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Blood, 1 April 2008, Vol. 111, No. 7, pp. 3893-3895.
Prepublished online as a Blood First Edition Paper on January 30, 2008; DOI 10.1182/blood-2007-10-120329.
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TRANSPLANTATION
Brief Report
The monoclonal anti–VLA-4 antibody natalizumab mobilizes CD34+ hematopoietic progenitor cells in humans
Fabian Zohren1,
Diamandis Toutzaris2,
Viola Klärner1,
Hans-Peter Hartung2,
Bernd Kieseier2, and
Rainer Haas1
Departments of1 Haematology, Oncology and Clinical Immunology; and
2 Neurology, Heinrich Heine-University, Düsseldorf, Germany
We investigated the role of adhesion molecule VLA-4 in CD34+ blood stem-cell mobilization. Therefore, we examined 20 patients with multiple sclerosis (MS) who were treated with the anti–VLA-4 antibody natalizumab. Treated patients had received a median number of 4 natalizumab infusions (range: 2-9 infusions). Blood samples were taken 4 weeks following the last infusion. With a median proportion of 7.6 CD34+ cells/µL (range: 2.2-30.4 cells/µL), these patients had a significantly higher (P = .003) amount of circulating CD34+ cells compared with 5 healthy volunteers (median: 1.4/µL; range: 0.6-2.4/µL) and 5 untreated MS patients (median: 1.0/µL; range: 0.5-1.7/µL) (P = .001). Serial measurements in 4 patients receiving their first natalizumab infusion showed a maximal significant increase in circulating CD34+ cells from 3.3/µL (range: 1.6-4.8/µL) to 10.4/µL (range: 7.5-12.04/µL) 72 hours following natalizumab infusion (P = .001), including pluripotent cells in colony-forming assays. This mobilizing ability of natalizumab might be useful for patients with poor response to granulocyte colony-stimulating factor (G-CSF)–based protocols.

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