Summary
Ex vivo expanded progenitor cells have been proposed as a source of cells to support high-dose chemotherapy and to decrease or eliminate the period of neutropenia following transplantation. To date, no clinical studies using ex vivo expanded cells have demonstrated any decrease in the time to neutrophil or platelet recovery, although a number of clinical studies have been performed using a variety of growth factor cocktails and culture conditions. During the past 6 years we have developed a static culture system that results in optimal expansion of myeloid progenitor cells as measured by GMCFC in vitro. We have initiated two clinical studies to evaluate this culture system in cancer patients receiving autologous peripheral blood progenitor cells (PBPC) or allogeneic cord blood cells (CB) to support high-dose chemotherapy. CD34 selected cells were cultured for 10 days in 800 ml of defined media containing 100 ng/ml each of rhSCF, rhG-SCF, and rhMGDF in 1-l teflon bags. After culture the cells were washed with 3 volumes of PBS to remove all media and growth factors and reinfused with doily administration of rhG-CSF. In both studies, unexpanded cells were given in addition to the expanded cells to ensure durability of the graft. Patients transplanted with expanded PBPC cells recovered neutrophil counts on day 5 (3 patients) or day 6 (3 patients) post transplant. The median time to neutrophil engraftment in historical controls was 11 days, with the earliest recovery at day 7. No effect on platelet recovery has been observed in any patients to date. These data demonstrate that PBPC expanded under the conditions defined can significantly shorten the time to engraftment of neutrophils. In the second study adult (weight, 46–116 kg) patients were transplanted with expanded CB cells (40% of product), while 60% of the product was transplanted unmanipulated. The following table summarizes the expansion and engraftment data for these patients:
Patient | Weight (kg) | Infused cells (×107/kg) | Expansion of CFC (fold) | Engraftment | ||
---|---|---|---|---|---|---|
Day 0 | Day 10 | ANC | Platelets | |||
1 | 116 | 0.35 | 0.09 | 26 | 34 | 62+ |
2 | 74 | 0.4 | 0.29 | 10 | 21 | 51 |
3 | 86 | 0.37 | 0.31 | 40 | 26 | 91 |
4 | 59 | 0.78 | 0.44 | 31 | 21 | 23+ |
5 | 60 | 0.70 | 0.40 | 22 | 23 | 102+ |
6 | 11 | 4.9 | 3.7# | 7 | 15 | 56+ |
Reinfusion of the expanded cells was not associated with any adverse events. Neutrophil engraftment (days to an absolute neutrophil count [ANC] >500/μl) occurred between days 21 to 34 in patients 1 to 5 and even earlier in patient 6, who recovered to an ANC >500 on day 15. This rapid engraftment in patient 6 is consistent with the infusion of expanded cells on day 0 compared to day +10 in the other patients. Previous studies by Gluckman and colleagues reported that for patients of more than 45 kg in weight, only 11 of 23 and 5 of 23 achieved neutrophil and platelet engraftment, respectively, by day 60; this suggests that expanded CB cells may provide more rapid engraftment in larger patients, with 5 of 5 achieving neutrophil engraftment by day 34 or earlier. The availability of CB products frozen in aliquots may enable more rapid engraftment, similar to the recovery of patient 6. Other studies are in progress that suggest a role of ex vivo expanded cells in cellular support for high-dose chemotherapy. The optimal use of expanded cells, however, still remains to be defined.
