Inverse relationship between megakaryocyte buoyant density and maturity

S ummary . We examined the relationship between rat megakaryocyte buoyant density and maturation stage in continuous Percoll density gradients. An average of 88% of megakaryocytes had buoyant densities <1–054 g/ml. There was an inverse relationship between megakaryocyte buoyant density and maturation. Morphologically mature forms comprised 90% of the megakaryocytes with buoyant densities of 1.030–1.033 g/ml. In contrast, immature morphology was present in three-quarters of megakaryocytes with buoyant densities of 1.042–1.046 g/ml. These morphological findings were confirmed by [³H]thymidine labelling studies. Cell viability assessed by trypan blue exclusion was highest among more dense megakaryocytes of which the majority were immature. The lowest trypan blue exclusion was found in the less dense, predominantly mature megakaryocytes indicating that these cells are more susceptible to membrane damage during marrow suspension. Megakaryocyte DNA content distributions and platelet antigen levels, determined by two-colour flow cytometry, were also related to megakaryocyte density; the more dense megakaryocytes showed an approximately two-fold higher proportion of 8N cells and less platelet antibody binding than did less dense megakaryocytes. These studies suggest that megakaryocytes can be fractionated according to their buoyant densities into immature and mature populations suitable for molecular studies of differentiation.     

Acute myeloid leukemia colony growth in vitro: differences of colony- forming cells in PHA-supplemented and standard leukocyte feeder cultures

Bone marrow or blood of patients with acute myeloid leukemia was subjected to cell separation and the cells investigated for in vitro colony growth. Discontinuous albumin density gradient centrifugation and depletion of E-rosette-forming cells resulted in purified fractions of acute myeloid leukemia cells. From these fractions, growth of large leukemic colonies was obtained in the PHA-leukocyte feeder (PHA-LF) colony technique in 12 of 14 patients. The standard double agar layer techniques with a leukocyte feeder for granulocyte-macrophage colony forming cells (GM-CFC) supported colony formation in only four cases. The PHA-LF leukemic colony-forming cells (CFC) were found to be of low buoyant density (always less than or equal to 1.062 g.ml-1) when compared to normal marrow GM-CFC (peak at 1.065 g.ml-1). The density profile of PHA-LF CFC paralleled the distribution of the nucleated cells in 8 cases, but in 4 patients, the cFC peak was found at a distinctly lower density; this suggested that a specific leukemic subpopulation had a colony-forming capacity. In three of the four patients with colony growth in the double layer agar technique, it was evident that these CFC had density properties different from those of PHA-LF CFC. These findings suggest that cells giving rise to large colonies in the PHA-LF and double layer agar assays represent distinct leukemic subpopulations.     

Distribution of carbohydrate structures in individual maturation stages of myeloid leukemic cells

The distribution of peanut agglutinin (PNA) receptors, nonspecific cross-reacting antigen (NCA) molecule and 3-fucosyl-N-acetyllactosamine (FAL) in myeloid leukemic cells isolated by density gradient centrifugation was compared using immunofluorescence test (IF). Patients with acute myelocytic leukemias (AML) type M2 and M5 showed low percentage of NCA+ and PNA+ cells. In chronic and acute phase of chronic myelocytic leukemias (CML) the number of NCA containing cells increased and the amount of PNA-binding cells decreased as more mature granulocytic fractions were isolated on Ficoll--Uropoline density gradient. In patients with myeloblastic crisis of CML (CML-BC) the number of cells expressing FAL structure did not change in relation to maturation stage of myeloid cells. Our results revealed that the expression of various markers could change in a different way during the differentiation of cells from myeloblasts to mature granulocytes.     

Quantitation by flow cytometry of anthracycline drug uptake by peripheral blood and bone marrow cells in human leukemias

The inherent fluorescence of the anthracycline drugs can be combined with flow cytometry to obtain a convenient and rapid method for the quantitation of anthracycline drug uptake by human leukemic cells. A good correlation exists between the average cellular fluorescence intensity and the amount of drug associated with the cell as measured by extraction. Cellular incorporation of adriamycin and daunomycin was determined in peripheral blood and bone marrow cells of human leukemic patients after standardized in vitro exposures. Differences in uptake were found between the different cell types, with cells of lymphatic origin incorporating less of the drugs than nonlymphatic cells. Preliminary observations made in two patients with nonlymphatic leukemia showed a correlation between the in vitro uptake of adriamycin and the clinical response.     

