Published online Oct 26, 2013. doi: 10.4252/wjsc.v5.i4.196
Revised: June 23, 2013
Accepted: July 30, 2013
Published online: October 26, 2013
Processing time: 199 Days and 18 Hours
AIM: To evaluate quantitatively and qualitatively the different CD34+ cell subsets after priming by chemotherapy granulocyte colony-stimulating factor (± G-CSF) in patients with acute myeloid leukemia.
METHODS: Peripheral blood and bone marrow samples were harvested in 8 acute myeloid leukemia patients during and after induction chemotherapy. The CD34/CD38 cell profile was analyzed by multi-parameter flow cytometry. Adhesion profile was made using CXC chemokine receptor 4 (CXCR4) (CD184), VLA-4 (CD49d/CD29) and CD47.
RESULTS: Chemotherapy ± G-CSF mobilized immature cells (CD34+CD38− population), while the more mature cells (CD34+CD38low and CD34+CD38+ populations) decreased progressively after treatment. Circulating CD34+ cells tended to be more sensitive to chemotherapy after priming with G-CSF. CD34+ cell mobilization was correlated with a gradual increase in CXCR4 and CD47 expression, suggesting a role in cell protection and the capacity of homing back to the marrow.
CONCLUSION: Chemotherapy ± G-CSF mobilizes into the circulation CD34+ bone marrow cells, of which, the immature CD34+CD38– cell population. Further manipulations of these interactions may be a means with which to control the trafficking of leukemia stem cells to improve patients’ outcomes.
Core tip: Timed sequential chemotherapy and priming with hematopoietic growth factors have been recently used in the treatment of acute myeloid leukemia in order to mobilize more leukemic cells in the cell cycle and therefore improve the cytotoxic effect of chemotherapy. In this paper, we looked the impact of this type of treatment in a small series of patients on the mobilization of different subsets of CD34+ cells involving “bulk” leukemic cells and more ‘‘immature’’ leukemic cells.