RESUMO
BACKGROUND: New drugs targeting specific genes required for unregulated growth and metastases have improved survival rates for patients with metastatic colorectal cancer. Resistance to monoclonal antibodies specific for the epidermal growth factor receptor (EGFR) has been attributed to the presence of activating point mutations in the proto-oncogene KRAS. The use of EGFR inhibitor monotherapy in patients that have KRAS wild type has produced response rates of only 10-20%. The molecular basis for clinical resistance remains poorly understood. We propose two possible explanations to explain these low response rates; 1) levels of resistant CRC cells carrying mutated KRAS are below the sensitivity of standard direct sequencing modalities (<5%) or 2) the standard practice of analyzing a single area within a heterogeneous tumor is a practice that can overlook areas with mutated KRAS. METHODS: In a collaborative effort with the surgical and molecular pathology departments, 3 formalin fixed paraffin embedded tissue blocks of human CRC were obtained from the human tissue bank maintained by the Lifespan Pathology Department and/or the human tissue bank maintained by the Molecular Pathology Core of the COBRE for Cancer Research Development. The three specimens previously demonstrated KRAS mutations detected by the Applied Biosystems Kit. The Wave system 4500 (high performance ion-pairing liquid chromatography (IP-HPLC)) was utilized to evaluate tissue for the presence of KRAS proto-oncogene mutations at codons 12 and 13. RESULTS: Initially, the sensitivity of WAVE technology was compared with direct sequencing by evaluating a dilutional series. WAVE detected mutant alleles at levels of 2.5% compared to 20% performed with standard direct sequencing. Samples from three patients were evaluated by WAVE technology. Eight samples from patient 1 were analyzed. In two of eight samples, no mutations were detected at concentrations as low as 5%. In one sample a mutation was noted by WAVE and not by direct sequencing. All four samples from patient 2 tested positive for Exon 12/13 mutations. Of the seven samples from patient 3, five were positive for Exon 12/13 mutations and two were negative for Exon 12/13 mutations. CONCLUSION: In these studies the analysis of three patients' colorectal cancer tissues were analyzed utilizing the WAVE technology. Results demonstrated a greater degree of sensitivity in mutation detection when compared to standard sequencing. These studies also demonstrated heterogeneity of expression of KRAS mutations between areas of the tissue samples at a genomic level. The low clinical response rates to EGFR inhibition might be explained by the variation in mutation presence, which was dependent upon the region examined. The heterogeneity demonstrated in these studies provides another phenotypic variant that will impact clinical care.
Assuntos
Cromatografia Líquida de Alta Pressão/métodos , Neoplasias Colorretais/genética , Análise Mutacional de DNA/métodos , Proteínas Proto-Oncogênicas/genética , Proteínas ras/genética , Neoplasias Colorretais/tratamento farmacológico , Resistencia a Medicamentos Antineoplásicos/genética , Receptores ErbB/antagonistas & inibidores , Humanos , Inclusão em Parafina , Proto-Oncogene Mas , Proteínas Proto-Oncogênicas p21(ras) , Sensibilidade e EspecificidadeRESUMO
Allogeneic and autologous marrow transplants are routinely used to correct a wide variety of diseases. In addition, autologous marrow transplants potentially provide opportune means of delivering genes in transfected, engrafting stem cells. However, relatively little is known about the mechanisms of engraftment in transplant recipients, especially in the nonablated setting and with regard to cells not of hemopoietic origin. In particular, this includes stromal cells and progenitors of the osteoblastic lineage. We have demonstrated for the first time that a whole bone marrow transplant contains cells that engraft and become competent osteoblasts capable of producing bone matrix. This was done at the individual cell level in situ, with significant numbers of donor cells being detected by fluorescence in situ hybridization in whole femoral sections. Engrafted cells were functionally active as osteoblasts producing bone before being encapsulated within the bone lacunae and terminally differentiating into osteocytes. Transplanted cells were also detected as flattened bone lining cells on the periosteal bone surface.
