The long-term survival of patients with acute myeloid leukemia (AML) is dismally poor. A permanent cure of AML requires elimination of leukemic stem cells (LSCs), the only cell type capable of initiating and maintaining the leukemic clonal hierarchy. We report a therapeutic approach using an activating monoclonal antibody directed to the adhesion molecule CD44. In vivo administration of this antibody to nonobese diabetic-severe combined immune-deficient mice transplanted with human AML markedly reduced leukemic repopulation. Absence of leukemia in serially transplanted mice demonstrated that AML LSCs are directly targeted. Mechanisms underlying this eradication included interference with transport to stem cell-supportive microenvironmental niches and alteration of AML-LSC fate, identifying CD44 as a key regulator of AML LSCs. The finding that AML LSCs require interaction with a niche to maintain their stem cell properties provides a therapeutic strategy to eliminate quiescent AML LSCs and may be applicable to other types of cancer stem cells.

Angiogenesis is essential for tumor growth and metastasis. In the process of angiogenesis, the interaction between adhesive proteins of endothelial cells and extracellular matrix components plays an important role by mediating cell attachment, which is indispensable for their motility, and by transmitting the regulatory signals for cell locomotion and proliferation. In this study, we examined the hypothesis that CD44 expressed on the endothelial cell surface is involved in the angiogenesis process. The experiments using calf pulmonary artery endothelial cells (CPAE) and a human microvascular endothelial cell line (HMEC-I) show that a monoclonal antibody against CD44 (clone J 173) inhibits endothelial cell proliferation by about 30% and migration by 25-50%, and abolishes the stimulating effect of hyaluronan polysaccharides on endothelial cell migration and proliferation. This antibody also suppresses the capillary formation of CPAE in an in vitro model of angiogenesis using fibrin matrix. These results provide evidence of the involvement of endothelial-cell-associated CD44 in angiogenesis.o 1996 Wiley-Liss, Inc.Angiogenesis plays a fundamental role in many physiological and pathological processes including wound healing, tissue repair and tumor growth (Folkman, 1995). For the formation of a new vessel, migration of stimulated endothelial cells and subsequent tube formation virtually depend on the occurrence of timely and locally coordinated extracellular proteolysis, cell adhesion and activation during the cell migration. Therefore, the interaction of adhesive proteins expressed on the endothelial cell surface with the components of extracellular matrix is one of the factors determining the occurrence of angiogenesis. Perturbation of these interactions may abolish an ongoing angiogenesis process. For example, blocking the binding of the integrin molecule to matrix-associated vitronectin led to endothelial cell apoptosis and abolished tumor-induced angiogenesis in vivo (Brooks et al., 1994). Furthermore, the interaction of adhesive proteins with their endothelial cell-surface receptors may also activate the process of angiogenesis. For instance, endothelial cells could be stimulated by the surrounding fibrin I1 matrix to form capillary tubes in vitro (Chalupowicz et al., 1995). However, due to the complexity of the mechanisms involved in cell adhesion, the functions of many adhesive molecules on the endothelial cell surface still remain to be determined.One of the examples is CD44, discovered through its role in mediating leukocyte adhesion and lymphocyte homing (Haynes et al., 1989). Although several studies reported the presence of CD44 on endothelial cells such as human microvascular endothelial cells (HMEC-1) (Xu et al., 1994), bovine microvascular endothelial cells (BME) (Bourguignon et al., 1992) and human umbilical endothelial cells (HUVEC) (Liesveld et al., 1994), the role of CD44 expressed on the endothelial cell surface still remains to be clarified. CD44 is a transmembrane molecule with multiple isofo...

Blockage in myeloid differentiation characterizes acute myeloid leukemia (AML); the stage of the blockage defines distinct AML subtypes (AML1/2 to AML5). Differentiation therapy in AML has recently raised interest because the survival of AML3 patients has been greatly improved using the differentiating agent retinoic acid. However, this molecule is ineffective in other AML subtypes. The CD44 surface antigen, on leukemic blasts from most AML patients, is involved in myeloid differentiation. Here, we report that ligation of CD44 with specific anti-CD44 monoclonal antibodies or with hyaluronan, its natural ligand, can reverse myeloid differentiation blockage in AML1/2 to AML5 subtypes. The differentiation of AML blasts was evidenced by the ability to produce oxidative bursts, the expression of lineage antigens and cytological modifications, all specific to normal differentiated myeloid cells. These results indicate new possibilities for the development of CD44-targeted differentiation therapy in the AML1/2 to AML5 subtypes.