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d'Onofrio G. Full-field hemocytometry. Forty years of progress seen through Clinical and Laboratory Hematology and the International Journal of Laboratory Hematology. Int J Lab Hematol 2021; 43 Suppl 1:7-14. [PMID: 34288438 DOI: 10.1111/ijlh.13546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/19/2021] [Accepted: 03/29/2021] [Indexed: 12/19/2022]
Abstract
The extraordinary advances in clinical hematology, biology, and oncology in the last decades would not have been possible without discovering how to identify and count the cells circulating in the blood. For centuries, scientists have used slides, counting chambers (hemocytometers), and diluting and staining solutions for this task. Then, automated hemocytometry began. This science, now linked to the daily routine of laboratory hematology, has completed an overwhelming path over a few decades. Our laboratories today operate with versatile multiparameter systems, ranging from complex single-channel instruments to bulky continuous flow machines. In terms of clinical information obtained from a simple routine blood test, the full exploitation of their potential depends on the operators' imagination and courage. A comprehensive review of the scientific publications that have accompanied the development of hemocytometry from the 1950s to today would require entire volumes. More than seven hundred contributions that authors worldwide have published in Clinical and Laboratory Haematology until 2007 and then the International Journal of Laboratory Hematology are summarized. Such journals have represented and hopefully will continue to represent the privileged place of welcome for future scientific research in hemocytometry. Improved technologies, attention to quality, new reagents and electronics, information technology, and scientist talent ensure a more profound and deeper knowledge of cell properties: current laboratory devices measure and count even minor immature or pathological cell subpopulations. Full-field hemocytometry includes the analysis of nonhematic fluids, digital adds to the microscope, and the development of effective point-of-care devices.
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Affiliation(s)
- Giuseppe d'Onofrio
- Clinical Pathology and Sports Hematology, Catholic University of Sacred Heart, Rome, Italy
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Mohammadi S, Jalili M, Malek Mohammadi A, Nikbahht M, Aminian P, Bagherian M, Mousavi SA, Heshmati F. An alternative test for determining autologous stem cell transplantation cell harvesting outcome: Comparison between predictive values of two tests. Transfus Apher Sci 2020; 59:102763. [PMID: 32273231 DOI: 10.1016/j.transci.2020.102763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 11/16/2022]
Abstract
Daily CD34+ cells enumeration as a success indicator of stem cell pheresis procedure using flow cytometry is costly, lengthy, and labor-intensive. Thus, finding a simpler method to achieve the optimum time for harvesting the minimum required stem cells for transplantation could be helpful. The aim of this study was to evaluate the predictive value of reticulocytes fractions and their sensesivity and specificity in guiding CD34+ cell harvesting by G-CSF mobilization strategy. In this study, 49 candidates for autologous peripheral blood stem cell transplantation were enrolled. Before leukapheresis, the immature reticulocytes fraction (IRF) and CD34+ cell count were measured. Moreover, patients were evaluated for leukapheresis outcomes in two MNC and cMNC groups. Here we demonstrated that IRF, LFR, and MFR with the associated criterion of >17.3, ≤82.5, and >15.9, respectively, earned 100 % specificity and 47.2 %, 47.22 %, and 41.46 % sensitivity to predict the minimum required CD34+ cell count. Furthermore, IRF-V (Value) and MFR-V with the associated criterion of >0.77 and >0.55, respectively, earned 58.33 %, 66.67 % sensitivity and 84.62 %, 69.23 % of specificity, separately. As only MFR-V was able to predict the platelet engraftment (P-value = 0.014), none of the other above mentioned factors were not able to predict the neutrophil engraftment. Likewise, it was shown that patients who underwent MNC leukapheresis had a statistically significantly higher total WBC, harvested CD34+ cells, MNCs/ kg, and lower apheresis durations (P-values<0.05). Taken together, using IRF and its maturity stages seems to be a compelling predictor of minimal required CD34+ cells in autologous peripheral blood stem cell transplantation.
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Affiliation(s)
- Saeed Mohammadi
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran; Cell Therapy and Hematopoietic Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mahdi Jalili
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran; Cell Therapy and Hematopoietic Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ashraf Malek Mohammadi
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran; Cell Therapy and Hematopoietic Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Nikbahht
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran; Cell Therapy and Hematopoietic Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Privash Aminian
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran; Cell Therapy and Hematopoietic Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Bagherian
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran; Cell Therapy and Hematopoietic Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Syed Asadollah Mousavi
- Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran; Cell Therapy and Hematopoietic Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Heshmati
- Transfusion Medicine Unit, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France.
