Impact of CD133 positive stem cell proportion on survival in patients with glioblastoma multiforme

Abstract

BackgroundThe aim of the study was to assess the impact of CD133-positive (CD133+) cancer stem cell proportions on treatment results of glioblastoma multiforme (GBM) patients.Patients and methodsPatients with GBM (n = 42) received postoperative radiotherapy (± chemotherapy). Surgically excised GBM tissue sections were immunohistochemically examined for CD133 expression. The proportions of CD133+ GBM cells were determined (%). The proportion of CD133+ GBM stem cells was established by 2 independent researchers whose results were in good accordance (R = 0.8, p < 0.01). Additionally, CD133 expression levels were correlated with patients overall survival.ResultsThe proportion of CD133+ cells varied between patients, being from 0.5% to 82%. Mean and median proportions of CD133+ cells of the entire study group were 33% ± 24% (mean ± SD) and 28%, respectively. Clinical data do not support the association between higher proportion of stem cells and the aggressiveness of GBM. Median survival time of the study group was 10.0 months (95% CI 9.0–11.0). The survival time clearly depended on the proportion of CD133+ cells (log rank test, p = 0.02). Median survival times for patients with low (< median) and high (≥ median) proportion of CD133+ cells were 9.0 months (95% CI 7.6–10.5) and 12.0 months (95% CI 9.3–14.7), respectively. In multivariate analysis, the proportion of CD133+ cells emerged as a significant independent predictor for longer overall survival (HR 2.0, 95% CI 1.0–3.8, p = 0.04).ConclusionsIn patients with higher stem cell proportion, significantly longer survival times after postoperative radiotherapy were achieved. Underlying reasons and possible higher sensitivity of GBM stem cells to fractionated radio-therapy should be clarified in further studies.

High CD133 Expression Is Associated with Worse Prognosis in Patients with Glioblastoma

“…After reviewing the abstracts, only 25 studies were preliminarily included and were further assessed by reading full text [14][15][16][17][18][19][20][21][22][23][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]. Fifteen studies were then excluded for other types of gliomas or the lack of usable data [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42], and ten studies were finally included into the meta-analysis [14][15][16][17][18][19][20][21][22][23]. Those t...…”

Self-Renewal and CSCs In Vitro Enrichment: Growth as Floating Spheres

“…This resistance to treatment is attributed to characteristics such as overexpression of ABC transporters, enhanced aldehyde dehydrogenase activity, specific signaling pathways, response to DNA damage, epithelial to mesen-chymal transition, and dormancy [6, 7]. They can make up small fractions of the bulk tumor, as little as 0.1% [8]. CSC populations thus provide the tumor with a source of not only constant bulk renewal but continued survival for a small subpopulation despite drug treatment.…”

Multiple Subsets of Brain Tumor Initiating Cells Coexist in Glioblastoma

“…On a protein level, however, PROM1 failed as a consistent surface marker of this subpopulation (Fig. A), which may explain the unclear clinical implications of PROM1 expression in GBM . Our single‐cell transcriptional profiling technique nonetheless revealed other potential surface markers for prospective enrichment of each BTIC subpopulation.…”