Eliminating acute lymphoblastic leukemia cells from human testicular cell cultures: a pilot study.

OBJECTIVE: To study whether acute lymphoblastic leukemia (ALL) cells survive in a human testicular cell culture system. DESIGN: Experimental laboratory study. SETTING: Reproductive biology laboratory, academic medical center. PATIENT(S): Acute lymphoblastic leukemia cells from three patients and testicular cells from three other patients. INTERVENTION(S): Acute lymphoblastic leukemia cells were cultured alone or in combination with testicular cells, at various concentrations, in a system that has recently been developed to propagate human spermatogonial stem cells. MAIN OUTCOME MEASURE(S): Viability of ALL and testicular cells during culture was evaluated by flow cytometry using markers for live/dead cells. Furthermore, the presence of ALL cells among testicular cells was determined by highly sensitive (1:10,000 to 1:100,000 cells) patient-specific antigen-receptor minimal residual disease polymerase chain reaction. The presence of spermatogonia at the end of culture was determined by reverse transcription-polymerase chain reaction for ZBTB16, UCHL1, and GPR125. RESULT(S): The ALL cells cultured separately did not survive beyond 14 days of culture. When cultured together with testicular cells, even at extremely high initial concentrations (40% ALL cells), ALL cells were undetectable beyond 26 days of culture. Reverse transcription-polymerase chain reaction confirmed the presence of spermatogonia at the end of the culture period. CONCLUSION(S): Our pilot study shows that the described testicular cell culture system not only allows for efficient propagation of spermatogonial stem cells but also eliminates contaminating ALL cells.