IntroductionEarly stages of human B-cell development can be identified by the expression of cytoplasmic and cell-surface markers and the ordered rearrangements of the V, D, and J gene segments that encode the variable domain of the immunoglobulin heavy-chain (IgH) locus. 1 Thus, D3J H rearrangements in pro-B cells precede the V3DJ H rearrangement in pre-B cells. The earliest B-cell precursors that carry a complete VDJ H rearrangement have been identified by their intracellular expression of a chain without light (L) chain. These pre-B cells express the CD10 and CD19 antigens and the chain associated with a surrogate light chain coded by the 5/14.1 and VpreB genes. 2 More primitive pro-B cells recognized by their expression of CD34, CD19, and CD10 antigens carry a DJ H rearrangement, which can be transcribed. More recently, CD19 Ϫ cells have been isolated from fresh bone marrow, which expresses the B-cell receptor (BCR)-associated molecule CD79a or Vpre-B proteins and a DJ H rearrangement. [3][4][5][6] This suggests that the B-cell program can be activated prior to the expression of the CD19 antigen and VDJ H rearrangement. How multipotent stem cells progressively restrict their potential to a B-cell fate has been best studied in mice deleted of key control genes, such as E2A, EBF, Absence of the first 2 arrest B-cell differentiation prior to the DJ H rearrangement, whereas typical B220 ϩ c-Kit ϩ pro-B cells, which have initiated DJ H rearrangement and express Rag-1, Rag-2, TdT, 5, VpreB, E2A, and EBF, can be isolated from the bone marrow of Pax-5 Ϫ/Ϫ mice. Despite their pro-B phenotype, these cells can differentiate into macrophages, osteoclasts, dendritic cells, natural killer (NK) cells, T cells, granulocytic cells and erythroid cells in vitro and in vivo, when exposed to the appropriate conditions. 10,11 On the basis of these observations, it has been proposed that the B-cell program is first activated in a "multipotent" cell and that the function of Pax-5 is to repress the myeloid and T-cell genes and restrict cells to a B-cell fate. 12,13 Even though this 2-step pattern has not been demonstrated using primary cells or wild-type mice, a close proximity exists between B-lymphoid, macrophages, and osteoclast lineages in healthy mice, [14][15][16] perhaps controlled by the relative levels of Pu.1 and Pax-5. 17,18 Investigating human B-cell differentiation is hampered both by the low proliferation rate of human pro-B cells 8,19 and the small number of markers recognizing early-B cells, as opposed to those available in mice (B220, CD43, CD24, c-Kit, AA4.1). [20][21][22] Furthermore, reproducible conditions to grow human B-cell progenitors in vitro have been described only recently. High numbers of CD34 Ϫ CD19 ϩ CD10 ϩ sIgM Ϫ pre-B cells that express Pax-5, -like, and transcripts are obtained 23 in cocultures of cord bloodderived CD34 ϩ cells on murine feeders. [23][24][25][26][27][28] Human B-cell differentiation can also be obtained in vivo in NOD-SCID (nonobese diabetic severe combined immunodeficient) mice inj...