Expression of dipeptidylaminopeptidase-IV in some human T and B cell lines

The specificity of the expression of dipeptidylaminopeptidase-IV (DAP-IV) was examined in cells from leukemia patients and in 33 normal and leukemic human cell lines widely used in various studies. There was no correlation between DAP-IV activity and OKT4 positivity or maturation stage in T cells. In addition, DAP-IV was unexpectedly expressed by 4 B cell lines and 1 histiocytic lymphoma cell line, indicating either lack of specificity of DAP-IV or infidelity of gene expression under unnatural culture environment.     

Transient versus permanent expression of cancer-related glycopeptides on normal versus leukemic myeloid cells coinciding with marrow egress

Release of mature cells from the bone marrow (BM) into the peripheral blood (PB) compartment is supposed to be triggered by changes in cell surface constituents, most probably in glycoproteins. The supposed importance of glycoproteins in marrow exit prompted us to investigate glycopeptides, i.e., the carbohydrate part of the cell-surface-located glycoproteins of isolated human bone marrow cells of the myeloid series at different stages of maturation. Fractionation of cells was performed by a four-step procedure, comprised of density gradient centrifugation and velocity sedimentation at unit gravity in specially designed separation chambers. With this method, promyelocytes/myeloblasts, granulocytes from bone marrow, and granulocytes from peripheral blood were isolated in high quantity with purities up to 90%, 90%, and 100%, respectively. Surface glycopeptides of the various myeloid cells were investigated by gel filtration analysis after metabolic labeling with radioactive fucose or after external labeling with periodate- borotritide under mild conditions. Within the normal myeloid maturation sequence, mature granulocytes within the bone marrow were found to transiently express altered surface glycopeptides, which disappeared after release into the peripheral blood. These oligosaccharide structures appeared similar to those encountered on leukemic blast cells, known as "cancer-related glycopeptides." In contrast to normal granulocytes from BM, leukemic blast cells retained these aberrant carbohydrate structures on their surface after marrow release. A possible role for cancer-related glycopeptides in the process of marrow cell exit might be hypothesized.     

Elevated low density lipoprotein receptor activity in leukemic cells with monocytic differentiation

The receptor-mediated degradation of 125I-low density lipoprotein (LDL) was compared in normal white blood cells and leukemic cells. The cells were isolated from the peripheral blood and bone marrow of healthy subjects and patients with newly diagnosed leukemia. The cells from most of the 40 consecutive patients with acute myelogenous leukemia showed markedly higher degradation rates as compared to mononuclear cells and granulocytes from peripheral blood and nucleated cells from the bone marrow of healthy individuals. Leukemic cells from patients with monocytic (FAB-M5) or myelomonocytic leukemia (FAB-M4) exhibited the highest degradation rates. The rate of receptor-mediated degradation of 125I-LDL was also high in leukemic cells from all three patients with chronic myelogenous leukemia in blast crisis, as well as in two of three patients with acute undifferentiated leukemia. In contrast, leukemic cells isolated from two patients with acute lymphoblastic leukemia showed low rates. In most cases, there was little difference in LDL receptor activity between leukemic cells isolated from peripheral blood and those from bone marrow. Hypocholesterolemia was a frequent finding in the leukemic patients. There was an inverse correlation between the plasma cholesterol level and the rate of receptor-mediated degradation of 125I-LDL by the leukemic cells. Studies are now in progress to investigate the possibilities of using LDL as a carrier of cytotoxic drugs in the treatment of leukemia.     

