Hematogones Predict Better Outcome in Allogeneic Hematopoietic Stem Cell Transplantation Irrespective of Graft Sources

Biol Blood Marrow Transplant. 2018 Oct;24(10):1990-1996. doi: 10.1016/j.bbmt.2018.06.011. Epub 2018 Jun 15.


Benign precursors of B lymphocytes, termed hematogones, are observed in the regenerative state of hematopoiesis following chemotherapy or allogeneic hematopoietic stem cell transplantation (allo-HSCT). Previous studies have demonstrated that expansion of hematogones correlates with better clinical outcomes after allo-HSCT. We retrospectively analyzed the association between hematogones and clinical outcomes in 309 consecutive patients who underwent allo-HSCT, which is the largest population-based cohort reported so far. The incidence of hematogones was significantly higher in complete remission (CR) patients at the time of transplantation than in non-CR patients, after myeloablative conditioning than after reduced-intensity conditioning, with tacrolimus-based graft-versus-host disease (GVHD) prophylaxis than with cyclosporine-based prophylaxis, and with disease other than malignant lymphoma (all P < .05). Patients with hematogones developed less acute GVHD and infections than did those without them (P < .05). Emergence of hematogones was associated with superior GVHD-free relapse-free survival and lower nonrelapse mortality, and was an independent prognostic factor for overall survival, irrespective of donor sources.

Keywords: Bone marrow transplantation; Cord blood transplantation; GVHD-free relapse-free survival; Hematogones; Peripheral blood stem cell transplantation.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Allografts
  • Cyclosporine / administration & dosage
  • Disease-Free Survival
  • Female
  • Graft vs Host Disease / mortality
  • Graft vs Host Disease / prevention & control
  • Hematologic Neoplasms* / metabolism
  • Hematologic Neoplasms* / mortality
  • Hematologic Neoplasms* / pathology
  • Hematologic Neoplasms* / therapy
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Remission Induction
  • Retrospective Studies
  • Survival Rate
  • Tacrolimus / administration & dosage
  • Transplantation Conditioning*


  • Cyclosporine
  • Tacrolimus