Evaluation of parameters obtained from the Sysmex XN‐2000 for predicting the recovery of the absolute neutrophil count and platelets after hematopoietic stem cell transplantation

<jats:title>Summary</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>We analyzed abilities of parameters from Sysmex <jats:styled-content style="fixed-case">XN</jats:styled-content>‐2000 (Sysmex, Kobe, Japan) to predict absolute neutrophil count (<jats:styled-content style="fixed-case">ANC</jats:styled-content>) and platelet recovery after hematopoietic stem cell transplantation (<jats:styled-content style="fixed-case">HSCT</jats:styled-content>) in patients with hematologic malignancies.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We prospectively analyzed 911 follow‐up peripheral blood samples from 44 <jats:styled-content style="fixed-case">HSCT</jats:styled-content>‐performed patients and evaluated the performances of the following parameters: <jats:styled-content style="fixed-case">WBC</jats:styled-content>, immature granulocyte (<jats:styled-content style="fixed-case">IG</jats:styled-content>), hematopoietic stem and progenitor cells (<jats:styled-content style="fixed-case">HPC</jats:styled-content>), immature reticulocyte fraction (<jats:styled-content style="fixed-case">IRF</jats:styled-content>), immature platelet fraction (<jats:styled-content style="fixed-case">IPF</jats:styled-content>), platelet distribution width (<jats:styled-content style="fixed-case">PDW</jats:styled-content>), mean platelet volume (<jats:styled-content style="fixed-case">MPV</jats:styled-content>), and platelet larger cell ratio (P‐<jats:styled-content style="fixed-case">LCR</jats:styled-content>).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>When compared to four other parameters, the identification of initiation in <jats:styled-content style="fixed-case">IG</jats:styled-content> (%)/<jats:styled-content style="fixed-case">HPC</jats:styled-content> (%) increase enabled earlier prediction of <jats:styled-content style="fixed-case">ANC</jats:styled-content> recovery to >500/<jats:italic>μ</jats:italic>L and >1000/<jats:italic>μ</jats:italic>L with more time benefit of 3.5–6.5 days/2.0–5.0 days and 3.0–6.0 days/2.0–5.0 days, respectively. When compared to <jats:styled-content style="fixed-case">IPF</jats:styled-content> (%), the identification of initiation in <jats:styled-content style="fixed-case">PDW</jats:styled-content>,<jats:styled-content style="fixed-case"> MPV</jats:styled-content>, and P‐<jats:styled-content style="fixed-case">LCR</jats:styled-content> (%) increase enabled earlier prediction of platelet recovery to >20 000/<jats:italic>μ</jats:italic>L and >50 000/<jats:italic>μ</jats:italic>L with more time benefit of 2.5–3.5 days and 2.0–3.0 days, respectively. However, the standard deviation of time benefit obtained from <jats:styled-content style="fixed-case">IG</jats:styled-content> (%)/<jats:styled-content style="fixed-case">HPC</jats:styled-content> (%)/<jats:styled-content style="fixed-case">PDW</jats:styled-content>/<jats:styled-content style="fixed-case">MPV</jats:styled-content>/P‐<jats:styled-content style="fixed-case">LCR</jats:styled-content> (%) was consistently large (3.0–4.3 days).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>There is a systematic pattern where a rise in most of the studied parameters can be observed in most patients before <jats:styled-content style="fixed-case">ANC</jats:styled-content>/platelet recovery. However, the interindividual variation between the time of rise of these parameters and <jats:styled-content style="fixed-case">ANC</jats:styled-content>/platelet recovery is large, and therefore, using these parameters to predict recovery in the individual patient is probably not meaningful in the clinical setting.</jats:p></jats:sec>