Relativna učestalost nezrelog podtipa ćelija CD34+/CD90+ u perifernoj krvi posle mobilizacije je u tesnoj i obrnutoj korelaciji sa apsolutnim brojem matičnih ćelija u afereznom produktu kod bolesnika sa multiplim mijelomom
Sažetak
Uvod/Cilj. Matične ćelije (MĆ) obezbeđuju kompletnu/dugotrajnu repopulaciju kostne srži (KS) posle transplantacije. Cilj ove studije bila je procena apsolutnog broja ukupnih MĆ (utvrđena protokolom „ISHAGE-sequential-gating” – Stem-Cellish [SCish]) i relativne učestalosti primitivnih podipova CD34+/CD90+ (CD90+SCish) u perifernoj krvi (PK) kao prediktora efikasnosti mobilizacije i pokazatelja kvaliteta afereznog produkta (AP). Metode. Mobilizacija je postignuta hemioterapijom/faktor-rasta-granulocitopoeze (G-CSF). Prikupljanje je izvedeno pomoću sistema Spectra-Optia-IDL. Ćelije SCsish determinisane su kao konstitutivni deo CD34+ u regiji-matičnih-ćelija („stem-cell-region“) upotrebom protočnog citometra FC-500. U ovoj studiji, originalni protokol „ISHAGE-sequential-gating” modifikovan je uvođenjem monoklonskog antitela anti-CD90-PE radi analize ekspresije antigena CD90 na ćelijama SCish (CD90+SCish). Rezultati su prikazani kao procenat ćelija SCish u odnosu na broj nukleisanih ćelija, apsolutni broj SCish u mL PK ili AP, procenat ćelija CD90+SCish izražen u odnosu na SCish i apsolutni broj CD90+SCish u mL PK ili AP. Rezultati. Apsolutni broj ukupnih ćelija SCish i CD90+SCish bio je značajno (p = 0,0007 i p = 0,0266) veći u uzorcima AP nasuprot PK. Indeks CD90+SCish/ukupne SCish u uzorku PK je bio veći od indeksa u uzorku AP (p = 0,039). Relativna učestalost CD90+SCish pokazala je vrlo značajnu inverznu korelaciju sa apsolutnim brojem ukupnih SCish u PK i AP (p = 0.0003 i p = 0,0013). Relativna učestalost ćelija CD90+SCish u PK takođe je pokazala značajnu (p = 0,0002) inverznu korelaciju sa apsolutnim brojem ukupnih ćelija SCish. Bolesnici sa manje od 10% CD90+SCish u PK su imali značajno (p = 0,0025) veći apsolutni broj ukupnih SCish ćelija u AP. Zaključak. Smatramo da niži prinos CD90+SCish u AP nije prouzrokovan manje efikasnim prikupljanjem, već je najverovatnije posledica različitih, još uvek samo delimično razjašnjenih, citomorfoloških/biofizičkih osobina manje zrelih MĆ. Zato, posle mobilizacije hemoterapijom/G-CSF nameću se logična pitanja - da li bi trebalo pratiti apsolutni broj ukupnih SCish ćelija ili je celishodnije testirati relativnu učestalost CD90+SCish pre sprovođenja afereznog prikupljanja MĆ. Za donošenje definitivnih zaključaka neophodna su buduća kontrolisana i sveobuhvatnija istraživanja MĆ, u vezi sa utvrđivanjem korelacije cirkulišućih i priku-pljenih ćelija sa hematopoetskim oporavkom bolesnika.
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