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Peripheral blood harvest of unaffected CD34+ CD38- hematopoietic precursors
in paroxysmal nocturnal hemoglobinuria
GM Prince, M Nguyen, HM Lazarus, RA Brodsky, LW Terstappen and ME Medof
Institute of Pathology, Case Western Reserve University, Cleveland, OH
44106, USA.
Paroxysmal nocturnal hemoglobinuria (PNH) arises from somatic mutation of a
bone marrow progenitor that disrupts glycosylinositol phospholipid (GPI)
anchoring of cell surface proteins. We recently characterized the
expression of GPI-anchored decay acclerating factor (DAF) and CD59 during
hematopoietic development in PNH marrow. We found that, although a subset
of early hematopoietic precursors identified by the CD34+CD38- phenotype
exhibits normal DAF and CD59 expression, DAF and CD59 are absent on the
majority of CD34+CD38- cells. Pluripotent CD34+CD38- hematopoietic stem
cells normally circulate in the peripheral blood and can be collected by
apheresis, cryopreserved, and later used for reconstitution of
hematopoiesis. In this study, we examined the phenotypes of CD34+ cells
that are released into the blood of PNH patients. Analyses of apheresis
samples from three affected individuals showed discrete populations of
circulating DAF+CD59+CD34+ and DAF-CD59- CD34+ cells. Variable proportions
of CD34+CD38- cells were present within the peripheral blood CD34+ cells of
each patient, but in all three cases the DAF+CD59+CD34+CD38- cell subset
subset. Because CD34+ cells lacking CD38 antigen are highly enriched for
self-renewing hematopoietic stem cells, these findings indicate that
apheresis samples can serve as a source of unaffected stem cells for
autologous marrow transplantation of PNH patients.
Volume 86,
Issue 9,
pp. 3381-3386,
11/01/1995
Copyright © 1995 by The American Society of Hematology
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