Mai Aly
Department of Translational Hematology and Oncology Research/ Taussig Cancer Institute, Cleveland Clinic, USA; Faculty of Medicine, Assiut University, Faculty of Medicine, Suez University, Egypt
Douaa Sayed
Department of Hematology and BMT, Cairo University, Egypt
Esam ElBeih
Faculty of Medicine, Assiut University, Faculty of Medicine, Suez University, Egypt
Raafat Abdel Fattah
Department of Hematology and BMT, Cairo University, Egypt
Refat Fathy Abdel-Aal Naseer
Faculty of Medicine, Assiut University, Faculty of Medicine, Suez University, Egypt
Rania Hafez
Faculty of Medicine, Assiut University, Faculty of Medicine, Suez University, Egypt
Almetwaly M. Sultan
Nasser Institute for research and treatment, Cairo, Egypt
Nahla El-Sharkawy
Department of Clinical Pathology (NCI), Cairo University, Egypt
Reda Z. Mahfouz
Department of Translational Hematology and Oncology Research/ Taussig Cancer Institute, Cleveland Clinic, USA; Clinical Pathology, Menofia University, Egypt
Samar Mansour
Department of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
ABSTRACT
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the treatment of choice for severe aplastic anemia (SAA) in young age. Hematogones (HG), reflect regeneration of bone marrow post-chemotherapy as well as post-HSCT. The aim of this study is to examine the impact of HGs in comparison to other biomarkers (pre- transplant ferritin and the count of infused CD34⁺ cells) on allo-HSCT in SAA. We studied 21 SAA patients, treated with allo-HSCT from MSD (matched sibling donor). HG were measured at engraftment (n=18) by using CD34, CD38, CD10, CD19 antibodies. Cyclosporine with either Methotrexate (CSA+MTX, n=12) or Methylprednisolone (CSA+MP; n=9) used for graft versus host (GVHD) prophylaxis. All patients were followed up for GVHD, infections, counts and overall survival (OS). We used Receive- Operator Characteristics curve (ROC) to determine HG cut off; 0.37% of total mononuclear cells (MNC), CD34⁺ cut off; 6.8cell x106cells/Kg and ferritin cut off; 1337ng/dl. Patients with high HG had better total white cell count (WBC); P=.03, absolute neutrophil count (ANC); P=.04, platelet; P=.02 at engraftment time in addition to better OS (P=.005). On the other side CD34 and ferritin didn’t impact OS. In conclusion we showed that HG at engraftment directly affect the outcome of patients with SAA treated with allo-HSCT.
Keywords: Hematogones, Severe Aplastic Anemia, Allogeneic Hematopoietic Stem Cell Transplant.
