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 HGlevels 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.