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References
Williams WJ, Beutler E, Erslev AJ, Lichtman MA (eds) (1990) Hematology, 4th edn. McGraw-Hill, New York
Kay HEM (1965) How many cell generations? Lancet 2: 418–421
Bradley TR, Hodgson GS, Kriegler AB, McNiece IK (1985) Generation of CFU-S,3 in vitro. In: Hematopoietic stem cell physiology. Liss, New York, pp 39–56
McNiece IK, Bradley TR, Kriegler AB, Hodgson GS (1986) Subpopulations of mouse bone marrow high-proliferative-potential colony-forming cells. Exp Hematol 14: 856
McNiece IK, Williams NT, Johnson GR, Kriegler AB, Bradley TR, Hodgson GS (1987) Generation of murine hematopoietic precursor cells from macrophage highproliferative-potential colony-forming cells. Exp Hematol 15: 972
McNiece IK, Andrews RG, Stewart FM, Quesenberry PQ (1987) Synergistic interactions of human growth factors in in vitro cultures of human bone marrow cells. Blood 72 (5): 125a
Bernstein ID, Andrews RG, Zsebo KM (1991) Recombinant human stem cell factor enhances the formation of colonies by CD34+ and CD34+lin-cells, and the generation of colony-forming cell progeny from CD34+lin-cells cultured with interleukin-3, granulocyte colony-stimulating factor, or granulocyte-macrophage colony-stimulating factor. Blood 77: 2316
Haylock DN, To LB, Dowse TL, Juttner CA, Simmons PJ (1992) Ex vivo expansion and maturation of peripheral blood CD34+ cells into the myeloid lineage. Blood 80 (6): 1405
Purdy MH, Hogan CJ, Hami L, McNiece I, Franklin W, Jones W, Bearman S, Berenson RJ, Cagnoni PI, Heimfeld S, Shpall EJ (1995) Large scale ex vivo expansion of CD34positive hematopoietic progenitor cells for transplantation. J Hematother 4: 515–525
Briddell RA, Kern BP, Zilm KL, Stoney GB, McNiece IK (1996) Purification of CD34+ cells is essential for optimal ex vivo expansion of umbilical cord blood cells. Exp Hematol 24 (9): 1055
Shieh J-H, Chen Y-F, Briddell R, Stoney G, McNiece I (1994) High purity of blast cells in CD34 selected populations are essential for optimal ex vivo expansion of human GM-CFC. Exp Hematol 22 (8): 756a
Stoney GB, Briddell RA, Kern BP, Zilm KL, McNiece IK (1996) Clinical scale ex vivo expansion of myeloid progenitor cells and megakaryocytes under GMP conditions. Exp Hematol 24 (9): 1043a
Muench MO, Firpo MT, Moore MAS (1993) Bone marrow transplantation with interleukin-1 plus kit-ligand ex vivo expanded bone marrow accelerates hematopoietic reconstitution in mice without the loss of stem cell lineage and proliferative potential. Blood 81: 3463
Andrews RG, Briddell RA, Gough M, McNiece IK (1997) Expansion of G-CSF mobilized CD34+ peripheral blood cells (PBC) for 10 days in G-CSF, MGDF and SCF prior to transplantation decreased post-transplant neutropenia in baboons. Blood 90: 10: 92a
McNiece I, Hami L, Jones R, Bearman S, Cagnoni P, Nieto Y, Shpall EJ (1998) Transplantation of ex vivo expanded PBPC after high dose chemotherapy results in decreased neutropenia. Blood 92 (10): 126a
Reiffers J, Cailliot C, Dazey B, Duchez I, Pigneux A, Cousin T, Bussiere B, Boiron JM (1998) Infusion of expanded CD34+ selected cells can abrogate post myeloablative chemotherapy neutropenia in patients with hematologic malignancies. Blood 92 (10): 126a
Shpall EJ, Quinones R, Hami L, Jones R, Bearman S, Cagnoni P, Giller R, Nieto Y, Roman-Unfer S, Ross M, McNiece I (1998) Transplantation of cancer patients receiving high dose chemotherapy with ex vivo expanded cord blood cells. Blood 92 (10): 646a
Gluckman E, Rocha V, Boyer-Chammard A, Locatelli F, Arcese W, Pasquini R, et al (1997) Outcome of cord-blood transplantation from related and unrelated donors. N Engl J Med 337 (6): 373
Jaroscak J, Martin PL, Waters-Pick B, Armstrong RD, et al (1998) A phase I trial of augmentation of unrelated umbilical cord blood transplantation with ex-vivo expanded cells. Blood 92 (10): 646a
Stiff P, Pecora A, Parthasarathy M, Preti R, Chen B, et al (1998) Umbilical cord blood transplants in adults using a combination of unexpanded and ex vivo expanded cells: preliminary clinical observations. Blood 92 (10): 646a
Engelhardt M, Douville J, deReys S, von Kalle C, Behringer D, et al (1998) Transplantation of ex vivo perfusion culture expanded bone marrow cells produces durable hematopoietic reconstitution after myeloablative chemotherapy. Blood 92 (10): 126a
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McNiece, I., Jones, R., Cagnoni, P., Bearman, S., Nieto, Y., Shpall, E.J. (2000). Ex Vivo Expansion of Hematopoietic Cells. In: Ikeda, Y., Hata, Ji., Koyasu, S., Kawakami, Y., Hattori, Y. (eds) Cell Therapy. Keio University Symposia for Life Science and Medicine, vol 5. Springer, Tokyo. https://doi.org/10.1007/978-4-431-68506-7_15
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DOI: https://doi.org/10.1007/978-4-431-68506-7_15
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