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

Liao, Hongyan; Zheng, Qin; Jin, Yongmei; Chozom, Tashi; Zhu, Ying; Liu, Li; Jiang, Nenggang

doi:10.1038/s41598-019-56126-2

Cited by 5 publications

(5 citation statements)

References 43 publications

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“…This value corresponded to the normal range for age in our population, as previously demonstrated in a Brazilian multicenter study 20 . Similar results had been described by other studies concerning MDS 28 , 29 and ALL in remission after induction 30 . Although the decrease of hematogones is considered to be a diagnostic hallmark of MDS, a preserved number in low-risk cases is a sign of a better survival.…”

Section: Discussionsupporting

confidence: 91%

A simple score derived from bone marrow immunophenotyping is important for prognostic evaluation in myelodysplastic syndromes

Vido-Marques

Reis-Alves

Saad

et al. 2020

Sci Rep

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Immunophenotyping of bone marrow (BM) precursors has been used as an ancillary diagnostic tool in myelodysplastic syndromes (MDS), but there is no general agreement about which variables are the most relevant for prognosis. We developed a parsimonious prognostic model based on BM cell populations well-defined by phenotype. We analyzed 95 consecutive patients with primary MDS diagnosed at our Institution between 2005 and 2012 where BM immunophenotyping had been performed at diagnosis. Median follow-up: 42 months (4–199). Median age: 67 years (33–79). According to IPSS-R, 71 cases were low or intermediate risk. Flow variables significant in the univariate Cox analysis: “%monocytes/TNCs”, “% CD16+ monocytes/TNCs”, “total alterations in monocytes”, “% myeloid CD34+ cells”, “number of abnormal expressions in myeloblasts” and “% of B-cell progenitors”. In the multivariate model remained independent: “% myeloid CD34+ cells”, B-cell progenitors” and “% CD16+ monocytes/TNCs”. These variables were categorized by the extreme quartile risk ratio strategy in order to build the score: % myeloid CD34+ cells” (≥ 2.0% = 1 point), B-cell progenitors” (< 0.05% 1 point) and “CD16+ monocytes/TNCs” (≥ 1.0% 1 point). This score could separate patients with a different survival. There was a weak correlation between the score and IPSS-R. Both had independent prognostic values and so, the flow score adds value for the prognostic evaluation in MDS.

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Section: Discussionsupporting

confidence: 91%

A simple score derived from bone marrow immunophenotyping is important for prognostic evaluation in myelodysplastic syndromes

Vido-Marques

Reis-Alves

Saad

et al. 2020

Sci Rep

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“…MRD assessment by molecular techniques was not done in our study. Similar to the CD19+ Hgs, the prognostic significance of stage 0 Hgs in MRD negative BCP‐ALL cases shall be studied in future (Arabi et al, 2023; Liao et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Deciphering stage 0 hematogones by flow cytometry in follow‐up bone marrow samples of pediatric B—Acute lymphoblastic leukemia cases: A potential mimicker of residual disease after anti CD19 therapy

Ramalingam,

Vaidhyanathan,

Muthu

et al. 2024

Cytometry Part B Clinical

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CD19 is frequently targeted for immunotherapy in B cell malignancies, which may result in loss of CD19 expression in leukemic cells as an escape mechanism. Stage 0 hematogones (Hgs) are normal CD19‐negative very early B cell precursors that can be potentially mistaken for CD19 negative residual leukemic cells by flow cytometry (FCM) in B cell acute lymphoblastic leukemia (BCP‐ALL) cases treated with anti CD19 therapy. Our main objective was to characterize and study the incidence of stage 0 hematogones in follow‐up bone marrow samples of pediatric BCP‐ALL cases. We analyzed the flow cytometry standard files of 61 pediatric BCP‐ALL cases treated with conventional chemotherapy and targeted anti‐CD19 therapy, for identifying the residual disease and normal B cell precursors including stage 0 Hgs. A non‐CD19 alternate gating strategy was used to isolate the B cells for detecting the residual disease and stage 0 Hgs. The stage 0 Hgs were seen in 95% of marrow samples containing CD19+ Hgs. When compared with controls and posttransplant marrow samples, the fraction of stage 0 Hgs was higher in patients receiving anti CD19 therapy (p = 0.0048), but it was not significant when compared with patients receiving chemotherapy (p = 0.1788). Isolated stage 0 Hgs are found in samples treated with anti‐CD19 therapy simulating CD19 negative residual illness. Our findings aid in understanding the stage 0 Hgs and its association with CD19+ Hgs in anti CD19 therapy and conventional chemotherapy. This is crucial as it can be potentially mistaken for residual disease in patients treated with anti CD19 therapy.