Decreased microviscosity of membrane lipids in leukemic cells: Two possible mechanisms

Steady-state fluorescence polarization studies with the fluorescent lipid probe 1,6-diphenyl 1,3,5-hexatriene were done to determine the degree of microviscosity of cellular membrane lipids and serum lipoproteins in human normal donors and leukemic patients. The results show a marked decrease in microviscosity of cellular membrane lipids in both intact lymphocytes and isolated cellular plasma membranes obtained from leukemic patients in clinical relapse as compared to intact lymphocytes and isolated cellular plasma membranes obtained from normal donors and leukemic patients in complete clinical remission. Concomitant to these dynamic changes in cellular membrane lipids, the degree of microviscosity of lipids in the blood serum of leukemic patients in clinical relapse is markedly reduced as compared to serum obtained from normal donors and leukemic patients in complete clinical remission. Moreover, an in vitro incubation of leukemic lymphocytes with normal low density lipoproteins results in an increased microviscosity of cellular membrane lipids. In addition to the interrelation between cellular membrane lipids and serum lipoproteins, plasma membrane vesicles with a high degree of lipid microviscosity were isolated from the blood serum and pleural effusion of leukemic patients in clinical relapse. Such membrane vesicles could not be detected in normal serum. Therefore, we suggest that the two major mechanisms associated with the decreased microviscosity of membrane lipids in human leukemic cells are an abnormal exchange in lipids between the leukemic cell surface membrane and leukemic serum lipoproteins and an exfoliation of plasma membrane vesicles with a high degree of microviscosity from the cell surface of leukemic cells.     

Increased susceptibility of peripheral mononuclear cells of leukemic patients to HTLV-I infection in vitro

Peripheral mononuclear cells (MNC) collected from 12 healthy donors and 44 leukemic patients at various stages of the disease were tested for natural killer (NK) activity and for their susceptibility to HTLV-I infection in vitro, measured in terms of percentage of p19 positive cells. MNC from leukemic donors at any stage of leukemia (ie, onset or relapse, ON/REL; complete remission or off-therapy, CR/OT donors) were highly susceptible to HTLV-I infection. This was true for acute leukemias of lymphoblastic (ALL) or nonlymphoblastic (ANLL) type. MNC of ON/REL patients were more susceptible to HTLV-I than those of CR/OT donors. In addition, leukemic blasts were more rapidly infected (ie, within five to seven days) than the HTLV-I-susceptible normal cord- blood lymphocytes. However, the presence of circulating blasts was not essential to virus susceptibility, since CR/OT MNC, presumably free of leukemic blasts, were still more susceptible to HTLV-I than normal cells. Basal NK function of MNC from leukemic patients was significantly lower than that detectable in healthy controls. However, no correlation was found between susceptibility to HTLV-I infection and NK activity.     

Expression of nonspecific cross-reacting antigen species in myeloid leukemic patients and healthy subjects

Summary The reactivity of two monoclonal antibodies recognizing NCA-95 and NCA-55 (MAb 47 and MAb 192, respectively) with a polyclonal anti-NCA serum in myeloid leukemic cells isolated by density gradient centrifugation was compared using an immunofluorescence test (IF). It was observed that the blood myeloid cells in 78.8% of the patients with different types of myelocytic leukemias and all granulocytes of 15 normal donors showed similar expression of the NCA species studied. The leukocytes of the remaining patients did not synthesize the NCA-95 species regardless of the maturation stage of the cells studied. In two patients, synthesis of this NCA form was limited to the fractions containing myelocytes and metamyelocytes. We have found that all anti-NCA antibodies studied recognized different antigenic epitopes in a myeloid cell series. A relationship between the patient's survival and the proportion of NCA-containing cells was also observed.Supported by Polish National Cancer Program No. 11.5, Grant No. 95.     

Prognostic significance of immunoglobulin phenotype in B cell chronic lymphocytic leukemia

Seventy-six consecutive untreated patients with B cell chronic lymphocytic leukemia (B-CLL) and classified according to Binet's staging system were studied at the clinical presentation. Several immunologic parameters (number of total and T circulating lymphocytes and their surface membrane immunoglobulin [Smlg] phenotypes and levels of serum Ig) were evaluated with the aim of identifying a biologic marker of prognostic relevance. In this series of persons, Binet staging confirmed its usefulness as a prognostic index (P less than .001). With regard to Smlg, they were mu-type in 41 cases (53.9%), mu-type plus delta-type in 29 cases (38.2%), alpha-type in one case, and not detectable in five cases. No correlations were found between clinical stage and immunoglobulin phenotype, although all but one patient in stage C showed mu-type Smlg alone. On analyzing the survival curves of our patients according to different Smlg phenotypes, we found that patients with only mu-type Smlg had a poorer prognosis (P less than .05) than those with mu-type plus delta-type; this difference was even more significant (P less than .01) in patients in stage A, whereas there were no statistical differences in those in stages B and C. Because the appearance of surface heavy chain of delta-type could be an expression of cell maturation, these results suggest that in B-CLL the presence of phenotypically more mature leukemic cells may correlate with better clinical prognosis, particularly in the early phase of the disease.     

