Quantitation of hematogones at the time of engraftment is a useful prognostic indicator in allogeneic hematopoietic stem cell transplantation

Takahiro Shima, Toshihiro Miyamoto, Yoshikane Kikushige, Yasuo Mori, Kenjiro Kamezaki, Ken Takase, Hideho Henzan, Akihiko Numata, Yoshikiyo Ito, Katsuto Takenaka, Hiromi Iwasaki, Tomohiko Kamimura, Tetsuya Eto, Koji Nagafuji, Takanori Teshima, Koji Kato, Koichi Akashi

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Transient marrow expansion of normal B-cell precursors, termed hematogones, is occasionally observed after hematopoietic stem cell transplantation (HSCT). To understand the clinical significance of this phenomenon, we enumerated hematogones in 108 consecutive patients who received allogeneic HSCT for the treatment of hematologic malignancies, including acute myelogenous leukemia, advanced myelodysplastic syndromes, acute lymphoblastic leukemia, and non-Hodgkin lymphoma. Hematogone quantitation was performed at the time of complete donor engraftment (median day 25 and 32 in patients who received bone marrow and cord blood cell transplants, respectively). Hematogones were polyclonal B cells, and their frequencies correlated positively with blood B-cell numbers, and inversely with donors' but not recipients' age, suggesting that hematogones reflect cell-intrinsic B-cell potential of donor cells. Interestingly, patients developing hematogones that comprised > 5% of bone marrow mononuclear cells constituted a group with significantly prolonged overall survival and relapse-free survival, irrespective of their primary disease or donor cell source. In addition, patients with > 5% hematogones developed severe acute graft-versus-host diseases less frequently, which may contribute toward their improved survival. We therefore conclude that the amount of hematogones at the time of engraftment may be a useful tool in predicting the prognosis of patients treated with allogeneic HSCT.

Original languageEnglish
Pages (from-to)840-848
Number of pages9
JournalBlood
Volume121
Issue number5
DOIs
Publication statusPublished - Jan 31 2013

All Science Journal Classification (ASJC) codes

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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