# HemaHier: Chain-Conditioned Ordinal Hierarchies for Lineage-Aware Bone-Marrow Cytology

arXiv: https://arxiv.org/abs/2609.12835 · HTML: https://mlsanity.com/paper/2609.12835/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 10 of its 19 references that are in the map.
- First posted on arXiv 11 Sep 2026.

## Builds on (most cited first, 10 of 10)

- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [Attention-based Deep Multiple Instance Learning](https://mlsanity.com/paper/1802.04712/) (2018)
- [Rank consistent ordinal regression for neural networks with application to age estimation](https://mlsanity.com/paper/1901.07884/) (2019)
- [Making Better Mistakes: Leveraging Class Hierarchies with Deep Networks](https://mlsanity.com/paper/1912.09393/) (2019)
- [DinoBloom: A Foundation Model for Generalizable Cell Embeddings in Hematology](https://mlsanity.com/paper/2404.05022/) (2024)
- [HMIL: Hierarchical Multi-Instance Learning for Fine-Grained Whole Slide Image Classification](https://mlsanity.com/paper/2411.07660/) (2024)
- [A Continual Learning Approach for Cross-Domain White Blood Cell Classification](https://mlsanity.com/paper/2308.12679/) (2023)
- [CytoSAE: Interpretable Cell Embeddings for Hematology](https://mlsanity.com/paper/2507.12464/) (2025)
- [CytoDINO: Risk-Aware and Biologically-Informed Adaptation of DINOv3 for Bone Marrow Cytomorphology](https://mlsanity.com/paper/2512.17930/) (2025)

## Abstract (arXiv)

Bone-marrow cytology is inherently structured: each cell belongs to a hematopoietic lineage, and many cell types lie on ordered maturation trajectories. Standard flat classifiers ignore this structure, treating a mild same-lineage confusion the same as a severe cross-lineage mistake and predicting only discrete labels. We propose HemaHier, an ordinal-hierarchical prediction head for a frozen or lightly adapted cytology foundation model. Its central component is a chain-conditioned maturity score that reads a single maturity value under a per-chain query, supervised only on biologically valid healthy chains, while dysplastic and off-chain cell types remain classes but are excluded from maturity supervision. Fine and lineage predictions are coupled through a shared posterior that guarantees hierarchical consistency, and a staged objective first stabilizes recognition, then adds lineage and maturity supervision. On three bone-marrow datasets under a shared ontology, HemaHier achieves competitive recognition while reducing biologically severe errors and adding a within-lineage maturity ordering that flat classifiers lack. Code is available at https://github.com/xmindflow/HemaHier.