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Noronha JFA, Lorand-Metze IGH, Grotto HZW. Hematopoietic progenitor cells (HPC) and immature reticulocytes evaluations in mobilization process: new parameters measured by conventional blood cell counter. J Clin Lab Anal 2006; 20:149-53. [PMID: 16874808 PMCID: PMC6807316 DOI: 10.1002/jcla.20123] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Monitoring the timing of leukapheresis in peripheral blood stem cells (PBSC) mobilization is an important clinical decision that requires an accurate analytical tool. The present study assessed hematopoietic progenitor cells (HPC) and immature reticulocyte fraction (IRF) counts provided by a routine automated blood counter as potential parameters for predicting the appropriate time for harvesting. The HPC and IRF values were compared with white blood cell (WBC) and CD34+ cell counts obtained by flow cytometry in 30 adult patients with hematological malignancies undergoing PBSC mobilization. It was observed that there was a significant correlation between HPC counts and CD34(+) cells in peripheral blood counts (r=0.61, P=0.0003) and between the number of HPC and CD34+cells collected by leukapheresis (r=0.5733, P=0.0009). Comparing HPC, IRF, WBC, and CD34+ cells parameters as a sign of hematological recovery showed that the raise in immature reticulocytes counts preceded the increase of WBC (P=0.0002), HPC (P=0.0001), and CD34(+) (P=0.0001) cells in peripheral blood counts. According to our results, HPC and IRF parameters may be integrated into clinical protocols to evaluate the timing of leukapheresis. IRF, as previously demonstrated in bone marrow transplantation, is the earliest sign of hematopoietic recovery in mobilization process.
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Affiliation(s)
- J F A Noronha
- Department of Clinical Pathology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), São Paulo, Brazil.
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Dunlop LC, Cohen J, Harvey M, Gallo J, Motum P, Rosenfeld D. The immature reticulocyte fraction: a negative predictor of the harvesting of CD34 cells for autologous peripheral blood stem cell transplantation. ACTA ACUST UNITED AC 2006; 28:245-7. [PMID: 16898963 DOI: 10.1111/j.1365-2257.2006.00797.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The optimal time for the harvesting of peripheral blood stem cells following chemotherapy and growth factors for autologous transplantation is based on the CD34 cell count. In this study, 51 patients having 59 stem cell mobilizations were assessed for the timing of the harvest by a CD34 cell count and an immature reticulocyte fraction (IRF). Results from 272 preharvest tests showed that when the CD34 cells were not harvestable, defined as a CD34 cell count of < 15 cells/microl, the IRF was always < or = 0.2. A low IRF resulted in a negative predictive value of 1 for the harvesting of stem cells. The IRF is therefore a valuable negative predictor of the timing of autologous stem cell harvesting.
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Affiliation(s)
- L C Dunlop
- South Western Area Pathology Service, Liverpool Hospital, Liverpool, NSW, Australia.
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Gutensohn K, Magens M, Krüger W, Kröger N, Kühnl P. Comparison of flow cytometry vs. a haematology cell analyser-based method to guide the optimal time-point for peripheral blood stem cell apheresis. Vox Sang 2006; 90:53-8. [PMID: 16359356 DOI: 10.1111/j.1423-0410.2005.00720.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES For timing the onset of apheresis, parameters obtained by flow cytometry and by a haematological cell analyser were compared. MATERIALS AND METHODS Haematopoietic cell counts (n = 159) were performed by two different methods; CD34 analyses by flow cytometry, immature myeloid information (IMI) and human progenitor cell counts (HPC) by a haematological cell analyser. RESULTS Comparing the IMI total results with CD34+ analyses (n = 159) revealed a correlation of r = 0.46 (P < 0.05). Similar results were obtained for HPC (r = 0.44; P < 0.05). CONCLUSION The haematology analyser-based method does not allow the precise determination of absolute haematopoietic stem cell numbers and is thus not able to replace flow cytometry for the monitoring of peripheral blood stem cell counts.