Heterogeneity of the response of chronic lymphocytic leukemia cells to phorbol ester

The ability of the tumor promotor 12-0-tetradecanoylphorbol 13-acetate (TPA) to induce differentiation of leukemic cells was studied in 10 cases of chronic lymphocytic leukemia (CLL). An increase in modal volume and an enhancement of the capacity of te leukemic cells to stimulate in mixed lymphocyte reaction (MLR) was seen in the majority of cases. A significant increase in Ia expression was observed upon culture of leukemic cells with TPA in 6 of the 10 cases; 5 of these cases also showed an induction of cytoplasmic IgM production. Correlations between the phenotypic markers of the leukemic cells and their ability to respond to TPA were evaluated. CLL cells with low amounts to surface Ig. a volume less than or equal to 165 fl. and relatively low la expression responded well to TPA. Cells with bright surface Ig. a volume greater than or equal to 178 fl. and elevated amounts of Ia responded poorly to TPA. These results suggest that differences in the response of B leukemic cells to TPA reflect the underlying heterogeneity of the leukemic cells and might be correlated with their stage of maturation.     

Giant neutrophils derived from tetraploid leukemic clone in an acute myeloblastic leukemia: cytofluorometric study

Near-tetraploid chromosomes were observed in a patient with acute myeloblastic leukemia with maturation (M2 in FAB classification). Large and morphologically bizarre leukemic cells and giant neutrophils in each maturation stage were observed in both peripheral blood and bone marrow. Cytogenetic studies revealed that the main stem line was 93; XXYY, +9, and DNA cytofluorometry showed that these large leukemic cells and giant neutrophils had 4C DNA content. These findings strongly suggested that these giant neutrophils were derived from leukemic clone with tetraploidy.     

Induction of NK activity in large granular lymphocyte leukemia: activation with anti-CD3 monoclonal antibody and interleukin 2

Large granular lymphocyte (LGL) leukemia is a rare disease characterized by clonal expansion of LGL associated with chronic neutropenia, multiple auto-antibodies, and occasionally polyarthritis. We studied cell surface antigen expression and functional activity of leukemic LGL from ten such patients. Using two-color flow cytometric analysis, we found that leukemic LGL from all ten patients expressed the CD3 and HNK-1 markers, while cells from only four patients expressed IgG Fc receptors (FcR). The LGL leukemic cells had little or no NK activity (defined as MHC-nonrestricted cytotoxicity against K562 target cells); however, NK activity could be induced in leukemic LGL by in vitro treatment with as little as 0.05 microgram/mL of anti-CD3 monoclonal antibody. Cell sorting experiments demonstrated that NK activity was induced in CD3+ leukemic LGL (either CD3+, HNK-1+ or CD3+, FcR+) with anti-CD3 monoclonal antibody but not in normal CD3+, FcR- T cells. Treatment with purified interleukin 2 (IL 2) also caused direct activation of some CD3+ leukemic LGL. Despite induction with anti-CD3 MAb or IL 2, activated leukemic LGL did not proliferate or express high density IL 2 receptors detectable by cell sorter analysis. Treatment with alpha interferon had minimal effect on NK activity of LGL leukemic cells. These results suggest that leukemic LGL may provide a useful model for examining the signals required for LGL maturation and activation.     