Assuntos
Células da Medula Óssea/classificação , Transplante de Medula Óssea , Quimera , Osteoblastos/transplante , Osteogênese , Animais , Feminino , Sobrevivência de Enxerto , Hibridização in Situ Fluorescente , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Células Estromais/transplante , Cromossomo YRESUMO
The most primitive engrafting hematopoietic stem cell has been assumed to have a fixed phenotype, with changes in engraftment and renewal potential occurring in a stepwise irreversible fashion linked with differentiation. Recent work shows that in vitro cytokine stimulation of murine marrow cells induces cell cycle transit of primitive stem cells, taking 40 h for progression from G0 to mitosis and 12 h for subsequent doublings. At 48 h of culture, progenitors are expanded, but stem cell engraftment is markedly diminished. We have investigated whether this effect on engraftment was an irreversible step or a reversible plastic feature correlated with cell cycle progression. Long-term engraftment (2 and 6 mo) of male BALB/c marrow cells exposed in vitro to interleukin (IL)-3, IL-6, IL-11, and steel factor was assessed at 2-4-h intervals of culture over 24-48 h using irradiated female hosts; the engraftment phenotype showed marked fluctuations over 2-4-h intervals, with engraftment nadirs occurring in late S and early G2. These data show that early stem cell regulation is cell cycle based, and have critical implications for strategies for stem cell expansion and engraftment or gene therapy, since position in cell cycle will determine whether effective engraftment occurs in either setting.
Assuntos
Ciclo Celular/fisiologia , Transplante de Células-Tronco Hematopoéticas , Células-Tronco Hematopoéticas/citologia , Células-Tronco Hematopoéticas/fisiologia , Animais , Ciclo Celular/efeitos dos fármacos , Células Cultivadas , Citocinas/farmacologia , Feminino , Masculino , Camundongos , Camundongos Endogâmicos BALB CRESUMO
Recombinant murine granulocyte macrophage colony-stimulating factor (rGM-CSF) has been produced in Escherichia coli and purified to homogeneity. GM-CSF has an established role as an in vitro regulator of granulocyte and macrophage colony formation. We have determined that rGM-CSF also has intrinsic activity as a megakaryocyte colony-stimulating factor and that rGM-CSF augments the effect of interleukin 3 (IL-3) on megakaryocyte colony formation. The dose-response curve for megakaryocyte colony induction with rGM-CSF showed plateau megakaryocyte stimulation at 9 ng/ml. When IL-3 (at a plateau dose for megakaryocyte colony induction) was added to rGM-CSF over a 0-22-ng/ml dose range, the resultant megakaryocyte colony stimulation approximated the sum of the levels of stimulation produced by either factor alone. These results establish GM-CSF as a multilineage growth factor with definite megakaryocyte colony-stimulating activity and indicate that both GM-CSF and IL-3 are important in the regulation of megakaryocytopoiesis.
Assuntos
Fatores Estimuladores de Colônias/farmacologia , Hematopoese/efeitos dos fármacos , Células-Tronco Hematopoéticas/efeitos dos fármacos , Interleucina-3/farmacologia , Megacariócitos/citologia , Animais , Diferenciação Celular/efeitos dos fármacos , Ensaio de Unidades Formadoras de Colônias , Sinergismo Farmacológico , Feminino , Granulócitos , Macrófagos , Camundongos , Camundongos Endogâmicos BALB C , Proteínas Recombinantes/farmacologiaRESUMO
alpha 2-Macroglobulin receptor/low density lipoprotein receptor-related protein (alpha 2M-R/LRP) is a broad specificity receptor that may function in lipoprotein metabolism, proteinase regulation, and growth factor regulation. In this study, we demonstrated that alpha 2M-R/LRP expression in macrophages can be markedly decreased by LPS and by IFN-gamma. Regulation of alpha 2M-R/LRP in RAW 264.7 cells was demonstrated at the mRNA, antigen, and receptor-function levels. In receptor-function studies, the decrease in alpha 2M-R/LRP expression was detected as a 90% decrease in the Bmax or maximum receptor binding capacity for activated alpha 2M after treatment with LPS or IFN-gamma. Western blot analysis of whole cell lysates demonstrated significant loss of alpha 2M-R/LRP heavy-chain. Northern blot analysis of poly(A)+ RNA revealed a marked decrease in alpha 2M-R/LRP mRNA after treatment with LPS (79% decrease) or IFN-gamma (70% decrease). Other cytokines, including tumor necrosis factor-alpha, transforming growth factor-beta-1, and interleukin-6 did not regulate alpha 2M-R/LRP. The ability of LPS and IFN-gamma to regulate alpha 2M-R/LRP was confirmed in experiments with primary cultures of murine bone marrow macrophages. These studies demonstrate that macrophage alpha 2M-R/LRP is subject to significant downregulation by physiologically significant cytokines and signaling macromolecules.