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“…5,16,17,20,37 However, the prognostic value of HGs in ALL patients is not well understood. 27,38 In the present study, we investigated the significance of detectable HGs following remission after chemotherapy in childhood ALL. Our results show the independent prognostic value of HGs on RFS after adjustment for other prognostic factors.…”

Section: Discussionmentioning

confidence: 99%

“…The potential prognostic impact of BM HGs has been suggested by recent reports, as previous studies have demonstrated that presence of HGs at the recovery phase was associated with favorable outcomes in patients with AML and patients undergoing HSCT 5,16,17,20,37 . However, the prognostic value of HGs in ALL patients is not well understood 27,38 …”

Section: Discussionmentioning

confidence: 99%

“…It also allows for intensification of treatment for children with certain unfavorable prognostic factors 25,26 . Thus far, two studies (one conducted on adults and the other on children) have reported the impact of HGs on the survival of patients with ALL 27,28 . The goal of current study was to evaluate the impact of HGs in childhood ALL on RFS and OS, controlling for multiple factors.…”

Section: Introductionmentioning

confidence: 99%

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

Arabi

Yousefian

Kavosh

et al. 2022

Pediatric Blood & Cancer

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Background: Recent studies have demonstrated hematogones (HGs) expansion to be associated with favorable outcomes in hematological diseases, especially in patients with acute myeloid leukemia and patients undergoing hematopoietic stem cell transplantation. Acute lymphoblastic leukemia (ALL) is the most common form of cancer in children. As of now, minimal residual disease (MRD) remains the most compelling independent prognostic factor in childhood ALL. There is need for more prognostic tools for evaluating relapse risk. Procedure:The goal of this study was to assess the prognostic value of HGs on relapsefree survival (RFS) and overall survival (OS) in childhood ALL. In this prospective cohort study, a total of 122 subjects with definitive diagnosis of precursor B lymphoblastic leukemia were evaluated. Flow cytometric HG detection was performed in bone marrow aspirates after induction and consolidation therapy. Results:The median follow-up period of patients was 35.5 ± 9.4 (SD) months. Patients who had at least 1.0% HGs had a significantly better RFS (p = .023). Moreover, univariate and multivariate analyses confirmed that positive HGs were independently associated with longer RFS (unadjusted model: hazard ratio = 0.33, 95% CI = 0.12-0.91, p = .031; adjusted model: hazard ratio = 0.30, 95% CI = 0.11-0.82, p = .020). Conclusions:Along with the role of MRD, our study shows the significance of HGs as an independent prognostic factor. The results indicate the independent prognostic value of HGs on RFS after adjustment for other prognostic factors, and can be beneficial for risk stratification and treatment modifications amongst pediatric B-cell ALL patients.

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

Cited by 5 publications

References 43 publications

A simple score derived from bone marrow immunophenotyping is important for prognostic evaluation in myelodysplastic syndromes

A simple score derived from bone marrow immunophenotyping is important for prognostic evaluation in myelodysplastic syndromes

Deciphering stage 0 hematogones by flow cytometry in follow‐up bone marrow samples of pediatric B—Acute lymphoblastic leukemia cases: A potential mimicker of residual disease after anti CD19 therapy

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

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