Hematogones as a Prognostic Indicator in Allogeneic Hematopoietic Stem Cell Transplantation in Severe Aplastic Anemia, Single Center Experience

Authors

  • 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

Keywords:

Hematogones, Severe Aplastic Anemia, Allogeneic Hematopoietic Stem Cell Transplant

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.

Downloads

Published

2026-06-11

Issue

Vol. 61 No. 2 (2025)

Section

Article