Assuntos
Interferon gama/farmacologia , Lipopolissacarídeos/farmacologia , Macrófagos/metabolismo , Receptores Imunológicos/metabolismo , Receptores de LDL/metabolismo , Animais , Northern Blotting , Western Blotting , Linhagem Celular , Células Cultivadas , Escherichia coli , Humanos , Cinética , Proteína-1 Relacionada a Receptor de Lipoproteína de Baixa Densidade , Macrófagos/efeitos dos fármacos , Macrófagos/imunologia , Camundongos , Camundongos Endogâmicos BALB C , Poli A/genética , Poli A/isolamento & purificação , RNA/genética , RNA/isolamento & purificação , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Receptores Imunológicos/efeitos dos fármacos , Receptores de LDL/efeitos dos fármacos , Proteínas Recombinantes , alfa-Macroglobulinas/metabolismoRESUMO
The adult marrow hematopoietic stem cell biology has largely been based on studies of highly purified stem cells. This is unfortunate because during the stem cell purification the great bulk of stem cells are discarded. These cells are actively proliferating. The final purified stem cell is dormant and not representative of the whole stem cell compartment. Thus, a large number of studies on the cellular characteristics, regulators and molecular details of stem cells have been carried on out of non-represented cells. Niche studies have largely pursued using these purified stem cells and these are largely un-interpretable. Other considerations include the distinction between baseline and transplant stem cells and the modulation of stem cell phenotype by extracellular vesicles, to cite a non-inclusive list. Work needs to proceed on characterizing the true stem cell population.
Assuntos
Células da Medula Óssea/fisiologia , Células-Tronco Hematopoéticas/fisiologia , Animais , Ciclo Celular , Humanos , Camundongos , Nicho de Células-Tronco/fisiologiaRESUMO
PURPOSE: This report defines new concepts of hematopoietic stem cell biology. RECENT FINDINGS: We have utilized 3 different approaches which show that long-term repopulating hematopoietic stem cells are actively cycling and always changing phenotype. In addition this is reversible. This indicates that the stem cell cannot be purified by current epitope selection approaches. The vast bulk of hematopoietic stem cells are discarded in different populations when stem cells are purified to lineage negative c-kit positive and Sca-1 positive cells. Studies to define the hematopoietic niche have been largely carried out on these irrelevant purified cells and thus are not definitive. Studies have indicated the presence of baseline stem cells which function during the normal lifetime of mice. Baseline hematopoiesis appears to be run by thousands of relatively short lived clones with limited differentiation capacity. Thus there appear to be two basic hematopoietic stem cell modes; emergency and baseline.
RESUMO
Most models of hematopoiesis have been hierarchical in nature. This is based on a large volume of correlative data. Recent work has indicated that, at least at the stem/progenitor level, hematopoiesis may, in fact, be a continuum of transcriptional opportunity. The most primitive hematopoietic stem cells are either continually cycling at a slow rate or entering and exiting cell cycle. Associated with this cycle passage are changes in functional phenotype including reversible alterations in engraftment, adhesion protein expression, cytokine receptor expression, homing to marrow, and progenitor cell numbers. Global gene expression, as measured in one point in cycle, is also markedly altered. The differentiation potential of the marrow as it transits cell cycle in response to a set differentiation stimulus also shows marked variations. This cycle-related plasticity has been clearly established for hematopoiesis. It also holds for the ability of murine marrow stem cells to home to lung and to convert to pulmonary cells. These data indicate that bone marrow stem cells can probably not be defined as discrete entities but must rather be studied on a population basis. They also indicate that mathematical modeling will become progressively more important in this field.
