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Polyclonal primitive hematopoietic progenitors can be detected in mobilized
peripheral blood from patients with high-risk myelodysplastic syndromes
M Delforge, H Demuynck, P Vandenberghe, G Verhoef, P Zachee, V van Duppen, P Marijnen, H Van den Berghe and MA Boogaerts
Department of Hematology, University Hospital Gasthuisberg, Leuven,
Belgium.
Myelodysplastic syndromes (MDS) form a heterogeneous group of clonal
hematopoietic disorders with unfavourable prognosis. Allogeneic bone marrow
transplantation is the only potentially curative treatment, but remains
limited to a small subgroup of younger patients with HLA- compatible
donors. As autologous stem cell transplantation is currently being explored
as an alternative treatment strategy for MDS, more information needs to be
acquired regarding the clonal nature of the progenitor cells in these
autografts. Therefore, we have analyzed the clonal patterns of highly
purified hematopoietic progenitors and their mature daughter cells in
mobilized peripheral blood collections produced from five female patients
with high-risk MDS in complete hematologic remission. X-chromosome
activation patterns of flow-sorted immature (CD34 + 38low, CD34 + 33low)
and committed (CD34 + 38high, CD34 + 33high) progenitors were studied with
the polymerase chain reaction-based HUMARA assay. In four patients, a
polyclonal remission was shown in all stem cell subpopulations and their
mature daughter cells whereas one patient was found to remain skewed in all
fractions, except T lymphocytes. This study provides strong evidence that
polyclonal immature hematopoietic progenitors can be mobilized and
harvested in patients high-risk MDS after treatment with high-dose
chemotherapy.
Volume 86,
Issue 10,
pp. 3660-3667,
11/15/1995
Copyright © 1995 by The American Society of Hematology
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