Hematogones: a multiparameter analysis of bone marrow precursor cells
TA Longacre, K Foucar, S Crago, IM Chen, B Griffith, L Dressler, TS McConnell, M Duncan and J Gribble
Department of Pathology, University of New Mexico School of Medicine,
Albuquerque.
Morphologically distinct lymphoid cells with homogeneous, condensed
chromatin and scant cytoplasm can be observed in large numbers in the bone
marrow of children with a variety of hematologic and nonhematologic
disorders. In some patients, these cells may account for greater than 50%
of the bone marrow cells, creating a picture that can be confused with
acute lymphoblastic leukemia (ALL) or metastatic tumor. Although originally
called hematogones (HGs), a variety of other names have been proposed for
these unique cells. The clinical significance of expanded HGs has not been
resolved, and the biologic features of these cells are incompletely
described. In this study, we correlate the clinical, morphologic,
cytochemical, flow cytometric, molecular, and cytogenetic properties of
bone marrow samples from 12 children with substantial numbers of HGs (range
8% to 55% of bone marrow cells). Diagnoses in these patients included
anemia, four; neutropenia, one; anemia and neutropenia, one; idiopathic
thrombocytopenic purpura, two; retinoblastoma, two; Ewing's sarcoma, one;
and germ cell tumor, one. Flow cytometric analyses of bone marrow cells
demonstrated a spectrum extending from early B-cell precursors (CD10+,
CD19+, TdT+, HLA-Dr+) to mature surface immunoglobulin-bearing B cells in
these patients, corroborating our morphologic impression of HGs,
intermediate forms, and mature lymphocytes. DNA content was normal, and no
clonal abnormality was identified by either cytogenetic or immunoglobulin
and T-cell receptor (TCR) gene rearrangement studies. Follow-up ranged from
3 months to 3 years. None of the patients has developed acute leukemia or
bone marrow involvement by solid tumor. The possible role of HGs in immune
recovery and hematopoiesis is presented.
Volume 73,
Issue 2,
pp. 543-552,
02/01/1989
Copyright © 1989 by The American Society of Hematology
