The importance of immunophenotyping by flow cytometry in distinction between hematogones and B lymphoblasts

Abstract

Hematogones are normal B-lineage lymphoid precursors in the bone marrow. B lymphoblasts are immature neoplastic cells present in patients with precursor B-cell acute lymphoblastic leukemia (B-ALL). Hematogones and B lymphoblasts share characteristics, such as morphological similarity often indistinct and expression of the same antigens in immunophenotypic analysis. Increased numbers of hematogones in patients with B-ALL during regeneration of bone marrow after treatment for leukemia, in cases of disease relapse or marrow transplantation, may be subject to questions about the nature and prognosis of this immature cell. This article presents information about the morphological and immunophenotypic characteristics of B lymphoid precursors and verifies the relevance of immunophenotyping by flow cytometry (FC) in the distinction between those cells. This differentiation is essential to establish a correct prognosis and assist in medical decision about the most appropriate therapeutic scheme.

Congenital Acute Lymphoblastic Leukemia – A Mosaic Trisomy Chromosome 22 and t(5;15)(p15;q15) : A Case Report

“…For example in immature type of haematagones, there would be positive of CD34 and Tdt with absent of CD19. In term of intermedia type, those young cells will acquire expression of CD19 and lose expression of CD10 and Tdt where as in mature phase of haematagones, those cells will have negative or low intensity of CD10 expression [7]. However, in our patient, the lymphoblasts permit high expression of CD10, Tdt, CD79a and CD19 positive cells thus exhibited incomplete maturation spectrum.…”

“…They are described as round to oval, sometimes indented with fine chromatin pattern, scanty basophilic cytoplasm without vacuoles. Haematogones are hyperplasia benign Blymphoid cells precursor that are present in higher amounts in the bone marrow (BM) of healthy infants and children and decline within minutes as age increase [7]. Haematogones are also present due to severe infection in newborn.…”

Immunophenotypic aberrancies in acute lymphoblastic leukemia from 282 Iraqi patients

“…Furthermore, CD38 was under‐expressed in 31.1% of cases. Such patterns are in contrast to that of hematogones, as they defy normal antigenic evolution of B‐cell precursors and asynchronously co‐express early and late antigens (eg, CD34 and CD20) or over or under‐express others . Such asynchronous expression of early and late B‐cell markers had been reported by many earlier studies on B‐ALL with variable rates .…”