Stem Cell Enumeration, by Flowcytometry Test
About Stem Cell Enumeration, by Flowcytometry Test
| Field | Value |
|---|---|
| Also Known As | CD34+ Stem Cell Enumeration, CD34 Count, Haematopoietic Stem Cell (HSC) Enumeration, CD34 Cell Quantification |
| Sample Type | Bone marrow and peripheral blood (EDTA tube) |
| Fasting Required | No |
| Report Time | 3 days |
| Recommended For | All ages, both genders; primarily patients undergoing stem cell transplantation or bone marrow donation |
| Price | Starting at ₹2,500 |
What is a Stem Cell Enumeration by Flowcytometry Test?
The Stem Cell Enumeration by Flowcytometry test is a specialised laboratory procedure that counts haematopoietic stem cells, specifically those carrying the CD34 marker, in a patient's blood or bone marrow. Doctors order this test to assess whether enough stem cells are available before a transplant procedure. It is also known as CD34+ Stem Cell Enumeration or CD34 Count. Samples are collected from peripheral blood and bone marrow.
What Does a Stem Cell Enumeration by Flowcytometry Test Measure?
The Stem Cell Enumeration by Flowcytometry test procedure analyses several specific features of stem cell populations. The table below outlines the key parameters measured:
| Parameter | What It Tells Us |
|---|---|
| CD34+ cells | Identifies haematopoietic stem cells at early stages of development using the CD34 surface marker |
| Absolute CD34+ count (cells/µL) | The total number of viable CD34+ and CD45+ stem cells present in the sample |
| CD34+ percentage (%) | The proportion of CD34+ cells out of the total viable white blood cell count |
| Cell viability | Confirms only living stem cells are counted, using a special dye to exclude dead cells |
Why is a Stem Cell Enumeration by Flowcytometry Test Done?
This test plays a central role in the care of patients with blood disorders and those being prepared for stem cell transplantation. The following sections outline the common reasons a doctor may request it.
Common Symptoms That May Require This Test
A doctor may order this test for patients presenting with conditions or complaints that suggest underlying blood or bone marrow problems. Common symptoms include:
- Persistent fatigue or unexplained weakness
- Recurrent infections suggesting a weakened immune system
- Anaemia (low red blood cell levels)
- Easy bruising or unusual bleeding
- Unexplained bone pain
- Low platelet counts detected on a routine blood test
Conditions This Test Can Help Detect
The CD34 Stem Cell Enumeration test is used in the assessment and management of several conditions. These include:
- Evaluation of graft viability before stem cell transplantation
- Assessment of the timing and adequacy of peripheral blood stem cell harvests
- Determining when a bone marrow stem cell transplant should be performed
- Deciding whether to continue or stop apheresis (the procedure used to filter and collect stem cells from blood)
- Evaluating the quality of bone marrow and cord blood samples
- Diagnosis and classification of leukaemia subtypes such as acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML)
Stem Cell Enumeration, by Flowcytometry Test for Chronic Disease Monitoring
This test is repeated at regular intervals during stem cell mobilisation, the process of encouraging stem cells to move from the bone marrow into the bloodstream. Daily blood samples may be taken until the CD34+ cell count reaches an adequate level for harvesting, typically between 8 and 20 cells/µL. It is also used on an ongoing basis for patients with haematological malignancies to monitor treatment response and transplant readiness.
How to Prepare and What to Expect
Preparation for the Stem Cell Enumeration by Flowcytometry test is straightforward. The sections below explain what you need to know before your appointment.
Do You Need to Fast?
No, fasting is not required before this test. You may eat and drink normally on the day of sample collection. Follow any additional instructions given by your treating doctor, as individual circumstances may differ.
Practical Tips Before Your Test
The following steps will help ensure a smooth and accurate sample collection:
- Bring a detailed clinical history including your symptoms, previous test results, and family history, as this is required for the test.
- Inform your doctor about all current medications, supplements, and any recent chemotherapy or radiation therapy.
- Wear comfortable, loose-fitting clothing that allows easy access to the arm for blood collection.
- Stay well-hydrated, as this makes vein access easier during blood draw.
- No special dietary restrictions or activity limitations apply before this test.
Step-by-Step Procedure
This test requires two types of samples: peripheral blood and bone marrow. The collection process for each is described below.
Peripheral Blood Collection:
- A trained phlebotomist cleans the site on your arm and draws a small blood sample into a lavender-top EDTA tube.
- The collection takes only a few minutes and causes minimal discomfort.
