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Lactate dehydrogenase as a hematopoietic stem cell mobilization biomarker in autologous transplantation
INTRODUCTION: Pre-apheresis peripheral blood CD34+ cell count (PBCD34+) is the most important predictor of good cell mobilization before hematopoietic stem cell transplantation, albeit flow cytometry is not always immediately available. Identification of surrogate markers can be useful. The CD34+ ce...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Hematologia e Hemoterapia
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627851/ https://www.ncbi.nlm.nih.gov/pubmed/36163321 http://dx.doi.org/10.1016/j.htct.2022.07.007 |
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author | Colunga-Pedraza, Perla R. Irabien-Zuñiga, Mariela Rodriguez-Roque, Carlos Saúl de la Cruz-de la Cruz, Carlos Gómez-De León, Andrés Santana-Hernández, Paola Jaime-Pérez, José Carlos Mancías-Guerra, Consuelo Gómez-Almaguer, David |
author_facet | Colunga-Pedraza, Perla R. Irabien-Zuñiga, Mariela Rodriguez-Roque, Carlos Saúl de la Cruz-de la Cruz, Carlos Gómez-De León, Andrés Santana-Hernández, Paola Jaime-Pérez, José Carlos Mancías-Guerra, Consuelo Gómez-Almaguer, David |
author_sort | Colunga-Pedraza, Perla R. |
collection | PubMed |
description | INTRODUCTION: Pre-apheresis peripheral blood CD34+ cell count (PBCD34+) is the most important predictor of good cell mobilization before hematopoietic stem cell transplantation, albeit flow cytometry is not always immediately available. Identification of surrogate markers can be useful. The CD34+ cells proliferate after mobilization, resulting in elevated lactate dehydrogenase (LDH) activity and correlating with the PBCD34+ count. OBJECTIVE: To determine the LDH cut-off value at which adequate CD34+ cell mobilization is achieved and its diagnostic yield. MATERIALS AND METHODS: A total of 103 patients who received an autologous stem cell transplantation (ASCT) between January 2015 and January 2020 were included. Demographic and laboratory characteristics were obtained, including complete blood count, pre-apheresis PBCD34+ and LDH levels. Receiver operating characteristic (ROC) curves were performed to identify the optimal serum LDH activity cut-off points for ≥ 2 and ≥ 4 × 10(6) cells/kg post-mobilization CD34+ count and their diagnostic yield. RESULTS: A post-mobilization serum LDH cut-off value of 462 U/L yielded a sensitivity (Se) = 86.8% (positive predictive value [PPV] = 72.7%), a pre- and post-mobilization serum LDH difference cut-off value of 387 U/L, an Se = 45.7% (PPV = 97%) and an LDH ratio of 2.46, with an Se = 47.1% (PPV = 97%) for an optimal mobilization count (CD34+ ≥ 4 × 10(6)). CONCLUSION: The LDH measurement represents a fast and affordable way to predict PBCD34+ mobilization in cases where flow cytometry is not immediately available. According to the LDH diagnostic yield, it could be used as a surrogate marker in transplant centers, supporting the CD34+ count, which remains the gold standard. |
format | Online Article Text |
id | pubmed-10627851 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Sociedade Brasileira de Hematologia e Hemoterapia |
record_format | MEDLINE/PubMed |
spelling | pubmed-106278512023-11-08 Lactate dehydrogenase as a hematopoietic stem cell mobilization biomarker in autologous transplantation Colunga-Pedraza, Perla R. Irabien-Zuñiga, Mariela Rodriguez-Roque, Carlos Saúl de la Cruz-de la Cruz, Carlos Gómez-De León, Andrés Santana-Hernández, Paola Jaime-Pérez, José Carlos Mancías-Guerra, Consuelo Gómez-Almaguer, David Hematol Transfus Cell Ther Original Article INTRODUCTION: Pre-apheresis peripheral blood CD34+ cell count (PBCD34+) is the most important predictor of good cell mobilization before hematopoietic stem cell transplantation, albeit flow cytometry is not always immediately available. Identification of surrogate markers can be useful. The CD34+ cells proliferate after mobilization, resulting in elevated lactate dehydrogenase (LDH) activity and correlating with the PBCD34+ count. OBJECTIVE: To determine the LDH cut-off value at which adequate CD34+ cell mobilization is achieved and its diagnostic yield. MATERIALS AND METHODS: A total of 103 patients who received an autologous stem cell transplantation (ASCT) between January 2015 and January 2020 were included. Demographic and laboratory characteristics were obtained, including complete blood count, pre-apheresis PBCD34+ and LDH levels. Receiver operating characteristic (ROC) curves were performed to identify the optimal serum LDH activity cut-off points for ≥ 2 and ≥ 4 × 10(6) cells/kg post-mobilization CD34+ count and their diagnostic yield. RESULTS: A post-mobilization serum LDH cut-off value of 462 U/L yielded a sensitivity (Se) = 86.8% (positive predictive value [PPV] = 72.7%), a pre- and post-mobilization serum LDH difference cut-off value of 387 U/L, an Se = 45.7% (PPV = 97%) and an LDH ratio of 2.46, with an Se = 47.1% (PPV = 97%) for an optimal mobilization count (CD34+ ≥ 4 × 10(6)). CONCLUSION: The LDH measurement represents a fast and affordable way to predict PBCD34+ mobilization in cases where flow cytometry is not immediately available. According to the LDH diagnostic yield, it could be used as a surrogate marker in transplant centers, supporting the CD34+ count, which remains the gold standard. Sociedade Brasileira de Hematologia e Hemoterapia 2023 2022-09-19 /pmc/articles/PMC10627851/ /pubmed/36163321 http://dx.doi.org/10.1016/j.htct.2022.07.007 Text en © 2022 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier España, S.L.U. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Colunga-Pedraza, Perla R. Irabien-Zuñiga, Mariela Rodriguez-Roque, Carlos Saúl de la Cruz-de la Cruz, Carlos Gómez-De León, Andrés Santana-Hernández, Paola Jaime-Pérez, José Carlos Mancías-Guerra, Consuelo Gómez-Almaguer, David Lactate dehydrogenase as a hematopoietic stem cell mobilization biomarker in autologous transplantation |
title | Lactate dehydrogenase as a hematopoietic stem cell mobilization biomarker in autologous transplantation |
title_full | Lactate dehydrogenase as a hematopoietic stem cell mobilization biomarker in autologous transplantation |
title_fullStr | Lactate dehydrogenase as a hematopoietic stem cell mobilization biomarker in autologous transplantation |
title_full_unstemmed | Lactate dehydrogenase as a hematopoietic stem cell mobilization biomarker in autologous transplantation |
title_short | Lactate dehydrogenase as a hematopoietic stem cell mobilization biomarker in autologous transplantation |
title_sort | lactate dehydrogenase as a hematopoietic stem cell mobilization biomarker in autologous transplantation |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627851/ https://www.ncbi.nlm.nih.gov/pubmed/36163321 http://dx.doi.org/10.1016/j.htct.2022.07.007 |
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