Characterization of a hierarchy in human acute myeloid leukemia progenitor cells

Despite the usual uniform and primitive appearance of cells derived from the leukemic clone in most patients with acute myeloid leukemia (AML), there is considerable heterogeneity among leukemic blasts, particularly with respect to their capacity to proliferate and/or self renew. We have assessed whether these differences in proliferative potential are correlated with the phenotypic changes that characterize normal hematopoiesis, which might suggest an analogous hierarchy of AML progenitors. We have used the ability of primitive AML cells to persist or produce blast colony forming cells (CFU-blast) detected after 2 to 8 weeks in the presence of growth factors in suspension cultures (SC) termed SC-initiating cells (IC), or with stroma in long-term cultures (LTC-IC) as a quantitative assay for a cell that may have primitive characteristics. This SC assay is linear, cell concentration independent, and the frequency of SC-IC by limiting dilution analysis is lower than primary CFU-blast. The average output of CFU-blast after 2 to 8 weeks by individual SC-IC varied between 2 and more than 100 in individual patients. Leukemic blasts were sorted based on their expression of antigens previously found useful to characterize normal progenitor differentiation, and analyzed for the percentage of CFU- blast SC-IC, and leukemic LTC-IC within each fraction. All of these progenitor types were heterogeneous in their expression of CD45RA and CD33, but expressed uniformly low levels of CD15 and differed from normal primitive progenitors in their high expression of HLA-DR. CFU- blast had a significantly higher expression of CD71 and CD38 as compared with SC-IC or leukemic LTC-IC. In patients with CD34+ blasts, the majority of their SC-IC at 4 weeks were CD34+/CD38-; however, patients with CD34- blasts had at least some CD34- progenitors. These results show that while heterogeneity exists between patients, it is possible to physically separate subpopulations of AML cells with different proliferative potentials. It also provides some support for the concept that quantitation of leukemic cells capable of producing CFU-blast for 4 weeks or more in vitro measures a less frequent leukemic progenitor with higher proliferative potential that may be the only relevant cell for maintaining the leukemic clone in vivo.     

Growth pattern and clinical correlation of subcutaneously inoculated human primary acute leukemias in severe combined immunodeficiency mice

We examined the ability of patient-derived human leukemic blasts to generate leukemic growth and dissemination in severe combined immunodeficiency (SCID) mice by subcutaneous inoculation without conditioning treatment or administration of growth-promoting cytokines. Additionally, we correlated the growth pattern with the clinical outcome of patients from whom the leukemic cells were derived. The leukemias displayed three distinct growth patterns, ie, either aggressive, indolent, or no tumor growth. Leukemic cells from 6 of 13 patients with acute myeloid leukemia (AML), 4 of 7 T-cell acute lymphoblastic leukemia (T-ALL), and 11 of 16 patients with B-lineage ALL grew as subcutaneous tumors, with a significant number subsequently disseminating into distant organs in SCID mice. Patients whose leukemic blasts displayed an aggressive growth and dissemination pattern in SCID mice had a relatively poor clinical outcome, whereas patients with AML and T- or B-lineage ALL whose leukemic blasts grew indolently or whose cells failed to induce growth had a more favorable clinical course. Our study has shown that the subcutaneous inoculation of patient-derived human leukemic cells in SCID mice can engraft and grow as subcutaneous tumors with subsequent dissemination to distant organs in a manner analogous to their pattern of growth in humans. Additionally, these data suggest a clinical correlation to the growth and dissemination of some leukemic subtypes that may represent not only an additional prognosticator for patient outcome, but also a vehicle for the study of the biologic behavior of human leukemias and the development of novel therapeutic strategies.     

CFUGEMM, CFUGM, CFUMK: analysis by equilibrium density centrifugation

A modification of the technique of Fauser and Messner was used for the culture of human multipotent hematopoietic progenitors. This modified technique shows a linear relationship between mixed granulocytic-erythrocytic colonies and the number of cells plated, even at extremely low cell doses (10(4) cells/dish) and is therefore a more suitable assay system for cell separation studies than the original non-linear method. The buoyant density of CFUGEMM (colony forming unit granulocytic-erythrocytic-megakaryocytic-macrophage) was determined using equilibrium density centrifugation. CFUGEMM were of lower buoyant density than the majority of nucleated marrow cells. Substantially enriched populations of CFUGEMM could be obtained with a single density separation procedure. The density distribution profile for CFUGEMM was also distinct from the density distribution of granulocyte-macrophage colony forming cells (CFUGM), the latter being of somewhat greater buoyant density than the former. Cells which formed clones containing only megakaryocytes in culture (CFUMK) had an intermediate density between that of CFUGEMM and CFUGM. The morphological characteristics of these progenitor cells were studied using correlation analysis. Results suggested that the CFUGEMM correspond to transitional cells without granules, the CFUGM to transitional cells with 1-4 granules and the heterogeneous group of GM-cluster forming cells to a broad category including myeloblasts, promyelocytes, myelocytes and metamyelocytes.     

