The biology and clinical uses of blood stem cells.
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
C A Juttner
Publications and source records attributed to C A Juttner.
Detection of minimal residual disease in an AML patient with trisomy 8 using interphase fish.
Patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) often exhibit clonal chromosomal abnormalities. Using a probe for the centromeric region of chromosome 8, fluorescence in situ hybridization (FISH) on interphase cells was used to detect trisomy 8 in an AML patient whose leukemia was characterised by the karyotype 47, XY, +8, del(9) (q21.1q32). We have demonstrated using FISH the presence of the trisomy at all stages of the patient's disease course (including remission, peripheral blood cell harvest and relapse), whereas conventional karyoptypic analysis was only able to detect the trisomy at diagnosis and clinical relapse. We have also shown using immunophenotyping, cell sorting and FISH, that the trisomic cells in this patient were restricted to the CD34+ subset of blood and bone marrow and could not be found in the CD 34-, T or B cell compartment. Overall we have shown FISH to be a rapid, quantitative method for the detection of cells with numerical chromosome abnormalities. FISH analysis of interphase cells provides valuable information on the status of the whole population, rather than just cycling cells, and can be applied successfully to monitor the level of leukemic cells.
Acute Disease↗
Ex vivo culture of peripheral blood CD34+ cells: effects of hematopoietic growth factors on production of neutrophilic precursors.
A major potential application for ex vivo culture of hematopoietic progenitor cells is the treatment of cytopenia following high-dose chemotherapy and hematopoietic transplantation. We have previously postulated that infusion of a sufficient number of neutrophil postprogenitor cells generated by ex vivo culture of CD34+ cells may be able to abrogate neutropenia. In this article, we describe further development of an efficient stromal-free, cytokine-dependent, static culture system for generation of these cells. Our previous studies indicated that maximal production of nucleated cells and myeloid progenitor cells from PB CD34+ cells occurred with multiple hematopoietic growth factor (HGF), notably the 6-HGF combination of interleukin (IL)-1, IL-3, IL-6, granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage-CSF (GM-CSF), and stem cell factor (SCF). In the present study, we determine the contribution of each of these 6 HGF in generation of neutrophilic precursors. SCF, G-CSF, and IL-3 were found to be the most important HGF for production of neutrophilic cells. The 4-HGF combination of IL-3, IL-6, G-CSF, and SCF was optimized by performing dose-response experiments and shown to be as potent as 6 HGF for production of nascent CFU-GM and neutrophilic precursors.
Antigens, CD34↗
Partially differentiated ex vivo expanded cells accelerate hematologic recovery in myeloablated mice transplanted with highly enriched long-term repopulating stem cells.
The ability of an infusion of ex vivo expanded hematopoietic cells to ameliorate cytopenia following transplantation of hematopoietic stem cells (HSCs) is controversial. To address this issue, we measured the recovery of circulating leukocytes, erythrocytes, and platelets in lethally irradiated mice transplanted with 10(3) enriched HSCs, with or without their expanded equivalent (EE) generated after 7 days of culture in interleukin-3 (IL-3), IL-6, granulocyte colony-stimulating factor and Steel Factor. Two HSC populations differing in their content of short-term repopulating progenitors were evaluated. Thy-1loLIN-Sca-1+ (TLS) bone marrow (BM) is enriched in colony-forming cells (CFCs), day 8 and day 12 spleen colony-forming units (CFU-S) (435 +/- 19, 170 +/- 30, and 740 +/- 70 per 10(3) cells, respectively), and stem cells with competitive long-term repopulating potential (> or = 1 per 43 cells). Thy-1loSca-1+H-2Khl cells (TSHFU) isolated from BM 1 day after treatment of donor mice with 5-fluorouracil (5-FU) are also highly enriched in competitive repopulating units (CRU, > or = 1 per 55 cells), but are depleted of CFCs, day 8 and day 12 CFU-S (171 +/- 8, 0 and 15 +/- 4 per 10(3) cells, respectively). Recipients of 10(3) TLS cells transiently recovered leukocytes to > or = 2,000/microL in 12 days, but sustained engraftment required 25 days. Platelets recovered to > or = 200,000/microL in 15 days, and erythrocytes never decreased below 50% of normal. Mice transplanted with 10(3) TSHFU cells recovered leukocytes in 15 days, and platelets and erythrocytes in 18 days. Recipients of unseparated normal or 5-FU-treated BM cells (containing 10(3) TLS or TSHFU cells) recovered safe levels of blood cells in 9 to 12 days, suggesting that unseparated marrow contains early engrafting cells that were depleted by sorting. Upon ex vivo expansion, total cells, CFCs and day 12 CFU-S were amplified 2,062-,83- and 13-fold, respectively, from TLS cells; and 1,279-, 259- and 708-fold, respectively, from TSHFU cells. Expanded cells could regenerate the majority of lymphocytes and granulocytes in primary (17 weeks) and secondary (26 weeks) hosts and were only moderately impaired compared to fresh HSCs. The EE of TSHFU cells was more potent than that of TLS cells, suggesting that more highly enriched HSCs are more desirable starting populations for this application. When mice were transplanted with 10(3) TSHFU cells and their EE, the duration of thrombocytopenia was shortened from 18 to 12 days, and anemia was abolished. Leukocytes were also elevated on days 9 to 12, although sustained recovery was not accelerated. Anemia was also abrogated in recipients of 10(3) TLS cells and their EE. Early platelet counts were slightly higher than with TLS cells alone, but leukocyte recovery was not improved. These data confirm that TLS cells contribute to early and sustained hematopoiesis, and demonstrate a benefit of ex vivo expanded cells in accelerating engraftment of more primitive TSHFU stem cells depleted of progenitors.
