Ex Vivo Expansion of Cd34-Positive Peripheral Blood Progenitor Cells from Patients with Non-Hodgkin's Lymphoma: No Evidence of Concomitant Expansion of Contaminating Bcl2/Jh-Positive Lymphoma Cells

The aim of the present study was to evaluate the capacity to expand of hematopoietic stem cell (HSC) samples from eight patients with NHL,, and to follow in parallel the fate of tumor cells in four of eight samples still containing bcl2/ JH tumor cells after CD34(+) or CD19(-/)20(-)/34(+) cell selection. The presence of bcl2/JH(+) cells was also investigated after expansion in four of eight samples, two of which were bcl2/JH at harvesting and two which were initially bcl2/JH(+) but became bcl2/JH(-) ( below the level of PCR detection) after cell selection, to assess a possible reappearance of occult tumor cells after expansion culture. We used culture conditions that we previously had established to allow high level expansion of normal precursors, progenitors and LTC-ICs, In this study, particular attention was given to the role of Flt3-ligand, known to favor the growth of B cells. The expansion conditions were: 1.5 x 10(3) cells/ml in serum-free medium containing stem cell factor (SCF), interleukin-3 (1L-3), IL- 6, granulocyte-stimulating factor (G-CSF), erythropoietin ( Epo) +/- Flt3-ligand (Flt3-L) for 10 days, After culture, total cells, CFU-GMs, BFU-Es and LTC-ICs were expanded to a mean of 833-, 6.6-, 4.6-, and 1.8-fold, respectively with the cocktail of cytokines not including Flt3-L. When Flt3-L was added, the mean expansion values were 1095-, 31-, 15- and three-fold, respectively. Residual bcl2/JH(+) cells present in four of eight samples before expansion were not detected after expansion. Similarly, no tumor cells reappeared after expansion of the two samples which had become negative after selection, as well as in the two samples which were bcl2/JH at harvesting, These results suggest first that ex vivo expansion of hematopoietic stem cells in patients with non- Hodgkin's lymphoma is feasible without incurring the parallel risk of amplifying tumor cells; second, that Flt3-L did not stimulate the growth of tumor cells while it clearly favored the growth of normal progenitors