Impact of Bone Marrow Hematogones on Umbilical Cord Blood Transplantation Outcomes in Patients with Acute Myeloid Leukemia

Honebrink, Theodore; Dayton, Vanessa; Burke, Michael J.; Larsen, Karen; Cao, Qing; Brunstein, Claudio; Weisdorf, Daniel; Miller, Jeffery S.; Wagner, John E.; Verneris, Michael R.

doi:10.1016/j.bbmt.2011.11.015

« Previous Next »Biology of Blood and Marrow Transplantation
Volume 18, Issue 6 , Pages 930-936, June 2012

Impact of Bone Marrow Hematogones on Umbilical Cord Blood Transplantation Outcomes in Patients with Acute Myeloid Leukemia

Theodore Honebrink
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
Vanessa Dayton
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
Michael J. Burke
- Division of Hematology/Oncology and Blood and Marrow Transplantation in the Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
Karen Larsen
- Quest Diagnostics, New Brighton, Minnesota
Qing Cao
- Biostatistic Core of the Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
Claudio Brunstein
- Division of Hematology/Oncology and Transplantation in the Department of Medicine, University of Minnesota, Minneapolis, Minnesota
Daniel Weisdorf
- Division of Hematology/Oncology and Transplantation in the Department of Medicine, University of Minnesota, Minneapolis, Minnesota
Jeffery S. Miller
- Division of Hematology/Oncology and Transplantation in the Department of Medicine, University of Minnesota, Minneapolis, Minnesota
John E. Wagner
- Division of Hematology/Oncology and Blood and Marrow Transplantation in the Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
Michael R. Verneris
- Division of Hematology/Oncology and Blood and Marrow Transplantation in the Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
- Correspondence and reprint requests: Michael R. Verneris, MD, University of Minnesota, Department of Pediatrics, Division of Hematology/Oncology and Blood and Marrow Transplantation, 660 CCRB, 425 E. River Rd, Minneapolis, MN, 55455.

Received 1 July 2011; accepted 9 November 2011. published online 21 November 2011.

Early after umbilical cord blood transplantation, patients show marked differences in bone marrow (BM) hematogone percentages. Little is known about whether these differences are clinically relevant. We hypothesized that early recovery of hematogones may be associated with improved transplantation outcomes. BM aspirates were assessed from 88 patients with acute myeloid leukemia by two independent reviewers at day 21 and 100 after umbilical cord blood transplantation. Interobserver variability for BM hematogone percentages at these time points showed correlation coefficients of 0.83 and 0.98, respectively (P ≤ .01 for both). A high percentage of hematogones at day 21 was associated with less acute graft-versus-host disease grade 3 to 4 (P = .01). At day 100, a high percentage of BM hematogones was associated with improved overall survival (P = .02) and lower treatment-related mortality (P ≤ .01). This study shows that BM hematogone percentages may be useful prognostic indicators in patients with acute myeloid leukemia after umbilical cord blood transplantation and should be routinely reported in BM differential counts.

Key Words: AML, Umbilical cord blood, Hematogones