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Detection and viability of tumor cells in peripheral blood stem cell
collections from breast cancer patients using immunocytochemical and
clonogenic assay techniques [see comments]
AA Ross, BW Cooper, HM Lazarus, W Mackay, TJ Moss, N Ciobanu, MS Tallman, MJ Kennedy, NE Davidson and D Sweet
BIS Laboratories, Reseda, CA 91335.
Although peripheral blood stem cell collections (PBSC) are thought to have
less tumor involvement than bone marrow (BM), the incidence of circulating
tumor cells in patients with breast cancer has not been widely
investigated. We prospectively investigated the incidence and viability of
tumor cell involvement in PBSC and BM collections from breast cancer
patients undergoing high-dose chemotherapy/hematopoietic stem cell
transplantation. Paired samples of PBSC and BM from 48 patients were
analyzed using an immunocytochemical technique that detects one
epithelial-derived tumor cell per 5 x 10(5) mononuclear cells.
Immunostained tumor cells were detected in 9.8% (13/133) PBSC specimens
from 9/48 (18.7%) patients and in 62.3% (38/61) BM specimens from 32/48
(66.7%) patients, a significantly higher rate than in PBSC (P < .005).
The geometric mean concentration of tumor cells in contaminated PBSC
specimens was 0.8/10(5) mononuclear cells (range 0.33 to 2.0/10(5))
compared with 22.9/10(5) mononuclear cells in BM (range 1 to 3,000/10(5), P
< .0001). In culture experiments, clonogenic tumor colonies grew in
21/26 immunocytochemically positive specimens. No tumor colony growth was
detected in 30/32 immunocytochemically negative specimens.
Immunocytochemical detection of tumor involvement in BM and PBSC correlated
significantly with in vitro clonogenic growth (P < .0001). We conclude
that PBSC contain fewer tumor cells than paired BM specimens from patients
with advanced breast cancer and that these tumor cells appear to be capable
of clonogenic growth in vitro.
Volume 82,
Issue 9,
pp. 2605-2610,
11/01/1993
Copyright © 1993 by The American Society of Hematology
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