Animals↗
Comparison of myeloma cell contamination of bone marrow and peripheral blood stem cell harvests.
lt could be speculated for patients with myeloma and other lymphoproliferative disorders that peripheral blood stem cells may be preferable to bone marrow for autologous transplantation because they may be less contaminated by neoplastic cells. To test this possibility, the immunoglobulin heavy chain gene rearrangement and limiting dilution polymerase chain reaction were used to sensitively quantify myeloma cells in bone marrow and peripheral blood stem cell collections, taken at a similar time, from eight patients with multiple myeloma. Levels of residual disease in the peripheral blood stem cell harvests were variable and did not reflect the tumour burden in the marrow. Peripheral blood stem cells contained 1.7 to 23700-fold fewer myeloma cells compared with the bone marrow and would have resulted in reinfusion of 0.08 to 59480-fold fewer myeloma cells based on total reinfused CFU-GM and 0.24 to 24700-fold fewer myeloma cells based on total reinfused nucleated cells. Assuming that the proportion of clonogenic myeloma cells is equivalent, peripheral blood stem cells may be better than bone marrow as a source of haemopoietic stem cells for transplantation in multiple myeloma. The clinical followup suggested that patients transplanted with peripheral blood stem cells containing a low number of myeloma cells had better disease control than those transplanted with peripheral blood stem cells containing a high number.
Adult↗
Standardization of the CFU-GM assay using hematopoietic growth factors.
The colony-forming unit-granulocyte-macrophage (CFU-GM) assay is used commonly to assess adequacy of progenitor number in bone marrow transplantation. The assay is poorly standardized, resulting in variability of results between and within laboratories. We assessed three variables that contribute to the lack of standardization. The colony-stimulating activity of human placental-conditioned medium (HPCM) was compared with combinations of recombinant hematopoietic growth factors (HGF) in 5 normal bone marrow donors. A protocol for batch testing of fetal calf serum (FCS) is described. In addition, a rigid training program has been introduced to minimize interstaff and intrastaff variability in the counting of colonies. We show that a five-factor combination of interleukin-3 (IL-3), IL-6, granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage CSF (GM-CSF), and stem cell factor (SCF) produces a mean increase of 85% in colony number. Some combinations of three HGF produce similar growth to HPCM, and all four HGF combinations are equivalent or superior to HPCM. Batch testing of FCS shows variability between batches. We show significant interstaff and intrastaff variability between a new and experienced staff member that improves following a period of training. In summary, the use of recombinant HGF in association with a rigorous program of batch testing of FCS and staff training results in a CFU-GM assay that can be standardized between laboratories.
Blood Cell Count↗
Peripheral blood stem cells mobilized from patients with acute myeloid leukaemia have different platelet repopulating abilities compared with those mobilized from patients with other diseases.