Human acute myelomonocytic leukemia: serologic studies with simian antisera.

Simian antisera to human leukemia cells were able to distinguish antigens specific for lymphocytic types of leukemia from those expressed on certain myeloid leukemia cells. In this investigation, cells from acute myelomonocytic leukemia patients (AMML) were examined for their membrane-associated leukemia antigens. Simian antisera to both lymphocytic and myelogenous leukemia cells lysed cells from AMML donors. Monkey antisera to AMML cells, by direct microcytotoxicity testing, were cytotoxic for cells from all AMML patients, as well as for cells of certain patients with myeloid leukemia. Cells from patients with lymphatic leukemia were nonreactive. However, absorption studies indicated an antigen present on cells from patients with chronic lymphocytic leukemia which cross-reacted with AMML cell antigens. Sequential analyses of the serologic reactivity of cells from AMML patients undergoing chemotherapy corresponded with the clinical course of the patient, even though there was little correlation between the percentage of blast cells present and the per cent cytotoxicity with the antisera. At certain times a higher percentage of seropositive cells could be detected over that seen on morphological evaluation. The estimation of leukemic cells by serologic means could aid in the diagnosis and management of AMML patients during chemotherapy.     

The serological detection of leukemia-associated antigens in chronic leukemia: Correlation with disease status

Changes in the expression of leukemia-associated antigens (LAA) on the peripheral blood cells of patients with chronic lymphocytic leukemia (CLL) and chronic myelogenous leukemia (CML) were monitored over a period of several months with a battery of heterologous antisera in a complement-dependent microcytotoxicity test system. The sera were prepared by immunization of rabbits and monkeys with human CLL, CML, or acute lymphoblastic, myeloblastic, or myelomonocytic leukemic cells, or cell extracts. Following extensive adsorption with normal human erythrocytes and leukocytes, these sera did not exhibit reactivity with peripheral blood monuclear cells, nor, in most cases, with enriched B-lymphocyte preparations from healthy donors. Cells from CLL patients reacted mainly with adsorbed antisera raised against lymphocytic leukemic cells, but there was significant cross-reactivity with antisera raised against myelomonocytic leukemia cells; the number and intensity of positive reactions correlated with leukemic cell counts. Cells from patients in the chronic stage of CML reacted almost exclusively with adsorbed antisera to myeloid leukemic cells. However, blastic transformation of CML was regularly accompanied and on one occasion preceded by the appearance of reactivity with antisera to lymphocytic leukemic cells. During remission, peripheral blood cells from most CML patients were LAA-negative; positive serologic reactions were often followed by major hematologic and clinical deterioration within a few months. These observations suggest that serological monitoring of LAA may represent a useful adjunct to present methods of evaluating the course and prognosis of chronic leukemias. Serological reactions may also have some utility in the differential diagnosis of leukemia.     

Interleukin-7 differentiates a subgroup of acute lymphoblastic leukemias

The bone marrow stromal cell-derived growth factor interleukin-7 (IL-7) is known to stimulate growth of normal human B-cell precursors. In the present report, we have examined the effect of IL-7 on neoplastic B-cell precursors. Leukemic cells from 20 patients with common acute lymphoblastic leukemia (ALL) were highly purified by removing contaminating T cells and monocytes by rosetting with immunomagnetic beads. IL-7 markedly reduced the DNA synthesis in leukemic cells from three patients. This inhibition of DNA synthesis was accompanied by maturation of the cells, as demonstrated by the induced expression of the differentiation antigens CD19, CD20, CDw75, and surface mu-chain, and a decreased expression of terminal deoxynucleotidyl transferase. By examining G1 parameters, such as MYC, 4F2, and transferrin-receptor levels analyzed by flow cytometry as well as RNA and the cell cycle regulated antigen Ki67, it appeared that the cells were inhibited late in G1. Leukemic cells from the majority of the cases (12 of the 20 patients) responded to IL-7 with enhanced DNA synthesis without detectable maturation, as has been reported for their normal counterparts. Low molecular weight B-cell growth factor greatly potentiated the IL-7-induced growth stimulation of these cells. Thus, we have shown that IL-7 is capable of inhibiting proliferation of leukemic cells isolated from a subgroup of ALLs, and that this growth inhibition is accompanied by maturation of the cells.