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Prevalence and growth characteristics of malignant stem cells in B- lineage acute lymphoblastic leukemia

H Nishigaki, C Ito, A Manabe, M Kumagai, E Coustan-Smith, Y Yanishevski, FG Behm, SC Raimondi, CH Pui and D Campana

Department of Hematology-Oncology, St Jude Children's Research Hospital, University of Tennessee College of Medicine, Memphis 38105, USA.

We used a stroma-supported culture method to study the prevalence and growth characteristics of malignant stem cells in acute lymphoblastic leukemia (ALL). In 51 of 108 B-lineage ALL samples, bone marrow-derived stroma not only inhibited apoptosis of ALL cells but also supported their proliferation in serum-free medium. When single leukemic cells were placed in the stroma-coated wells of microtiter plates, the percentage of wells with leukemic cell growth after 2 to 5 months of culture ranged from 6% to 20% (median, 15%; 5 experiments). The immunophenotypes and genetic features of cells recovered from these cultures were identical to those noted before culture. All cells maintained their stroma dependency and self-renewal capacity. Leukemic clones derived from single cells contained approximately 10(3) to 10(6) cells after 1 month of culture; other clones became detectable only after prolonged culture. Cell growth in stroma-coated wells correlated with the number of initially seeded cells (1 or 10; r = .87). However, the observed percentages of positive wells seeded with 10 cells always exceeded values predicted from results with single-cell-initiated cultures (P < .003 by paired t-test), suggesting stimulation of leukemic cell growth by paracrine factors. In conclusion, the proportion of ALL cells with clonogenic potential may be considerably higher than previously thought.

Volume 89, Issue 10, pp. 3735-3744, 05/15/1997
Copyright © 1997 by The American Society of Hematology


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