Hematogones: a sensitive prognostic factor for Chinese adult patients with acute myeloid leukemia.
BACKGROUND
Hematogones (hgs) are normal B-lymphocyte precursors that increase in some hematologic diseases. Many studies indicate that hgs might be a favourable prognostic factor. We thus considered it important to determine whether hgs are also a prognostic factor for Chinese adult patients with acute myeloid leukemia (aml) and whether the hg-positive and hg-negative groups show any serologic or phenotypic differences.


METHODS
Chinese adult aml patients (n = 177) who were all initially hg-negative underwent standard chemotherapy and were thereafter divided into hg-positive and hg-negative groups according to hg levels in bone marrow during their first remission.


RESULTS
The follow-up study confirmed that survival duration (both leukemia-free and overall) was significantly greater in the hg-positive group than in the hg-negative group and was accompanied by a lower relapse rate. A retrospective study of patient characteristics at the time of first diagnosis revealed some differences between the hg-positive and the hg-negative groups, including elevations in white blood cells, lactate dehydrogenase, and β2-microglobulin in the hg-negative group. Retrospective phenotypic analysis revealed a significantly lower proportion of abnormal chromosome karyotype and CD34 expression in hg-positive patients. Finally, we evaluated whether additional intensive chemotherapy after standard chemotherapy could further increase hgs.


CONCLUSIONS
The present work verified the validity of hgs as a prognostic factor for Chinese adult patients with aml. Compared with hg-negative patients, hg-positive patients not only experienced longer survival and a lower relapse rate, but they also had some serologic and phenotypic characteristics that are all considered indicators of better outcome. Additional intensive chemotherapy could further increase the level of hgs, which might imply better clinical results.
Department of Hematology, General Hospital of Tianjin Medical University, Tianjin, P.R.C.;
L
L
Li
Department of Hematology, General Hospital of Tianjin Medical University, Tianjin, P.R.C.;
R
R
Fu
Department of Hematology, General Hospital of Tianjin Medical University, Tianjin, P.R.C.;
T
T
Zhang
Department of Hematology, General Hospital of Tianjin Medical University, Tianjin, P.R.C.;
X
X
Xie
Department of Hematology, General Hospital of Tianjin Medical University, Tianjin, P.R.C.;
J
J
Liu
Department of Hematology, General Hospital of Tianjin Medical University, Tianjin, P.R.C.;
J
J
Tao
Department of Hematology, General Hospital of Tianjin Medical University, Tianjin, P.R.C.;
J
J
Song
Department of Hematology, General Hospital of Tianjin Medical University, Tianjin, P.R.C.;
H
H
Liu
Department of Hematology, General Hospital of Tianjin Medical University, Tianjin, P.R.C.;
W
W
Zhang
Department of Health Statistics, School of Public Health, Tianjin Medical University, Tianjin, P.R.C.
W
W
Lu
Department of Hematology, General Hospital of Tianjin Medical University, Tianjin, P.R.C.;
Z
Z
Shao
Acute myeloid leukemia; hematogones; intensive chemotherapy; prognosis; standards