Impact of Bone Marrow Hematogones on Umbilical Cord Blood Transplantation Outcomes in Patients with Acute Myeloid Leukemia

Overview

Journal Biol Blood Marrow Transplant

Date 2011 Nov 24

PMID 22108570

Citations 11

Authors

Theodore Honebrink

Vanessa Dayton

Michael J Burke

Karen Larsen

Qing Cao

Claudio Brunstein

Daniel Weisdorf

Jeffery S Miller

John E Wagner

Michael R Verneris

Affiliations

Soon will be listed here.

Abstract

Early after umbilical cord blood transplantation, patients show marked differences in bone marrow (BM) hematogone percentages. Little is known about whether these differences are clinically relevant. We hypothesized that early recovery of hematogones may be associated with improved transplantation outcomes. BM aspirates were assessed from 88 patients with acute myeloid leukemia by two independent reviewers at day 21 and 100 after umbilical cord blood transplantation. Interobserver variability for BM hematogone percentages at these time points showed correlation coefficients of 0.83 and 0.98, respectively (P ≤ .01 for both). A high percentage of hematogones at day 21 was associated with less acute graft-versus-host disease grade 3 to 4 (P = .01). At day 100, a high percentage of BM hematogones was associated with improved overall survival (P = .02) and lower treatment-related mortality (P ≤ .01). This study shows that BM hematogone percentages may be useful prognostic indicators in patients with acute myeloid leukemia after umbilical cord blood transplantation and should be routinely reported in BM differential counts.

Citing Articles

Analytical Appraisal of Hematogones in B-ALL MRD Assessment Using Multidimensional Dot-Plots by Multiparametric Flow Cytometry: A Critical Review and Update.

Das N, Gajendra S, Gupta R Indian J Hematol Blood Transfus. 2024; 40(1):12-24.

PMID: 38312180 PMC: 10830989. DOI: 10.1007/s12288-023-01696-5.

Prognostic Value of Hematogones in Patients With Hematopoietic Disorders After Allogeneic Hematopoietic Stem Cell Transplantation: A Systematic Review and Meta-Analysis.

Mori H, Koyama D, Sato Y, Kataoka Y, Taito S, Ishio T Cureus. 2023; 15(10):e47184.

PMID: 37854480 PMC: 10580303. DOI: 10.7759/cureus.47184.

Hematogones: The Supreme Mimicker and a Cytomorphological Confounder in Acute Lymphoblastic Leukemia.

Singh K, Tiwari D, Boddu R, Somasundarum V, Mishra K J Lab Physicians. 2023; 15(2):212-216.

PMID: 37323612 PMC: 10264119. DOI: 10.1055/s-0042-1757586.

The prognostic significance of hematogones and CD34+ myeloblasts in bone marrow for adult B-cell lymphoblastic leukemia without minimal residual disease.

Liao H, Zheng Q, Jin Y, Chozom T, Zhu Y, Liu L Sci Rep. 2019; 9(1):19722.

PMID: 31871314 PMC: 6928064. DOI: 10.1038/s41598-019-56126-2.

Quantification of marrow hematogones following autologous stem cell transplant in adult patients with plasma cell myeloma or diffuse large B-cell lymphoma and correlation with outcome.

Santiago V, Lazaryan A, McClune B, McKenna R, Courville E Leuk Lymphoma. 2017; 59(4):958-966.

PMID: 28728454 PMC: 5776059. DOI: 10.1080/10428194.2017.1352094.

References

Kobayashi S, Seki K, SUWA N, Koama C, Yamamoto T, Aiba K . The transient appearance of small blastoid cells in the marrow after bone marrow transplantation. Am J Clin Pathol. 1991; 96(2):191-5. DOI: 10.1093/ajcp/96.2.191. View

Arakawa-Hoyt J, Dao M, Thiemann F, Hao Q, Ertl D, Weinberg K . The number and generative capacity of human B lymphocyte progenitors, measured in vitro and in vivo, is higher in umbilical cord blood than in adult or pediatric bone marrow. Bone Marrow Transplant. 2000; 24(11):1167-76. DOI: 10.1038/sj.bmt.1702048. View

Sandhaus L, Chen T, Ettinger L, Mehta K, Raskova J . Significance of increased proportion of CD10-positive cells in nonmalignant bone marrows of children. Am J Pediatr Hematol Oncol. 1993; 15(1):65-70. DOI: 10.1097/00043426-199302000-00007. View

Muehleck S, McKenna R, Gale P, BRUNNING R . Terminal deoxynucleotidyl transferase (TdT)-positive cells in bone marrow in the absence of hematologic malignancy. Am J Clin Pathol. 1983; 79(3):277-84. DOI: 10.1093/ajcp/79.3.277. View

