Autograft of blood stem cells

Autologous blood stem cell transplantation (ABSCT) is a new technique which has been increasingly used in recent years. It is now well established that ABSCT can be performed as safely as autologous bone marrow transplantation (ABMT) when high numbers of hemopoietic precursors are infused. Multiple leukophoreses are performed during marrow regeneration following chemotherapy-induced aplasia. Hemopoietic recovery (predominantly the granulocytic series) is probably faster after ABSCT than after ABMT. Among other advantages there may be minimal contamination by residual tumor cells in buffy-coats; however, this has not been fully investigated.     

An inhibitor of murine stem cell proliferation produced by normal human bone marrow

Media conditioned by normal human bone marrow cells contain a specific inhibitor of haemopoietic stem cell proliferation. Molecular ultrafiltration and dose response studies indicate that it is similar to a previously described factor obtained from freshly isolated or long-term cultured murine bone marrow cells. It is suggested that the mechanisms involved in the control of murine and human stem cell proliferation may be essentially identical.     

造血干细胞移植治疗中高度恶性非霍奇金淋巴瘤5例

造血干细胞移植治疗非霍奇淋巴瘤５例,包括４例第 完全缓中,高度恶性ＮＨＬ;１例高度恶性ＮＨＬ合并淋巴瘤白血病。其中自体骨髓移植４例,异基因外周血干细胞移植１例。所有病例的移植成功。４例ＡＢＭＴ患者已无病生存５０,４８,３９和３个月,１例ａｌｌｏ－ＰＢＳＣＴ发生慢性移植物抗宿主病,移植后１２人月死于白血病复发。结果显示ＡＢＭＴ是治疗中,高度恶性ＮＨＬ有效手段。     

Single-agent high-dose melphalan salvage therapy for Hodgkin's disease: Cost, safety, and long-term efficacy

Background: Few data are available on the cost, safety, and long-termefficacy of single agent high-dose melphalan (HDM) followed by autologousbone marrow (ABMT) or blood stem cell (ABSCT) transplantation in the salvagetherapy of Hodgkins disease (HD).Patients and methods: From February 1981 to September 1996, 23 patientswith relapsed (n = 15) or refractory (n = 8) HD received salvage therapywith HDM 140–200 mg/m² followed by non-cryopreservedABMT (n = 18) or cryopreserved ABSCT (n = 5). The cost of HDM/ABSCT in 1996,from initial consultation until transfer back to referring physician, wasdetermined and compared to the estimated costs of two multi-agent regimenscommonly used for HD.Results: HDM was well tolerated with no early transplant-relatedmortality. The five-year overall and progression-free survival rates were52% and 50%, respectively. The average total cost in Canadianfunds of HDM/ABSCT in 1996 was $34,400/patient. This cost wasestimated to be $4,700–6,800 cheaper per patient than themulti-agent high-dose regimens.Conclusion: These data suggest that HDM is safe, feasible, active, andreasonably inexpensive salvage therapy for patients with relapsed/refractoryHD.     

Regulators of stem cell proliferation in the haemopoietic tissues of W/Wv and SI/SId mice

The presence of CFU-S proliferation stimulatory and inhibitory activities in the bone marrow and spleens of normal mice (+/+) and mice with mutations affecting the proliferative behaviour of stem cells (S1/S1^d and W/W^v) has been investigated.S1/S1^d and +/+ bone marrow and spleen contain virtually no detectable stimulator but the corresponding tissues from W/W^v mice are both strongly stimulatory. SI/SI^d marrow in particular, but also +/+ marrow are strongly inhibitory whilst +/+ spleen, S1/SI^d spleen, W/W^v marrow and W/W^v spleen all contain inhibitory activity but at a lower specific activity.The data are compatible with studies of cell and tissue grafts that have indicated an intrinsic haemopoietic stem cell defect in W/W^v mice and an extrinsic, microenvironmental defect in SI/SI^d mice. It is suggested that they are also compatible with defective regulatory interactions between stem cells and regulator-producing cells and that the W and S1 loci may code for products involved in the production of, or response to, CFU-S proliferation regulators.     

Identification of cancer stem cells in the "side population"

Both normal somatic stem cells and cancer cells are thought to be capable of unlimited proliferation. Paradoxically, however, some cancers seem to contain stem-like cells (cancer stem cells). There is increasing evidence that cancers might contain their own stem cells. Many cancers, like normal organs, seem to be maintained by a hierarchical organization that includes slowly dividing stem cells,rapidly dividing transit amplifying cells (precursor cells), and differentiated cells. Malignant gliomas, for example,often contain both undifferentiated and differentiated cells and sometimes contain cells that express neuronal markers as well as cells that express glial markers, suggesting that they may contain multipotent neural stem cell-like cells. We have shown that some cancer cell lines contain a small side population (SP), which, in many normal tissues, is thought to contain the stem cells of the tissue. We provide evidence that SP cells in the C6 glioma cell line can produce both neurons and glial cells and thus have cancer stem cell property. Taken together with studies on normal neural stem cells, studies on cancer stem cells will help us to understand a link between normal stem cells and cancer stem cells.     

