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Blood, Vol. 95 No. 10 (May 15), 2000:
pp. 3078-3084
Limiting numbers of G156A
O6-methylguanine-DNA methyltransferase-transduced marrow
progenitors repopulate nonmyeloablated mice after drug selection
Brian M. Davis,
Omer N. Koç, and
Stanton L. Gerson
From the Division of Hematology/Oncology, Case Western Reserve
University, the Molecular Virology Training Program, and the Ireland
Cancer Center, University Hospitals of Cleveland, Cleveland, OH.
The limited efficacy of hematopoietic gene therapy can be improved
by in vivo selection for transduced long-term repopulating cells
(LTRC). We selected for G156A MGMT ( MGMT) transduced LTRC present in
5 × 104 to 100 × 104 marrow cells
infused into nonmyeloablated mice by the administration of
O6-benzylguanine (BG) and BCNU every 3 to 4 weeks. To
facilitate engraftment, mice were given a nonablative dose of BG and
BCNU before infusion. Without selection, MGMT was not detected in any hematopoietic colony-forming units (CFU) 24 to 30 weeks after infusion. After BG and BCNU, MGMT+ CFU were frequently
detected, and their proportions increased with each treatment cycle.
After 2 to 3 cycles of BG and BCNU, many mice were stably reconstituted
with 75% to 100% MGMT+ CFU for at least 6 months,
representing up to 940-fold enrichment. Thus, BG and BCNU stem cell
toxicity allows MGMT-transduced LTRC to repopulate the bone marrow.
This degree of selection pressure in nonmyeloablated mice is far
greater than that observed in previous drug-resistance gene transfer
studies. These data support our approved clinical trial to select for
drug-resistant, transduced hematopoietic cells, potentially decreasing
cumulative drug-induced myelosuppression in patients with cancer. These
data also suggest that MGMT may be a potent, dominant, selectable
marker for use in dual gene therapy.

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