Significance of Increased Proportion of CD10-Positive Cells in Nonmalignant Bone Marrows of Children

Immunophenotypic analysis of hematogones (B-lymphocyte precursors) in 662 consecutive bone marrow specimens by 4-color flow cytometry

“…However, our observations regarding the association of these disorders with increased hematogones are similar to those of several other studies. [3][4][5]9,[13][14][15]17,18 The biological significance of increased marrow hematogones in these conditions is presently unclear, but our findings and those of other investigators suggest that B lymphocytogenesis is stimulated in some diseases and as a phenomenon of marrow regeneration. 9,19 The method of specimen processing and marrow involvement by neoplastic cells impacted the relative size of the hematogone compartment.…”

“…4,9 The number of bone marrow hematogones may fluctuate with disease status or, in some clinical settings, persistent elevations may be observed. 12,17,19,35 van Wering and colleagues observed persistent elevations of bone marrow B-cell precursors for 2 years following cessation of chemotherapy for ALL, and Leitenberg and associates found elevations for more than a year following bone marrow transplantation. 19,35 Transient elevations in hematogones were observed in most of the few patients with repeat analyses in our study (Table 3).…”

“…[3][4][5][6][7][8][9][10] Hematogones may be particularly prominent in the regeneration phase following chemotherapy or bone marrow transplantation and in patients with autoimmune and congenital cytopenias, neoplasms, and acquired immunodeficiency syndrome (AIDS). 3,7,[11][12][13][14][15][16][17][18][19][20][21][22][23][24] In some instances they constitute 5% to more than 50% of cells. 3,5,8,25,26 Increased numbers of hematogones may cause problems in diagnosis because of the morphologic features they commonly share with the neoplastic lymphoblasts of acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma.…”

“…5 Single-and 2-color flow cytometry do not reliably differentiate hematogones from leukemic lymphoblasts. 4,5,8,17,[27][28][29][30] However, appropriately applied, 3-and 4-color multiparametric flow cytometry are reported to distinguish between these cell populations in nearly all instances. 10,[31][32][33] While several studies on small populations of patients have demonstrated increased numbers of bone marrow hematogones in young children relative to other age groups, no comprehensive prospective study of a large population across all ages has been published.…”

“…The reports of increased hematogones in specific diseases are mostly retrospective studies based on relatively small patient cohorts, lacking broad control populations. [3][4][5]9,13 Furthermore, in most flow cytometry studies hematogones have been reported as the percent of total lymphocytes or of B lymphocytes 8,17,26,[34][35][36] and in only a few reports as a percent of total events. 9,10,37 Finally, prior studies have not addressed the effects of the specimen-processing method and marrow involvement with neoplastic cells on the percentage of hematogones.…”