SPECIFICITY OF HEMATOPOIETIC STEM CELL HOMING

Homing of hematopoietic stem cells (HSC) may be defined as the cells’ ability to seek marrow stroma selectively, to interact with it and subsequently to lodge within it to initiate hematopoiesis. This complex process is no doubt mediated through multiple recognition/adhesion events. Homing may proceed through one of several alternative mechanisms, however, such as through physical trapping of stem cells by marrow ultrastructural elements or through the providing of a selective survival and/or proliferative advantage by marrow. A third alternative that provides for the central element of stem cell homing—its high degree of specificity—is through the action of a specific homing protein in HSC. There are data to support this latter mechanism of stem cell homing as the correct one, and the nature of this protein may be similar to that of the lymphocyte homing receptors that are lectin-like molecules. Lectin–carbohydrate interactions are known to provide enormous specificity to cell recognition processes and to participate in cellular targeting. Leukemic cells have recently been demonstrated to home to marrow stroma and proliferate in the same way as normal stem cells. Thus, identification of proteins or other adhesion molecules that participate in normal and malignant cell homing could lead to more specific recruitment regimens for tumour-free collections.     

Specific inhibition of haemopoietic stem cell proliferation: characteristics of the inhibitor producing cells

Media conditioned by normal murine bone marrow cells contain a specific inhibitor of haemopoietic stem cell proliferation. Fractionated cell populations have been examined for their yield of this inhibitory activity in order to characterise its cellular source. The inhibitor is produced by low density, adherent, phagocytic, radio-resistant, Thy 1.2⁻, Fc⁺ cells. The results indicate that the producer cells reside in the heterogeneous macrophage population of the bone marrow.     

Stimulation of haemopoietic stem cell proliferation: Characteristics of the stimulator-producing cells

Media conditioned by regenerating murine bone marrow cells contain a stimulator of haemopoietic stem cell proliferation. Fractionated cell populations have been examined for production of this stimulatory activity in order to characterize its cellular source. The stimulator is produced by adherent, phagocytic radioresistant, Thy 1.2^?, Fc⁺ cells in a population concentrated in a density range of 1.064 – 1.072 g/ml. The results indicate that the producer cells reside in the heterogenous mononuclear phagocytic population of the bone marrow.     

Bispecific single-chain antibodies as effective tools for eliminating epithelial cancer cells from human stem cell preparations by redirected cell cytotoxicity.

High-dose chemotherapy (HDC) with autologous bone marrow or peripheral stem cell transplantation is discussed as one option to treat the extensive stage of a variety of tumors. Effective methods to eliminate contaminating tumor cells from human bone marrow or stem cell grafts may improve the outcome of the patients. We investigated 3 recombinant bispecific single-chain antibodies (bscAbs) directed against 17-1A (EpCAM), c-erbB-2 (HER-2/neu) and LeY on the one and CD3 on the other binding site for their ability to induce lysis of epithelial tumor cells by retargeting autochthonous T lymphocytes present in bone marrow mononuclear cells (BMMC) and in peripheral stem cell mononuclear cells (PSMC). The bscAbs showed remarkable specific lysis of different epithelial tumor cell lines with BMMCs as well as with PSMCs as effector cells. Investigation of the alpha 17-1A-alpha CD3 bscAb revealed a significant correlation between the percentage of CD3(+) cells present in the BMMCs and the rate of lysis as well as the absence of detrimental effects on the viability of hematopoietic progenitor cells as determined by colony-forming unit assays (CFUs). Our results indicate that recombinant bispecific single-chain antibodies could be new tools for purging of human bone marrow and peripheral stem cell grafts from contaminating epithelial cancer cells for patients receiving autologous stem cell transplantation after HDC.     

Clinical outcome of peripheral blood stem cell support

Two clinical results of peripheral blood stem cell support are commonly considered: (1) the effect on hematopoietic recovery and (2) the effect on the underlying malignancy. The dynamics of hematopoietic recovery after autoiogous bone marrow transplantation and after autologous peripheral blood stem cell transplantation in a clinical setting are similar if no exogenous cytokines are administered and the peripheral stem ceils are collected while their numbers are not deliberately increased (mobilised). If mobilized peripheral stem cells are transplanted, hematopoietic recovery is accelerated. In some circumstances, patients who receive peripheral stem cell transplantation may experience an improved progression-free survival after high-dose therapy when compared with similar patients who receive autologous bone marrow transplantation. Explanations for such a survival advantage might include (1) a lower likelihood of occult tumor cells capable of restoring disease in peripheral stem cell autograft products than in bone marrow harvests, (2) a greater number of cytotoxic effector cells capable of destroying occult tumor ceils in the peripheral stem cell collections than in bone marrow harvests, and (3) a different and advantageous pattern of immunologic recovery following autologous peripheral stem cell transplant compared to autologous bone marrow transplant.     

