, in which the 3 markers predicted engraftment on the same day, and 3) 1 case, in which NEUTRO pre- dicted engraftment on the same day as ANC and MONO failed to predict engraftment. Conclusions: By analyzing the data from daily complete blood counts, engraftment can be predicted approximately 4 days earlier than ANC >500/µL using NEUTRO as a base marker and MONO as a supplementary marker.
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