Serum Flt3 ligand variation as a predictive indicator of hematopoietic stem cell mobilization.
Flt3 ligand (FL) is a good indicator of bone marrow (BM) cellularity, having a reciprocal relationship with white blood cell (WBC) count in aplastic anemia and chemotherapy-induced neutropenia. In this report, serum FL level was measured by enzyme-linked immunosorbent assay (ELISA), in 16 consecutive patients undergoing autologous peripheral stem cell transplantation, with an average of 12 selected levels for each patient based on major changes of WBC counts at different procedure stations. We found a significant increase of serum FL level at the WBC nadir after mobilization chemotherapy and a more dramatic increase at the WBC nadir post transplantation, consistent with a more profound BM aplasia after myeloablative chemotherapy as compared to high-dose cyclophosphamide used for mobilization. Hence, we reproduced the reciprocal relationship between serum FL and BM cellularity. A direct correlation between the increase of FL level after mobilization chemotherapy and the length of mobilization was also established, which may help physicians, at the individual patient level, to predict the time of stem cell collection. Finally, we showed a direct correlation between the peripheral CD34+ count at the time of stem cell collection and the peak FL level after transplantation, which can reflect BM stromal cell function. Our results suggest that variation of serum FL level may be used as predictive indicator of hematopoietic stem cell (HSC) mobilization.
Haidar
Joud H
JH
Department of Pathology and Laboratory Medicine, American University of Beirut, 113-6044 Beirut, Lebanon. jh01@aub.edu.lb
Bazarbachi
Ali
A
Mahfouz
Rami
R
Haidar
Hounaida Abi
HA
Jaafar
Hassan
H
Daher
Rose
R
D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis; D015415:Biomarkers / Q000097:blood; D001781:Blood Component Removal / Q000592:standards; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization / Q000592:standards*; D006801:Humans; D007958:Leukocyte Count; D016014:Linear Models; D008297:Male; D008565:Membrane Proteins / Q000097:blood*; D008875:Middle Aged; D011237:Predictive Value of Tests
D018952:Antigens, CD34; D015415:Biomarkers; D008565:Membrane Proteins; C084881:flt3 ligand protein