Autologous peripheral stem cell transplantation

A number of recent reports have now shown that hematopoietic stem cells are present in the circulation, and these cells have the potential to restore complete hematopoiesis following marrow aplasia. Peripheral stem cells have been collected by continuous flow leukapheresis during periods of hematopoietic regeneration after 2 to 3 weeks of intensive chemotherapy. Following marrow ablative chemotherapy or chemoradiotherapy, the autologous peripheral stem cells are thawed and infused intravenously. When a sufficient stem cell dose was given, rapid neutrophil and platelet recovery has been confirmed, as compared with bone marrow transplantation. Acute leukemia, malignant lymphoma and solid tumors may benefit from this approach, and long-lasting remission or cure may result in a significant number of patients.     

胃癌发生的干细胞机制

研究表明,胃癌发生的部位与胃干细胞定居的部位一致,干细胞可能在胃癌发生的过程中扮演了重要角色.对干细胞与胃干细胞、肿瘤干细胞与胃癌、骨髓干细胞与胃癌之间关系的研究,提示胃癌可能是一种干细胞疾病.     

Structure and function of bone marrow hemopoiesis: mechanisms of response to ionizing radiation exposure

It is the purpose of this presentation to review the unique structure and function of bone marrow anchored hematopoiesis in their significance for its response mechanisms to an exposure to ionizing radiation. The ultimate objective of bone marrow hematopoiesis is to maintain in the peripheral blood a constant level of the different blood cell types (erythrocytes, granulocytes, platelets, lymphocytes, etc.). All of them have their particular turnover kinetics (such as granulocytes 120 x 10(9)/d, erythrocytes 200 x 10(9)/d or thrombocytes 150 x 10(9)/d), are semi-autonomous in their steady state regulatory mechanisms and dependent on a life-long supply of mature cells from a stem cell pool with unlimited replicative and pluripotent differentiative potential. The present knowledge of hematopoietic cellular renewal is the result of years of basic experimental and clinical studies using radionuclides in various metabolic forms including (59)Fe, (32)P (DF (32)P), (51)Cr, (131)I, (60)Co, (3)H ((3)HTdR) and (14)C ((14)CTdR). To understand the physiology but in particular the radiation-pathophysiology, it is essential to recognize in detail the infrastructure of the bone marrow as a distinct unit. Indispensable for a life-long cell production is the capsule of the marrow - the bone cortex -, the arterial supply of blood connected to the sinusoidal microvascular architecture with its sinusoids contorti and recti as well as the central (cell collecting) sinusoids. It is further of importance to recognize the significance of nerval regulation of blood flow, characterized by myelinated and unmyelinated nerve fibers. The type of unique lining cells of the sinusoids is the prerequisite for the cell traffic between the hemopoietic parenchyma and the blood. This in turn cannot be achieved without an alternative opening and closing of the sinusoidal segments which - in turn - requires a rigid long capsule to assure an - in toto - constant volume of each bone marrow unit. If a bone marrow unit is exposed to ionizing radiation, a perturbance of the balance between cellular growth pressure and blood flow dynamics can be observed, resulting in a special type of bone marrow hemorrhage and an "excess cell loss" that may result in an non-thrombopenic exhaustion of the stem cell pool. Of great importance is the question as to the mechanisms that allow the bone marrow hemopoiesis to act as one cell renewal system although the bone marrow units are distributed throughout more than 100 bone marrow areas or units in the skeleton. The observation that "the bone marrow" acts and reacts as "one organ" is due to the regulatory mechanisms: the humeral factors (such as erythropoietins, granulopoietins, thrombopoietins etc.), the nerval factors (central nervous regulation) and cellular factors (continuous migration of stem cells through the blood to assure a sufficient stem cell pool size in each bone marrow "sub-unit"). It should be recalled that the bone marrow functions as a physiological chimera and becomes established by the hematogeneic seeding of stem cells to a mesenchymal matrix during embryogenesis. The repopulation of the bone marrow after partial body irradiation, after strongly inhomogeneous radiation exposure or after total body exposure with stem cell transplantation can well be considered as a repetition of the embryogenesis of bone marrow hemopoiesis with the key element of stem cells migrating via the blood to stromal sites of the marrow prepared to accept stem cells to home and start their replication and differentiation if the micro-environmental quality permits. In summary, the radiation biology of bone marrow hemopoiesis requires a thorough understanding of the physiology and pathophysiology of structure, function and regulation not only of the process of cellular renewal but also of the intricate infrastructure.     