Assuntos
Modelos Biológicos , Células-Tronco/citologia , Células-Tronco/fisiologia , Animais , Diferenciação Celular , Regulação da Expressão Gênica , Hematopoese/fisiologia , Transplante de Células-TroncoRESUMO
Genetic instability is a common feature of many human cancers. This condition is frequently characterized by an abnormal number of chromosomes, although little is known about the mechanism that generates this altered genetic state. One possibility is that chromosomes are missegregated during mitosis due to the assembly of dysfunctional mitotic spindles. Because centrosomes are involved in spindle assembly, they could contribute to chromosome missegregation through the organization of aberrant spindles. As an initial test of this idea, we examined malignant tumors for centrosome abnormalities using antibodies to the centrosome protein pericentrin. We found that centrosomes in nearly all tumors and tumor-derived cell lines were atypical in shape, size, and composition and were often present in multiple copies. In addition, virtually all pericentrin-staining structures in tumor cells nucleated microtubules, and they participated in formation of disorganized mitotic spindles, upon which chromosomes were missegregated. All tumor cell lines had both centrosome defects and abnormal chromosome numbers, whereas neither was observed in nontumor cells. These results indicate that centrosome defects are a common feature of malignant tumors and suggest that they may contribute to genetic instability in cancer.
Assuntos
Centrossomo/ultraestrutura , Neoplasias/genética , Antígenos/análise , Centrossomo/química , Aberrações Cromossômicas , Imunofluorescência , Humanos , Técnicas Imunoenzimáticas , Neoplasias/ultraestrutura , Células Tumorais CultivadasRESUMO
We stably expressed the nerve growth factor receptor trkA or a truncated trkA lacking the kinase domain (trkA delta) in a highly tumorigenic rat glioma cell line, C6. Survival of rats with large intrastriatal inocula of C6trkA cells was significantly longer than for rats bearing C6 or C6trkA delta cells. Histological studies revealed that C6trkA cells were much less invasive than C6 or C6trkA delta cells and had a greater rate of apoptosis. There was no apparent induction of differentiation of C6 cells by trkA. Therefore, unlike what is observed in neuroblastomas, trkA decreases tumorigenicity by modulating invasiveness and tumor cell death independent of inducing differentiation. This novel mechanism suggests a new therapeutic strategy for malignant gliomas.
Assuntos
Glioma/patologia , Proteínas Proto-Oncogênicas/fisiologia , Receptores Proteína Tirosina Quinases/fisiologia , Receptores de Fator de Crescimento Neural/fisiologia , Animais , Masculino , Invasividade Neoplásica , Ratos , Ratos Endogâmicos WKY , Receptor trkA , Células Tumorais CultivadasRESUMO
Mesenchymal stromal cells (MSCs) have been shown to reverse radiation damage to marrow stem cells. We have evaluated the capacity of MSC-derived extracellular vesicles (MSC-EVs) to mitigate radiation injury to marrow stem cells at 4 h to 7 days after irradiation. Significant restoration of marrow stem cell engraftment at 4, 24 and 168 h post irradiation by exposure to MSC-EVs was observed at 3 weeks to 9 months after transplant and further confirmed by secondary engraftment. Intravenous injection of MSC-EVs to 500cGy exposed mice led to partial recovery of peripheral blood counts and restoration of the engraftment of marrow. The murine hematopoietic cell line, FDC-P1 exposed to 500cGy, showed reversal of growth inhibition, DNA damage and apoptosis on exposure to murine or human MSC-EVs. Both murine and human MSC-EVs reverse radiation damage to murine marrow cells and stimulate normal murine marrow stem cell/progenitors to proliferate. A preparation with both exosomes and microvesicles was found to be superior to either microvesicles or exosomes alone. Biologic activity was seen in freshly isolated vesicles and in vesicles stored for up to 6 months in 10% dimethyl sulfoxide at -80 °C. These studies indicate that MSC-EVs can reverse radiation damage to bone marrow stem cells.