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Affiliation(s)
- K Gutensohn
- Institute for Transfusion Medicine, University Hospital Eppendorf, University of Hamburg, Germany
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Lesesve JF, Lenormand B, Lacombe F. The role of high fluorescent reticulocytes in monitoring the aplasia outcome and optimizing the timing of peripheral blood stem cell harvesting. JOURNAL OF HEMATOTHERAPY & STEM CELL RESEARCH 2002; 11:987-9. [PMID: 12590715 DOI: 10.1089/152581602321080664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Kurata H, Takakuwa K, Tsuneki I, Aoki Y, Tanaka K. Circulating highly fluorescent reticulocytes to predict the adequate harvesting of peripheral blood progenitor cells in platinum-based chemotherapy. Transfus Apher Sci 2002; 27:199-202. [PMID: 12509213 DOI: 10.1016/s1473-0502(02)00065-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We prospectively evaluated whether peripheral blood progenitor cells (PBPC) yield from a single leukapheresis could be predicted by measurement of circulating highly fluorescent reticulocytes (HFR). PBPC were collected from 46 leukaphereses in 15 patients with gynecological cancer following platinum-based chemotherapy. Once a level of at least 5.0% HFR was achieved, sufficient PBPC were collected in a single harvest in 71% of the procedures. Whereas, failure to mobilize sufficient PBPC occurred in 24 of 28 leukaphereses when the percentage of circulating HFR was less than 5.0%. In conclusion, circulating HFR may aid in the efficiency of PBPC collections in platinum-based chemotherapy.
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Affiliation(s)
- H Kurata
- Department of Obstetrics and Gynecology, Faculty of Medicine, Niigata University, Asahimachi-dori 1-757, Niigata 951-8510, Japan.
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Kozuka T, Ikeda K, Teshima T, Kojima K, Matsuo K, Bessho A, Sunami K, Hiramatsu Y, Maeda Y, Noguchi T, Yamamoto K, Fujii N, Imai T, Takenaka K, Shinagawa K, Ishimaru F, Niiya K, Koide N, Tanimoto M, Harada M. Predictive value of circulating immature cell counts in peripheral blood for timing of peripheral blood progenitor cell collection after G-CSF plus chemotherapy-induced mobilization. Transfusion 2002; 42:1514-22. [PMID: 12421227 DOI: 10.1046/j.1537-2995.2002.00218.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Enumeration of CD34+ cells in peripheral blood (PB) before apheresis predicts the number of CD34+ cells collected, although flow cytometric techniques used are complex and expensive. In an attempt to determine the optimal timing for peripheral blood progenitor cell (PBPC) collection, the usefulness of circulating immature cell (CIC) counts in PB was evaluated. STUDY DESIGN AND METHODS CIC counts in PB and CD34+ cell counts in the apheresis product from 249 collections were assessed, and the relationship between these two parameters was evaluated by with the Pearson rank correlation analysis, the Fisher exact test, and the U-test. RESULTS CIC counts were correlated significantly with the number of CD34+ cells per kg of patient's body weight in the apheresis product (Pearson rank correlation analysis: r = 0.635, p < 0.0001). When a level of 1 x 10(9) CICs per L was selected as a cutoff value, the sensitivity and specificity for collecting more than 1 x 10(6) CD34+ cells per kg of body weight were 75.7 and 85.5 percent, respectively. CONCLUSION The present study strongly suggests that the number of CICs in PB may estimate the number of CD34+ cells collected. The data indicate that CIC counts above 1 x 10(9) per L can be used as a good predictor for PBPC collections containing more than 1 x 10(6) CD34+ cells per kg of body weight in a single apheresis procedure.
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Affiliation(s)
- Teruhiko Kozuka
- Second Department of Internal Medicine, Okayama University Medical School, Okayama, Japan.
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Lesesve JF, Lenormand B, Vannier JP. Increase of high fluorescence reticulocytes indicates mobilization of peripheral stem cells in children recovering from aplasia after chemotherapy or bone marrow transplantation. CLINICAL AND LABORATORY HAEMATOLOGY 2002; 24:291-4. [PMID: 12358890 DOI: 10.1046/j.1365-2257.2002.00467.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Enumeration of CD34 + cells is the standard assay procedure for optimization of peripheral blood stem cell harvesting. High fluorescence reticulocytes (HFR) have been shown to signal a rebound in haematopoiesis after chemotherapy. The aim of this study was to evaluate HFR determination, as compared to CD34 + cell counts and CFU-GM, as a potential predictor of PBSC counts after recovery from chemotherapy and/or bone marrow transplantation. Twenty-five paediatric patients undergoing intensive courses of chemotherapy and 9 undergoing bone marrow auto or allografts were investigated. In most of our cases, HFR recovered at the same time or earlier than CD34 + cells. Similarly, the rise in HFR preceeded the CFU-GM peak in most of these cases. In no case did we observe a CFU-GM peak without a rise in HFR%. In our experience, the daily relative HFR increase may be used to predict the optimal time for mobilization of stem cells and was therefore of value clinically to confirm the timing of apheresis.