Peripheral blood stem cell (PBSC) transplantation gives rapid recovery of neutrophils and platelets and sustained haemopoiesis. However in patients with acute myeloid leukaemia (AML) platelet recovery has a distinctive rapid rise and then secondary fall between 3 to 8 weeks post-transplant. This study compares platelet and neutrophil recovery after PBSC transplantation in 15 patients with AML and 29 patients with other diseases consecutively transplanted in a single unit. PBSC were collected during recovery from consolidation chemotherapy in AML patients and after cyclophosphamide or cytokine administration in the other patient groups. Mononuclear cell numbers collected were similar but CFU-GM numbers were greater from the AML patients. A significant secondary fall occurred only in the platelet count and only in AML patients. Long-term recovery of the platelet count was the same in AML as in the other patients. In AML patients, the fall was the same in the long term remitters as in those who eventually relapsed. Previous studies have not, demonstrated a difference in type of precursors mobilized by differing methods, but have not included AML patients. Megakaryocyte precursors were assayed in this study and showed no consistent differences in number between patient groups however pre-progenitor assays are not yet established especially in the megakaryocytic lineage. The possible explanation for this secondary fall in AML patients is discussed.
Acute Disease↗
Apoptosis regulatory gene NEDD2 maps to human chromosome segment 7q34-35, a region frequently affected in haematological neoplasms.
Developmentally regulated mouse gene Nedd2 encodes a protein similar to the product of the nematode Caenorhabditis elegans cell death gene ced-3 and the mammalian interleukin-1 beta-converting enzyme. Overexpression of Nedd2 in cultured mammalian cells induces apoptosis that can be blocked by proto-oncogene BCL2. We have isolated cDNA clones for the human homologue of the mouse gene and, by using these as probes, mapped the human NEDD2 gene to 7q34-35 by fluorescence in situ hybridisation. The potential tumour suppressor function of NEDD2 is discussed.
Apoptosis↗
Blood cell transplantation.
Blood cell transplantation (BCT) is the procedure of choice for autologous bone marrow transplantation. In this paper we review the current status of BCT with emphasis on important recent advances. These include increasing knowledge of the biologic nature of mobilized blood cells and important evidence showing that very primitive cells are present in blood cells. An increasing understanding of mechanisms of mobilization is likely to result in the design of more rational mobilization strategies. Current mobilization methods are discussed including justification of combined chemotherapy and cytokine mobilization as the method of choice for cancer patients. Single-apheresis BCT may be possible in the future. Recent data show variable malignant contamination of blood cell harvests, but whether this contributes to relapse is unknown. Clinical applications and the efficacy of high-dose therapy are discussed. BCT may allow novel approaches to increase both total dose and dose intensity of therapy as well as application to allogeneic transplantation.
Blood Cells↗
Direct analysis of FACS-sorted hemopoietic cell fractions using FISH.
Explore the source record for details and available documents.
Acute Disease↗
A comparative study of the phenotype and proliferative capacity of peripheral blood (PB) CD34+ cells mobilized by four different protocols and those of steady-phase PB and bone marrow CD34+ cells.
Peripheral blood (PB) CD34+ cells from four commonly used mobilization protocols were studied to compare their phenotype and proliferative capacity with steady-state PB or bone marrow (BM) CD34+ cells. Mobilized PB CD34+ cells were collected during hematopoietic recovery after myelosuppressive chemotherapy with or without granulocyte-macrophage colony-stimulating factor (GM-CSF) or granulocyte colony-stimulating factor (G-CSF) or during G-CSF administration alone. The expression of activation and lineage-associated markers and c-kit gene product were studied by flow cytometry. Proliferative capacity was measured by generation of nascent myeloid progenitor cells (granulocyte-macrophage colony-stimulating factor; CFU-GM) and nucleated cells in a stroma-free liquid culture stimulated by a combination of six hematopoietic growth factors (interleukin-1 (IL-1), IL-3, IL-6, GM-CSF, G-CSF, and stem cell factor). G-CSF-mobilized CD34+ cells have the highest percentage of CD38- cells (P < .0081), but otherwise, CD34+ cells from different mobilization protocols were similar to one another in their phenotype and proliferative capacity. The spectrum of primitive and mature myeloid progenitors in mobilized PB CD34+ cells was similar to their steady-state counterparts, but the percentages of CD34+ cells expressing CD10 or CD19 were lower (P < .0028). Although steady-state PB and chemotherapy-mobilized CD34+ cells generated fewer CFU-GM at day 21 than G-CSF-mobilized and steady-state BM CD34+ cells (P < .0449), the generation of nucleated cells and CFU-GM were otherwise comparable. The presence of increased or comparable numbers of hematopoietic progenitors within PB collections with equivalent proliferative capacity to BM CD34+ cells is not unexpected given the rapid and complete hematopoietic reconstitution observed with mobilized PB. However, all four types of mobilized PB CD34+ cells are different from steady-state BM CD34+ cells in that they express less c-kit (P < .0002) and CD71 (P < .04) and retain less rhodamine 123 (P < .0001). These observations are novel and suggest that different mobilization protocols may act via similar pathways involving the down-regulation of c-kit and may be independent of cell-cycle status.
