Characterization and quantitation of primitive hematopoietic progenitor cells present in peripheral blood autografts

In this report, we assess the content of primitive hematopoietic progenitor cells (HPC) that circulate transiently in the peripheral blood (PB) of cancer patients (group A) who received a PB stem-cell-mobilizing regimen that included high-dose chemotherapy (HD-CTX) of 7 g/m² cyclophosphamide followed by a combination of recombinant hematopoietic growth factors (C-HGF), including either interleukin-3 (IL-3) plus granulocyte-colony stimulating factor (G-CSF), IL-3 plus granulocyte-macrophage colony-stimulating factor (GM-CSF), or a recombinant GM-CSF/IL-3 fusion protein (PIXY-321). These data were compared to the HPC content of PB obtained from a similar group of cancer patients that had not received such a mobilization regimen (group B). Monoclonal antibody staining and fluorescence-activated cell sorting (FACS) were used to identify and isolate cell populations enriched for more differentiated HPC (CD34⁺HLA-DR⁺) and more primitive HPC (CD34⁺HLA-DR^-). The content of CD34⁺HLA-DR⁺ and CD34⁺HLA-DR^- cells in the PB of group A patients was significantly greater than that observed in the PB of group B patients. In addition, HD-CTX plus C-HGF mobilization resulted in the appearance of greater numbers of PB colony-forming units - granulocyte/macrophage, -granulocyte/erythroid/macrophage/megakaryocyte, and -megakaryocyte (CFU-GM, CFU-GEMM, and CFU-Mk), and burst-forming units-erythroid and megakaryocyte (BFU-E and BFU-Mk) than those observed in the PB of group B patients (p < 0.01). CD34⁺HLA-DR^- cells isolated from the PB of group A patients were capable of initiating long-term hematopoiesis in vitro, which persisted for 10 weeks, while CD34⁺HLA-DR^- cells obtained from the PB of group B patients were capable of sustaining long-term hematopoiesis in vitro for only 4 weeks. As determined by a limiting dilution analysis of group A PB CD34⁺HLA-DR^- cells, the frequency of cells capable of giving rise to hematopoietic progenitor cells (pre-CFC) after 2 weeks in liquid culture was 4.3% (range 1.0-8.3%). Pre-CFC constituted 0.01% (range 0.001-0.02%) of group A PB mononuclear cells, and 151 pre-CFC were calculated to be present in 1 mL mobilized PB (range 20-310/mL). These results suggest that peripheral blood mononuclear cells (PBMC) collected by leukapheresis following HD-CTX plus C-HGF mobilization contain not only differentiated HPC but also more primitive HPC.