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Prognostic Value of Hematogones in Patients with Acute Myeloid Leukemia in First Complete Remission

Mona Hassanein, Rasha Haggag, Shereen M. El Shorbagy and Hoda F. Ebian

Background: Hematogons (HGs) are normal bone marrow cells; that may reflect the quality of the bone marrow response to chemotherapy. Many studies have focused on the role of HGs in acute leukemia.

Methods: A total of 65 patients with nonpromyelocytic AML, in first complete remission were enrolled in this study, and four color flow cytometry was used to quantify Hematogones. We identify the HGs detectable group as those who had more than or equal to 0.01% HGs in bone marrow aspirated sample.

Results: HGs were detectable in 25 patients' marrow samples, and they were significantly associated with cytogenetic risk (p=0.01). After a median followup of 17.6 months, patients with detectable HGs had better DFS and OS than those with undetectable levels (p=0.013 and <0.001; respectively) and only 3 patients with detectable HGs in marrow remission samples experience relapse. On multivariate analysis, the HG ≥0.01% is an independent predictive value for DFS (p<0.0001), and OS (p<0.007), but number of chemotherapy cycles to achieve CR and poor cytogenetic had significant prognostic effect on DFS but not on OS, we can conclude that AML patients in first complete remission with HGs ≥0.01% have better DFS and OS.

Conclusions: We can conclude that AML patients in first complete remission with HGs ≥0.01% have better DFS and OS.