- The sample is labelled, stored at 2 to 8°C, and sent to the laboratory promptly.
Bone Marrow Collection:
- A doctor performs a bone marrow aspiration, usually from the back of the hip bone (iliac crest), under local anaesthesia.
- A small amount of marrow, approximately 3 mL, is drawn into an EDTA tube.
- Both samples are then mixed with special reagents containing monoclonal antibodies that attach to CD34 and CD45 markers, along with a viability dye.
- The prepared samples are incubated at room temperature and then processed to break down red blood cells.
- A flow cytometer analyses the remaining cells, identifying and counting viable CD34+ stem cells based on specific gating strategies.
- Results are reported as both an absolute count and a percentage of the total white blood cell population.
Factors That Can Affect Accuracy
Several factors may influence the reliability of your test results. These include:
- Sample freshness and correct storage temperature during transport
- The gating strategies used by the laboratory during flow cytometer analysis
- Quality and type of monoclonal antibodies used in the reagent kit
- Whether the sample is analysed in whole blood, as required by standard protocols
- Proper handling of counting beads during sample preparation
Understanding Your Stem Cell Enumeration by Flowcytometry Test Results
Your results will be reviewed by a haematologist or specialist in the context of your clinical situation. The table below provides general reference ranges for different sample types:
| Parameter | Sample Type | Normal Range | Unit |
|---|---|---|---|
| CD34+ cells (steady state) | Peripheral blood | 0.01 to 0.05 | % of WBC |
| CD34+ cells | Bone marrow | Less than 1 | % of mononuclear cells |
| CD34+ absolute count (mobilised blood) | Peripheral blood | 5 to 97 | cells/µL |
| CD34+ absolute count | Cord blood | 3.50 to 66.10 | cells/µL |
These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
Certain patient-specific factors can significantly influence CD34+ counts. Age plays a notable role: older patients, particularly those above 60, tend to yield fewer stem cells during mobilisation. Extended prior chemotherapy (lasting 12 months or more) and low platelet counts before mobilisation are also associated with lower CD34+ yields. These factors are considered by your doctor when interpreting your results.
How to Maintain Healthy Levels
While stem cell counts are largely determined by medical treatments and underlying conditions, a few general steps may support your overall health before collection.
- Follow your haematologist's recommended mobilisation protocol closely.
- Report any fever or active infection to your doctor, as these can affect stem cell counts.
- Maintain a balanced diet and get adequate rest in the days leading up to your stem cell collection.
Lupin Diagnostics Stem Cell Enumeration by Flowcytometry Test Price
The Stem Cell Enumeration by Flowcytometry test cost at Lupin Diagnostics starts at ₹2,500. This test requires a visit to a Lupin Diagnostics centre; home collection is not available for this test. The table below shows approximate prices across major Indian cities for reference:
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 2500 |
| CHENNAI | 2500 |
| HYDERABAD | 2500 |
| KOLKATA | 2500 |
| NAVI MUMBAI | 2500 |
| PUNE | 2500 |
Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Booking your Stem Cell Enumeration by Flowcytometry test online with Lupin Diagnostics is straightforward. Follow these steps:
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Visit the centre at your scheduled time for sample collection.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Frequently Asked Questions
This test helps doctors determine whether a patient has enough viable stem cells for a successful transplant. The CD34+ count is a key indicator of how well stem cells have mobilised into the bloodstream and whether the collected graft is of adequate quality for engraftment.
No, fasting is not required. You can eat and drink as normal before the test. However, inform your doctor about any medications or recent treatments, as these may affect your results.
A count of at least 2×10⁶ CD34+ cells per kilogram of body weight is generally accepted as a safe minimum for a single transplant. Counts below this threshold are associated with a higher risk of delayed recovery of blood cell production after transplantation.
Several factors are linked to low CD34+ yields. These include older age, a history of extended chemotherapy, prior radiation therapy, use of certain drugs such as doxorubicin or melphalan, and low platelet counts before mobilisation begins.
Peripheral blood is drawn from a vein in the arm into a lavender-top EDTA tube. Bone marrow is collected separately by a doctor through a procedure called bone marrow aspiration, usually from the hip bone. Both samples are needed for a full assessment.
If your CD34+ count does not meet the threshold needed for transplantation, your doctor may recommend additional apheresis sessions, use of a mobilisation-boosting medicine, or a direct bone marrow harvest under anaesthesia. Your specialist will discuss the most appropriate next step for your situation.
Stem Cell Enumeration, by Flowcytometry Test
