Prognostic significance of hematogone presence after autologous stem cell transplantation in patients with multiple myeloma

Abstract

Background: Morphologically and immunophenotypically, the number of B-lymphocyte progenitor cells, so-called hematogones increases after chemotherapy and allogeneic stem cell transplantions. It is thought that hematogones can be used as a prognostic marker in these patients. It is aimed to determine the prognostic significance and factors affecting the development of hematogones, which can be seen after autologous stem cell transplantation in multiple myeloma (MM) patients.Methods: This retrospective and single center study includes 80 patients who underwent autologous stem cell transplantation with the diagnosis of MM in our clinic between January 2013 and December 2019. The primary endpoint of the study was the relationship between the presence and rate of hematogone (HG) and progression free survival (PFS) and overall survival (OS). The secondary endpoint was to identify the factors affecting the development of HG.Results: HG was detected in 61.2% of the patients. There was a moderate and positive linear correlation between the amount of stem cells given and HG ratio (r = 0.387, p = 0.000). PFS and OS were significantly shorter in the group with HG (p = 0.000 and p = 0.012).Conclusions: HG positivity after autologous stem cell transplantation was found to be an independent prognostic marker for PFS and OS in patients with MM. There is a positive relationship between the amount of stem cells used during transplantation and the ratio of HG. As the amount of stem cells increases, the ratio of HG increases and when the ratio of HG increases, PFS and OS become shorter.

The prognostic significance of hematogones in childhood B‐cell acute lymphoblastic leukemia

“…16 In addition, better RFS and OS rates have been associated with emergence or expansion of HGs in patients after hematopoietic stem cell transplantation (HSCT). [17][18][19][20] Despite the prognostic impact of BM HGs in AML attracting attention recently, [14][15][16] far less is known when it comes to acute lymphoblastic leukemia (ALL). ALL is the most common form of cancer in children, accounting for one third of pediatric leukemia cases.…”

“…Superior outcome amongst AML patients with higher level of HGs was observed with both overall survival (OS) and relapse‐free survival (RFS) 16 . In addition, better RFS and OS rates have been associated with emergence or expansion of HGs in patients after hematopoietic stem cell transplantation (HSCT) 17–20 …”