ADP-ribosyl Cyclase↗
Collection efficiency on the Fenwal CS3000 when using filgrastim (recombinant methionyl human granulocyte colony-stimulating factor) as a peripheral blood stem cell mobilization agent.
The collection efficiency (CE) of the Fenwal CS3000 in collecting peripheral blood stem cells during post-chemotherapy recovery phase ranges from 58% to 73%. Recently filgrastim (recombinant methionyl human granulocyte colony-stimulating factor [G-CSF]) has also been shown to be effective as a mobilization agent although mobilization occurs during elevated and not low normal leukocyte counts. We compared the mononuclear cell (MNC) CE and the myeloid progenitor cell (CFU-GM) CE among 11 patients with G-CSF mobilization (33 procedures) and 19 patients during recovery following myelosuppression chemotherapy (93 procedures). Pre-apheresis leukocyte, neutrophil, MNC, and PB CFU-GM counts were significantly higher in the G-CSF group, while the granulocyte percentage in the apheresis products was similar in both groups. Both MNC CE (81.8 +/- 4.5% vs. 64 +/- 2.4%) and CFU-GM CE (79.5 +/- 10.5% vs. 55.8 +/- 3.5%) were higher in the G-CSF group. Only the pre-apheresis MNC count showed an independently significant correlation for both CE (P < .001). The higher CE in the G-CSF group can only be partly explained by a rise in MNC count during apheresis. These data suggest that the blood cell separator works better with leukocytosis, and especially with a higher MNC count. The improvement in CE is another benefit of G-CSF mobilization over chemotherapy mobilization.
Adult↗
Ex vivo hematopoietic progenitor cell expansion.
The ability to culture and expand hematopoietic progenitor cells ex vivo has major implications for both bone marrow and stem cell support following marrow ablative or subablative high-dose therapy and for improving the efficiency of retroviral transfection in gene marking and gene therapy. This review focuses on methods for the generation of myeloid progenitor and post-progenitor cells from peripheral blood stem cell collections, with particular emphasis on the characterization of these cells and practical issues associated with their expansion.
Antigens, CD↗
The use of the APAAP technique as a rapid indicator of peripheral blood progenitor cell levels.
Rapid and sustained engraftment following autotransplantation with peripheral blood stem cells (PBSC) depends on adequate numbers of stem cells and progenitor cells. In this study we have compared the number of myeloid progenitor cells quantitated using the colony forming units-granulocyte macrophage (CFU-GM) clonogenic assay with the number of CD34+ cells estimated both by flow cytometry and by the alkaline phosphatase anti-alkaline phosphatase (APAAP) technique. We have analysed 15 peripheral blood mononuclear cells (PBMNC) samples from 13 normal subjects and 179 PBMNC from 32 patients undergoing PBSC harvests during the recovery phase of high dose cyclophosphamide chemotheraphy. The number of CD34+ cells measured by the APAAP technique correlated well with the number of CD34+ cells measured by flow cytometry (r = 0.727, p = 0.0001), and also with the number of CFU-GM measured in the clonogenic assay (r = 0.721, p = 0.0001). The APAAP method provides a rapid, reliable measure of progenitor cell levels that can be used to monitor the optimal time to harvest peripheral blood stem cells (PBSC), and to estimate the marrow repopulating ability (MRA) of stem cell preparations used for transplantation.
Alkaline Phosphatase↗
c-kit is expressed by primitive human hematopoietic cells that give rise to colony-forming cells in stroma-dependent or cytokine-supplemented culture.