Origin of marrow stromal cells and haemopoietic chimaerism following bone marrow transplantation determined by in situ hybridisation.

The origin and cell lineage of stromal cells in the bone marrow is uncertain. Whether a common stem cell exists for both haemopoietic and stromal cells or whether these cell lines arise from distinct stem cells is unknown. Using in situ hybridisation for detection of the Y chromosome, we have examined histological sections of bone marrow from seven patients who received marrow transplants from HLA-matched donors of the opposite sex. Stromal cells (adipocytes, fibroblasts, endothelial cells, osteoblasts and osteocytes) were identified in these recipients as being of host origin. This result is consistent with the concept of a distinct origin and separate cell lineage for cells of the haemopoietic and stromal systems. It also shows that engraftment of marrow stromal cell precursors does not occur and that host stromal cells survive conditioning regimens for marrow transplantation. With the exception of one case, with a markedly hypocellular marrow, mixed chimaerism was seen in haemopoietic cells, indicating that this is not a rare event after marrow transplantation.     

Spatial organisation of CFU-S proliferation regulators in the mouse femur

CFU-S proliferation can be regulated by an inhibitor and a stimulator which are produced locally in the bone marrow. The spatial distribution of cells elaborating these factors has been studied by separating marrow, zonally, into axial, marginal and bone-associated fractions and further separating the inhibitor and stimulator producing cells from these fractions by means of density cuts in bovine serum albumin. The inhibitor- and stimulator-producing cells are found respectively in bands of density < 1.064 g/cm³ and 1.064–1.072 g/cm³. Factors synthesised by these individual fractions were assayed for their ability to inhibit or stimulate CFU-S proliferation by thymidine suicide measurements. Axial cells contain a high concentration of inhibitor-producing cells but the marginal and bone fractions contain relatively few. Stimulator-producing cells have a very sharp gradient in the opposite direction with an extremely high concentration in the vicinity of the bone surface. These distributions fit with those of CFU-S proliferation and of fibroblastoid-CFC suggesting that the inhibitor-producing cell is an integral part of the micro-environment which maintains the stem cell's capacities while the stimulator-producing cell may be more closely associated with the differentiation processes which take place closer to the bone surface.     

Monoclonal circulating B cells in multiple myeloma. A continuously differentiating, possibly invasive, population as defined by expression of CD45 isoforms and adhesion molecules.

The origin of the malignant stem cell in multiple myeloma, despite years of investigation by many laboratories, remains elusive. We have described a population of monoclonal circulating B-lineage lymphocytes that has been detected in all myeloma patients analyzed, both at diagnosis and after chemotherapy, and that has many properties consistent with its definition as either a stem cell compartment or an intermediate between the stem cell and the bone marrow localized plasma cells. On average, 40% to 50% of peripheral blood mononuclear cells are abnormal B cells that express CD10 and PCA-1 in conjunction with B-lineage markers CD19, CD20, and CD24 and variable expression of CD5. The B cells are monoclonal by Southern blot analysis and represent a highly pleiomorphic population. The migratory patterns of these cells are unknown, and their presence in blood may reflect cells in transit from a parent organ such as spleen to bone marrow for terminal differentiation, or they may originate in the bone marrow prior to circulation and seeding of other skeletal or extraskeletal sites. The working hypothesis underlying this work postulates that these abnormal B cells originate outside the marrow, giving rise to plasma cells only after migration to the bone marrow, which provides a microenvironment conducive to terminal plasma cell differentiation. Bone marrow plasma cells do not include an actively proliferating component and are terminally differentiated end stage cells. In contrast, the circulating abnormal B cells include proliferating cells and appear to be heterogeneous in differentiation stage. Analysis of CD45 isoform expression indicates a population continuously differentiating from a late B-cell stage through the early plasma cell stages to an end stage plasma cell. Quantitative and qualitative expression of CD45 has been shown to characterize B-cell development, with a high density of the CD45RA isoform on mature resting B cells, a transition to CD45R0 on activated B cells, and a gradual loss of total CD45, predominantly of the CD45R0 isoform, during plasma cell development until, on end stage plasma cells, all CD45 expression is lost. In myeloma patients, all of these B-cell stages are represented, with the least differentiated B cells occurring in blood, intermediate stages in both blood and marrow, the most differentiated B and/or plasma cells in the bone marrow.(ABSTRACT TRUNCATED AT 400 WORDS)     

胃癌发生的干细胞机制

研究表明,胃癌发生的部位与胃干细胞定居的部位一致,干细胞可能在胃癌发生的过程中扮演了重要角色.对干细胞与胃干细胞、肿瘤干细胞与胃癌、骨髓干细胞与胃癌之间关系的研究,提示胃癌可能是一种干细胞疾病.