Contamination of peripheral blood stem cell harvests by circulating neuroblastoma cells

Abstract

Peripheral blood stem cells (PBSC) are being used as one alternative to autologous marrow rescue for patients with neuroblastoma and other solid malignancies. Some physicians prefer use of PBSC because less risk of tumor contamination is believed to exist. This hypothesis was evaluated by immunocytologic analysis of blood samples and concurrently drawn bone marrow (BM) samples and of PBSC harvests obtained from 31 patients with disseminated neuroblastoma. We found circulating neoplastic cells in 75% of specimens analyzed at diagnosis, in 36% during therapy, and in 14% of PBSC harvests. Tumor cells in blood obtained during therapy did not appear until 3 months after the time of diagnosis. Clearance of circulating neuroblastoma cells was documented after two courses of induction chemotherapy. Six of 13 patients with minimal or no BM disease had positive blood specimens. We conclude that substantial risk of tumor contamination of PB harvests exists and recommend that induction chemotherapy be administered before hematopoietic progenitor cells are collected from blood.

Detection of tumour cells in peripheral blood and bone marrow from ewing tumour patients by rt‐pcr

“…Diagnosis of tumour cell dissemination is limited by the sensitivity of light microscopic screening methods unless tumour-specific markers are available which allow the use of either immunohistochemical or molecular biological techniques. The presence of circulating tumour cells has been demonstrated in patients with breast and lung cancer and with neuroblastoma (Moss et al, 1990(Moss et al, , 1991Brugger et al, 1994). Although a considerable amount of data is available on the clinical impact of minimal residual disease in leukemia, little information is available on "minimal metastatic" disease in patients with solid tumours.…”

“…Thus efficient monitoring of bone marrow and peripheral blood for the presence of micrometastases or circulating tumour cells at diagnosis could help to identify patients with disseminated disease. Studies in patients with neuroblastoma have demonstrated that the immunocytochemical detection of neuroblastoma bone marrow metastases allows prediction of the clinical outcome at diagnosis (Moss et al, 1991) and that the presence of circulating neuroblastoma cells in blood during treatment correlates with a high probability of relapse (Moss et al, 1990). Subsequent studies showed that the use of RT-PCR greatly increases the sensitivity of tumour cell detection.…”

Leukapheresis after high‐dose chemotherapy and autologous peripheral blood progenitor cell transplantation: a novel approach to harvest a second autograft

“…13 In vivo purging would be of special interest for patients undergoing autologous transplantation because it is well known that leukapheresis components collected after mobilization by CDCT plus growth factors can be contaminated with tumor cells. [21][22][23] To our knowledge, the present study is the first report on a series with 30 patients dealing with collection of circulating CD34+ cells during the phase of hematopoietic recovery after autologous PBPC transplantation. Patients were treated by HDCT plus autografting, 24 of whom (80%) underwent post-transplantation leukapheresis for the harvest of a further hematopoietic autograft.…”

“Less is More”: The Role of Purging in Hematopoietic Stem Cell Transplantation

“…Tumor cells and progenitor cells both are mobilized after chemotherapy and administration of hematopoietic growth factors (granulocyte colonystimulating factor) [8]. Several investigations have demonstrated tumor cell contamination of 10% to 30% of leukapheresis products used for transplants [7], and, in patients with neuroblastoma, stem cell harvests have been shown to contain contaminating tumor cells irrespective of marrow involvement [9]. In other studies in patients with breast cancer or lymphoma, tumor-contaminated peripheral blood stem cell collections resulted in a poor clinical outcome [10,11].…”