Assuntos
Vesículas Extracelulares/fisiologia , Células-Tronco Hematopoéticas/efeitos da radiação , Células-Tronco Mesenquimais/citologia , Animais , Células da Medula Óssea , Dano ao DNA , Vesículas Extracelulares/transplante , Sobrevivência de Enxerto , Humanos , Masculino , Camundongos , Efeitos da Radiação , Transplante de Células-Tronco , Transplante Heterólogo , Resultado do TratamentoRESUMO
The latent membrane protein 1 (LMP1) oncogene of Epstein-Barr virus (EBV) is selectively expressed in the Reed-Sternberg (RS) cells of EBV-associated Hodgkin's disease (HD). However, no differences in clinical presentation and course are found between EBV positive and EBV negative forms of HD suggesting a common pathogenetic mechanism. We have studied the LMP1 associated signaling pathways and their dominant negative inhibition in the myelomonocytic HD-MyZ and the B-lymphoid L-428 HD cell lines. In both EBV negative cell lines expression of LMP1 is associated with the formation of multinuclear RS cells. Dominant negative inhibition of NF-kappa B mediated signaling at the step of I kappa B-alpha phosphorylation results in increased cell death with only a few typical RS cells resistant to overexpression of the dominant negative inhibitor I kappa B-alpha-N delta 54. However, dominant negative inhibition of NF-kappa B mediated signaling at the early step of TRAF2 interaction results in the formation of multinuclear cells in both cell lines and, in addition, in clusters of small mononuclear cells in the HD-MyZ cell line. In HD-MyZ cells overexpression of the powerful JBD-inhibitor of the JNK signal transduction pathway is restricted to small cells and never observed in RS cells. These small cells undergo apoptosis as shown by the TUNEL technique. Apoptosis of small cells is still observed after co-transfection of JBD and LMP1 but in addition a few apoptotic HD-MyZ cells with large fused nuclear masses are identified suggesting that specific inhibition of JNK leads also to apoptosis of LMP1 induced RS cells. Thus, activation of the JNK signaling pathway is also important in the formation of Reed-Sternberg cells. Our findings are consistent with a model where all three LMP1 associated functions, i.e. NF-kappa B mediated transcription, TRAF2 dependent signaling, and c-Jun activation act as a common pathogenetic denominator of both EBV negative and EBV positive HD.
Assuntos
Herpesvirus Humano 4/isolamento & purificação , Doença de Hodgkin/metabolismo , Células de Reed-Sternberg/metabolismo , Transdução de Sinais , Proteínas da Matriz Viral/metabolismo , Doença de Hodgkin/patologia , Doença de Hodgkin/virologia , Humanos , Receptores do Fator de Necrose Tumoral/metabolismoRESUMO
The latent membrane protein 1 (LMP1) oncogene is one of the major proteins synthesized by the Epstein-Barr virus (EBV) and is expressed in Reed-Sternberg (RS) cells of EBV-associated Hodgkin's disease (HD). We have studied the effect of this oncoprotein on the formation of RS cells in the EBV-negative HD cell lines L-428 and KM-H2 as well as on the formation of multinucleated cells in the mononuclear human embryonic kidney cell line 293. LMP1 prototype (B95-8) and its naturally occurring carboxy terminal 30 base pair deletion variant LMP1-del were transfected into the cell lines and cytocentrifuge preparations were analysed after 24, 48, 72, 144, 216, and 240 h. While no oncoprotein expression was seen in the KM-H2 cell lines, expression of LMP1 and LMP1-del was observed in the L-428 and 293 cell lines. In the HD cell line L-428 oncoprotein expression was infrequent but when observed was very strong and preferentially associated with multinucleated RS cell morphology (71% of LMP1 positive cells). This is in contrast with the untransfected or transfected but not expressing cells where intermediate mononuclear elements predominated over multinucleated RS cells (< 3%). Frequent oncoprotein expression was observed in the 293 cells and again was associated with multinuclearity. These LMP1 expressing 293 giant cells showed strong expression of ICAM-1(CD54), not detectable in the untransfected cells. In the LMP1-del transfectants giant cells with more than four nuclei were frequently observed. However, giant cells were much less frequent in 293 cells transfected with the amino terminal deletion variant of LMP1 or the lytic form of LMP1, known to induce low NF-kappa B activation compared to the LMP1 prototype. Therefore, LMP1 mediated NF-kappa B activation appears to be involved in polycaria formation. The strong association of LMP1 expression with multinuclearity in a genetically unstable condition -the L-428 and 293 cells show multiple chromosomal abnormalities-suggests that this oncoprotein including its naturally occurring carboxy terminal deletion variant promote the formation of multinuclear cells, in particular of RS cells in EBV-associated HD.