Using monoclonal antibody (MAB) YB5.B8, we have examined the expression of the c-kit protein, the receptor for the hematopoietic cytokine stem cell factor (SCF), on primitive hematopoietic cells. Bone marrow mononuclear cells (BMMNC) enriched for immature cells by differential agglutination using the lectin soybean agglutinin (SBA) were subjected to multiparameter fluorescence activated cell sorting (FACS) based on light-scattering properties, the expression of the c-kit protein and the CD34 antigen, and the retention of the vital fluorescent dye, Rhodamine 123 (Rh123). Sorted populations were assayed for their content of directly clonogenic progenitor cells (colony-forming units-granulocyte/macrophage [CFU-GM], burst-forming units-erythroid [BFU-E], and multipotential colony-forming units [CFU-Mix]) and for the presence of more primitive progenitor cells ("pre-CFU"). The latter were assayed by (1) their ability to initiate and sustain hematopoiesis in a standard stromal cell-dependent culture system and (2) their capacity for de novo generation of clonogenic progenitors in response to a combination of six recombinant hematopoietic cytokines in a stroma-independent suspension culture assay. A mean of 76% of CD34+ cells were found to coexpress c-kit. The majority of directly clonogenic cells (98% of CFU-GM, 98% of CFU-Mix, and 85% of BFU-E) were found in the CD34+c-kit+ fraction. Similarly, all pre-CFU were recovered in the CD34+c-kit+Rh123dull fraction, irrespective of whether the cells were maintained on marrow stromal cells or in cytokine-supplemented liquid culture. A mean of 87% (range 70-100%) of the CD34+Rh123dull cells also expressed c-kit. Since SCF has been reported to act as a growth factor for early lymphoid cells as well as myeloid cells, we looked for coexpression of c-kit and early lymphoid markers in the CD34+ population by multiparameter flow cytometry. Coexpression of c-kit on a minority of cells with markers of B or T lineages was observed. The majority of early lymphoid cells, however, appeared to lack c-kit expression. This was confirmed by the finding that only 4% of c-kit+CD34+ cells showed terminal deoxynucleotidyl transferase (TdT) activity, compared with 25% of the c-kit-CD34+ cells.
Antigens, CD↗
The mobilization of primitive hemopoietic progenitors into the peripheral blood.
There is considerable interest in the use of peripheral blood progenitor cells (PBPC) for hemopoietic rescue following high dose chemotherapy. Current regimens mobilize CD34+ with variable efficacy and there remains considerable empiricism in the design of these regimens. Some involve myelosuppression, some the administration of various cytokines alone or in combination, while a combination of chemotherapy and cytokines is employed in others. Certain protocols result in mobilization within one week while in others, maximal PBPC levels occur only after several weeks. Thus, procedures required for optimal mobilization of PBPC remain to be defined. An understanding of the mechanisms responsible for mobilization may lead to the development of improved mobilization strategies. Herein we review data that explore the mechanisms involved in the mobilization of PBPC in man. These data demonstrate that mobilization is associated with marked changes in the expression and function of cell adhesion molecules (CAMs) on hemopoietic progenitor cells (HPC), suggesting that the release of HPC into the blood involves a perturbation of the adhesive interactions between these cells and the marrow stroma that, in steady-state conditions, serve to restrict HPC to the bone marrow. Downregulation of c-kit is invariably associated with successful mobilization which, when combined with data from in vitro studies, implies a key role for stem cell factor (SCF) as an orchestrator of mobilization.
Animals↗
Blood cell transplantation: report from an International Consensus Meeting.
An International Consensus Meeting on blood cell transplantation took place in Heemskerk, The Netherlands on 27-29 June 1994. The term 'blood cell transplantation' was preferred to peripheral blood stem cell transplantation. The following issues were addressed: stem cell assessment and ex vivo expansion, techniques for stem cell mobilization, applications of blood cell transplantation, malignant cell contamination and allogeneic blood cell transplantation.
Blood Component Removal↗
What's new in blood progenitor cell autotransplants?
Autotransplants of blood progenitor cells are increasingly used in persons with cancer, sometimes added to bone marrow cells but increasingly in their stead. Clearly, transplants of blood progenitor cells accelerate hematopoietic recovery after high-dose therapy. However, because some residual recipient-derived hematopoiesis typically persist even after the most intensive therapy, it is not certain that long-term hematopoiesis is from the blood progenitor cell autograft. However, this issue may be unimportant since the immediate goal is short-term recovery of bone marrow function regardless of which cells are responsible for long-term recovery. This issue is, however, of considerable import were more intensive treatment to be used or where blood progenitor cells were to be used for allografts. There are some reasons to think that transplants of blood-derived cells might have a lower likelihood of returning cancer cells to the recipient, at least in some lymphomas and solid tumors, than an autotransplant of bone marrow cells. This notion is as yet unproven and may be important only when and if more effective anti-cancer pretransplant regimens are developed. The potential role of transplants of blood progenitor cells depends on how useful autotransplants prove. Whether use of blood progenitor cells rather than bone marrow cells offers any advantage requires considerable additional data and controlled trials.
Animals↗