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Affiliation(s)
- J F Lesesve
- Laboratory of Haematology, CHU Rouen, Vandoeuvre, France.
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Abstract
The eyecount reticulocyte count has been replaced by semi-automated and fully automated methods in laboratories of nearly all developed nations, except for small-volume laboratories and office laboratories in which they are not as cost effective. The eyecount method remains the reference method as defined in NCCLS document H44-A.
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Affiliation(s)
- Robert V Pierre
- Department of Pathology, Los Angeles County/University of Southern California Medical Center, Los Angeles, California, USA
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Peng L, Yang J, Yang H, Peng Z, Xu C, Liu T. Determination of peripheral blood stem cells by the Sysmex SE-9500. CLINICAL AND LABORATORY HAEMATOLOGY 2001; 23:231-6. [PMID: 11683783 DOI: 10.1046/j.1365-2257.2001.00390.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The Sysmex SE-9500 automated haematology analyser provides an estimate of immature cells, referred to as 'haematopoietic progenitor cells' (HPC). The aim of this study was to evaluate the reliability and usefulness of the SE-9500 HPC parameter as compared with the CD34 + cell count and to determine whether the HPC count was of value in predicting the optimal harvesting time for peripheral blood stem cells (PBSC). Studies were performed on 112 samples from 21 patients with haematological malignancies and 13 healthy donors undergoing progenitor cell mobilisation. Coefficients of variation for the HPC count were 30%, 23.8%, 12.4% and 8.3% respectively for samples with low (4 x 106/l), medium (13 x 106/l), high (250 x 106/l) and very high (2413 x 106/l) counts. There was good linearity for HPC measurement in both peripheral blood (PB) and purified CD34 + cell suspensions (r > 0.995), and no detectable carryover was observed. There was an acceptable correlation between HPC and CD34 + cell counts for PB samples (r=0.669) and for CD34 + cell suspensions (r=0.859). Analysis of purified CD34 + cells using the SE-9500 HPC mode revealed that they appear both in the blast cell area and the immature granulocyte area of the analyser cell display. Quantitation of CD34 + cells and HPC during PBSC mobilisation showed good agreement between these parameters with regard to the optimal time for PBSC harvesting. These findings suggest that HPC counting with the Sysmex SE-9500 may be clinically useful for optimising the timing of PBSC collection.
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Affiliation(s)
- L Peng
- Department of Laboratory Medicine, First University Hospital, West China University of Medical Sciences, Chengdu, Sichuan, 610041, China.
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Riley RS, Ben-Ezra JM, Goel R, Tidwell A. Reticulocytes and reticulocyte enumeration. J Clin Lab Anal 2001; 15:267-94. [PMID: 11574956 PMCID: PMC6808174 DOI: 10.1002/jcla.1039] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2001] [Accepted: 04/09/2001] [Indexed: 11/09/2022] Open
Affiliation(s)
- R S Riley
- Department of Pathology, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0250, USA.
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Abstract
Hematopoietic stem cell transplantation has been extensively exploited as a therapeutic and research modality and has revolutionized current patient care. At present, more and more medical centers use peripheral blood progenitor cells for transplantation by mobilizing hematopoietic stem cells from bone marrow to peripheral blood because of potential advantages of peripheral blood stem cell transplantation over bone-marrow transplantation. Different effective mobilization regimens have been developed recently with chemotherapeutic agents, hematopoietic growth factors or their combination. This article reviews current developments related to hematopoietic stem cell mobilization including the biology of hematopoietic stem cells, strategies for mobilization, management for mobilization failure, mechanisms of mobilization, and side effects during mobilization. Finally, the Initiation-Amplification-Emigration-Adaptation Model is proposed to help aid understanding of the mechanisms of hematopoietic stem cell mobilization and to stimulate development of novel and optimal mobilization strategies for patient care.
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Affiliation(s)
- S Fu
- Department of Internal Medicine Hematology/Oncology, Blood and Marrow Transplant Program, 601 Elmwood Avenue, Box 610, Rochester, NY 14642, USA
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