Assuntos
Herpesvirus Humano 4/genética , Doença de Hodgkin/genética , Células de Reed-Sternberg/metabolismo , Proteínas da Matriz Viral/biossíntese , Western Blotting , Carcinoma/genética , Carcinoma/metabolismo , Carcinoma/patologia , Núcleo Celular/genética , Núcleo Celular/patologia , Células Cultivadas , Regulação Neoplásica da Expressão Gênica , Doença de Hodgkin/patologia , Doença de Hodgkin/virologia , Humanos , Rim/citologia , Rim/embriologia , Mutação , NF-kappa B/genética , NF-kappa B/metabolismo , Neoplasias Nasofaríngeas/genética , Neoplasias Nasofaríngeas/metabolismo , Neoplasias Nasofaríngeas/patologia , Fenótipo , Células de Reed-Sternberg/virologia , Deleção de Sequência , Transcrição Gênica , Transfecção , Células Tumorais Cultivadas , Proteínas da Matriz Viral/genéticaRESUMO
The debate surrounding adult stem cell plasticity derives from a confusion regarding definitions of important terms and the identification of key questions. After defining plasticity, lineage, differentiation and transdifferentiation, the authors put forth a framework for future dialogue as well as their perspective on the stem cell plasticity debate.
Assuntos
Diferenciação Celular , Células-Tronco Hematopoéticas/citologia , Animais , Células da Medula Óssea , Linhagem da Célula , Camundongos , Neurônios/citologiaRESUMO
Long-term multilineage allochimerism can be obtained in H2-mismatched B6.SJL to BALB/c transplants with host irradiation of 100 cGy, donor spleen cell pre-exposure and costimulator blockade with anti-CD40 ligand (CD40L) antibody. We evaluated this allochimerism approach in murine marrow transplants with different degrees of major histocompatibility complexe (MHC) mismatching; these include: (1) H2-mismatched transplant H2Kk to H2Kb, (2) full haplo-identical transplant H2Kbd to H2Kbk, (3) a partial haplo-identical transplant H2Kd to H2Kbd and (4) an MHC class II mismatch. Levels of chimerism increased up to 12 weeks and then stayed relatively stable up to 1 year after transplant. At 18 weeks post-transplant, the H2-mismatched, haplo-identical, partial haplo-identical and class II-mismatch transplants evidenced 17.9+/-4.4, 40.7+/-0.9, 25.1+/-4.19 and 33.7+/-3.5% donor chimerism, respectively. Dropping the anti-CD40 antibody treatment and spleen cells or changing the schedule of antibody to one injection, in haplo-identical or full-mismatched transplants resulted in no donor-derived chimerism. On the other hand, these still resulted in minor chimerism in class II-mismatched transplants. Lineage analysis of peripheral blood at 6 and 12 months post-transplant demonstrated a significant shift toward increased chimeric lymphocytes and decreased chimeric granulocytes in the full H2 as compared with haplo-identical or class II transplants. Transplantation with anti-CD40L antibody eliminated both graft-versus-leukemia and graft-versus-host disease (GVHD) and delayed lymphocyte infusion did not rescue animals from fatal leukemia. In conclusion, under the conditions of our tolerization regimen, a haplo transplant gives higher engraftment levels than a full H2 mismatch, and despite lower engraftment levels, a class II-mismatched transplant can be successfully accomplished with only 100 cGy and no CD40L blockade.