McKenna R, Washington L, Aquino D, Picker L, Kroft S . Immunophenotypic analysis of hematogones (B-lymphocyte precursors) in 662 consecutive bone marrow specimens by 4-color flow cytometry. Blood. 2001; 98(8):2498-507. DOI: 10.1182/blood.v98.8.2498. View

Paolucci P, Hayward A, Rapson N . Pre-B and B cells in children on leukaemia remission maintenance treatment. Clin Exp Immunol. 1979; 37(2):259-66. PMC: 1537816. View

Verneris M, Brunstein C, Barker J, MacMillan M, DeFor T, McKenna D . Relapse risk after umbilical cord blood transplantation: enhanced graft-versus-leukemia effect in recipients of 2 units. Blood. 2009; 114(19):4293-9. PMC: 2774557. DOI: 10.1182/blood-2009-05-220525. View

Brunstein C, Barker J, Weisdorf D, DeFor T, Miller J, Blazar B . Umbilical cord blood transplantation after nonmyeloablative conditioning: impact on transplantation outcomes in 110 adults with hematologic disease. Blood. 2007; 110(8):3064-70. PMC: 2018678. DOI: 10.1182/blood-2007-04-067215. View

Lin D . Non-parametric inference for cumulative incidence functions in competing risks studies. Stat Med. 1997; 16(8):901-10. DOI: 10.1002/(sici)1097-0258(19970430)16:8<901::aid-sim543>3.0.co;2-m. View

10.

Bengtsson M, Smedmyr B, Festin R, Oberg G, Simonsson B, Totterman T . B lymphocyte regeneration in marrow and blood after autologous bone marrow transplantation: increased numbers of B cells carrying activation and progression markers. Leuk Res. 1989; 13(9):791-7. DOI: 10.1016/0145-2126(89)90092-1. View

11.

Shono Y, Toubai T, Ota S, Ibata M, Mashiko S, Hirate D . Abnormal expansion of naïve B lymphocytes after unrelated cord blood transplantation--a case report. Clin Lab Haematol. 2006; 28(5):351-4. PMC: 1618819. DOI: 10.1111/j.1365-2257.2006.00809.x. View

12.

Cornelius A, Campbell D, Schwartz E, Poncz M . Elevated common acute lymphoblastic leukemia antigen expression in pediatric immune thrombocytopenic purpura. Am J Pediatr Hematol Oncol. 1991; 13(1):57-61. DOI: 10.1097/00043426-199121000-00014. View

13.

Lucio P, Parreira A, van den Beemd M, van Lochem E, van Wering E, Baars E . Flow cytometric analysis of normal B cell differentiation: a frame of reference for the detection of minimal residual disease in precursor-B-ALL. Leukemia. 1999; 13(3):419-27. DOI: 10.1038/sj.leu.2401279. View

14.

Mattei D, Bassan R, Mordini N, Rapezzi D, Rambaldi A, Strola G . Expansion of B cell precursors after unrelated cord blood transplantation for an adult patient. Bone Marrow Transplant. 2007; 40(3):283-5. DOI: 10.1038/sj.bmt.1705714. View

15.

Barker J, Weisdorf D, DeFor T, Blazar B, McGlave P, Miller J . Transplantation of 2 partially HLA-matched umbilical cord blood units to enhance engraftment in adults with hematologic malignancy. Blood. 2004; 105(3):1343-7. DOI: 10.1182/blood-2004-07-2717. View

16.

Sabattini E, Bacci F, Sagramoso C, Pileri S . WHO classification of tumours of haematopoietic and lymphoid tissues in 2008: an overview. Pathologica. 2010; 102(3):83-7. View

17.

Ribeiro E, Matarraz Sudon S, de Santiago M, Lima C, Metze K, Giralt M . Maturation-associated immunophenotypic abnormalities in bone marrow B-lymphocytes in myelodysplastic syndromes. Leuk Res. 2005; 30(1):9-16. DOI: 10.1016/j.leukres.2005.05.019. View

18.

Diaz M, Gonzalez-Vicent M, Ramirez M, Sevilla J, Lassaletta A, Perez A . Allogeneic cord blood transplantation in children with hematological malignancies: a long-term follow-up single-center study. Pediatr Hematol Oncol. 2009; 26(4):165-74. DOI: 10.1080/08880010902773040. View

19.

van Wering E, Szczepanski T, Willemse M, Baars E, Kamps W, van Dongen J . Regenerating normal B-cell precursors during and after treatment of acute lymphoblastic leukaemia: implications for monitoring of minimal residual disease. Br J Haematol. 2000; 110(1):139-46. DOI: 10.1046/j.1365-2141.2000.02143.x. View

20.

McKenna R, Asplund S, Kroft S . Immunophenotypic analysis of hematogones (B-lymphocyte precursors) and neoplastic lymphoblasts by 4-color flow cytometry. Leuk Lymphoma. 2004; 45(2):277-85. DOI: 10.1080/1042819031000151950. View