Assuntos
Transplante de Medula Óssea , Ligante de CD40/imunologia , Efeito Enxerto vs Leucemia/imunologia , Antígenos H-2/imunologia , Tolerância ao Transplante , Animais , Anticorpos Monoclonais , Transplante de Células , Relação Dose-Resposta a Droga , Citometria de Fluxo , Variação Genética , Sobrevivência de Enxerto/efeitos dos fármacos , Sobrevivência de Enxerto/efeitos da radiação , Imunofenotipagem , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos CBA , Camundongos Endogâmicos DBA , Baço/citologia , Quimeras de Transplante/imunologia , Irradiação Corporal TotalRESUMO
Patients with advanced MDS and secondary AML respond poorly to chemotherapy. Granulocyte-macrophage colony-stimulating factor (GM-CSF) can stimulate proliferation of leukemic blasts and sensitize these cells to the cytotoxic effects of S-phase-specific drugs. This is the first report of safety and efficacy of GM-CSF prior to and during cytarabine in a low-dose, intermittent regimen for elderly patients with poor risk acute myelogenous leukemia or myelodysplastic syndrome. Twenty patients, age 68 to 86 years, each received 250 microg/m2 of GM-CSF (Sargramostatin; Immunex, Seattle, WA, USA) subcutaneously (s.c.) or intravenously (i.v.) for 3 days followed by GM-CSF at the same dose and cytarabine 100 mg/m2 i.v. for 3 days. GM-CSF and cytarabine were both administered for 3 days during weeks 2 and 3 followed by a 3-week rest period. Rates of CR and PR were 20% and 40%, respectively. These included clinically significant resolution of cytopenias and transfusion requirements. Many of the responding patients had been heavily pretreated prior to enrollment. One- and 2-year survival estimates are 44% and 19%, respectively. Myelosuppression was the most significant toxicity. Our findings suggest that this novel combination of GM-CSF with sequential and concomitant low-dose cytarabine can benefit patients with poor risk myeloid malignancies.
Assuntos
Antimetabólitos Antineoplásicos/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Citarabina/administração & dosagem , Fator Estimulador de Colônias de Granulócitos e Macrófagos/administração & dosagem , Leucemia Mieloide/tratamento farmacológico , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Leucemia Mieloide/mortalidade , Leucemia Mieloide/patologia , Masculino , Pessoa de Meia-Idade , Neutropenia/induzido quimicamente , Taxa de Sobrevida , Trombocitopenia/induzido quimicamente , Resultado do TratamentoRESUMO
In unperturbed mice, the marrow cell numbers correlate with the stem cell numbers. High levels of long-term marrow engraftment are obtained with infusion of high levels of marrow cells in untreated mice. To address the issue of stem cell competition vs 'opening space', knowledge of total murine marrow cellularity and distribution of stem and progenitor cells are necessary. We determined these parameters in different mouse strains. Total cellularity in BALB/c mice was 530+/-20 million cells; stable from 8 weeks to 1 year of age. C57BL/6J mice had 466+/-48 million marrow cells. Using these data, theoretical models of infused marrow (40 million cells) replacing or adding to host marrow give chimerism values of 7.5 and 7.0%, respectively; the observed 8-week engraftment of 40 million male BALB/c marrow cells into female hosts (72 mice) gave a value of 6.91+/-0.4%. This indicates that syngeneic engraftment is determined by stem cell competition. Our studies demonstrate that most marrow cells, progenitors and engraftable stem cells are in the spine. There was increased concentration of progenitors in the spine. Total marrow harvest for stem cell purification and other experimental purposes was both mouse and cost efficient with over a four-fold decrease in animal use and a financial saving.
Assuntos
Células da Medula Óssea/citologia , Células-Tronco Hematopoéticas/citologia , Animais , Contagem de Células Sanguíneas , Separação Celular/métodos , Feminino , Sobrevivência de Enxerto , Transplante de Células-Tronco Hematopoéticas/métodos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BLRESUMO
Traditional models of hematopoiesis have been hierarchical in nature. Over the past 10 years, we have developed data indicating that hematopoiesis is regulated in a continuum with deterministic and stochastic components. We have shown that the most primitive stem cells, as represented by lineage negative rhodamine(low) Hoechst(low) murine marrow cells are continuously or intermittently cycling as determined by in vivo BrdU labeling. When marrow stem cells are induced to transit cell cycle by in vitro exposure to cytokines, either IL-3, IL-6, IL-11, and steel factor or thrombopoietin, FLT3 ligand, and steel factor, they progress through cycle in a highly synchronized fashion. We have determined that when the stem cells progress through a cytokine stimulated cell cycle the homing, engraftment, adhesion protein, global gene expression, and hematopoietic differentiation phenotypes all change in a reversible fashion. This has led to the continuum model, in which, with cycle transit, chromatin is continually changing altering open transcription areas and providing a continually changing landscape of transcriptional opportunity. More recently, we have extended the changing differentiation profiles to differentiation into lung cells and found that non-hematopoietic differentiation also shows cycle related reversibly modulation. These observations all together support a continuum model of stem cell regulation in which the phenotype of the marrow stem cells is continually and reversibly changing over time.
Assuntos
Células da Medula Óssea/fisiologia , Células-Tronco/citologia , Células-Tronco/fisiologia , Animais , Ciclo Celular/fisiologia , Diferenciação Celular/fisiologia , Humanos , Fenótipo , Processos EstocásticosRESUMO
Utilizing both in vivo and in vitro techniques, a great deal of information has been obtained on the structure and regulation of the hematopoietic cell lineages. A number of hematopoietic stem cells and regulators have now been well characterized and their possible physiologic relevance at least in part established. More recently, new "alternative" or primitive stem cells have been described which may provide important insights into the nature of hematopoietic regeneration and regulation. These include late CFUs, high proliferative potential colony-forming cells, colony-forming unit diffusion chamber and both bipotent and blast colonies assayed in in vitro culture systems. Regulators active at these stem cell levels are also under study and in large part appear to be produced by monocytes or lymphocytes. Cyclical hematopoiesis can be viewed as a genetic abnormality at the multipotent stem cell level with defective cell production. At present however, details of the defect await further investigation possibly including an evaluation of the role of primitive stem cells and their regulators.
Assuntos
Medula Óssea/patologia , Febre Familiar do Mediterrâneo/sangue , Hematopoese , Células-Tronco Hematopoéticas/patologia , Animais , Comunicação Celular , Diferenciação Celular , Ensaio de Unidades Formadoras de Colônias , Fatores Estimuladores de Colônias/fisiologia , Cães , Eritrócitos/citologia , Eritropoetina/fisiologia , Febre Familiar do Mediterrâneo/patologia , Granulócitos/citologia , Humanos , Macrófagos/citologia , Megacariócitos/citologia , Camundongos , Camundongos Mutantes , Modelos BiológicosRESUMO
Two types of murine marrow adherent cells derived from Dexter cultures have been characterized. Exposure of C57B1/6J, ICR, or BDF1 mice to 1000 R x-ray 24 h prior to killing and establishment of liquid marrow cultures resulted in the growth of two types of adherent cells. A macrophage-like cell was phagocytic, nonspecific esterase, and acid phosphatase, positive and alkaline phosphatase, myeloperoxidase, and factor-VIII negative. The second cell was large and epithelioid in appearance, had a subpopulation of giant fat cells, was nonphagocytic, alkaline phosphatase positive, and negative for acid phosphatase, nonspecific esterase, myeloperoxidase, and factor VIII. At low inoculum levels these cells formed three types of colonies within 1-3 weeks--macrophage, epithelioid, and mixed--while at higher inoculum levels they formed confluent monolayers. These radioresistant cells supported myeloid pluripotent stem cells (CFU-S) and granulocyte-macrophage stem cells (GM-CFU-C) in liquid culture of long term nonadherent marrow cells and stimulated GM-CFU-C in agar over-lays. Refeeding liquid cultures with nonadherent cells from long-term Dexter cultures revealed that myeloperoxidase-positive cells adhered predominantly to the colonies containing epithelioid cells.