Rapidness of leukocyte engraftment in patients receiving peripheral blood stem cell transplantation is clinically important because the risk of fatal opportunistic infections increases with time to engraftment. Adhesion receptor molecules on hematopoietic stem cells (HSCs) have been shown to modulate homing and engraftment of HSCs. Therefore, we correlated expression levels of ␣4 (CD49d) and ␣6 (CD49f) integrins in the CD34 ؉ HSC compartment with time to engraftment. Leukapheresis products from 103 patients were retrospectively analyzed for CD34, CD38, CD3, CD49f, and CD49d surface molecules by multiparameter flow cytometry. High expression levels of ␣4 integrin, but not ␣6 integrin on CD34 ؉ cells, were associated with regular engraftment of leukocytes (days 8-19), whereas low surface expression correlated with delayed recovery (> 19 days; P < .0005). We show that ␣4 integrin expression levels on HSCs in leukapheresis products predict the engraftment capacity of mobilized peripheral blood stem cells in peripheral blood stem cell transplantation patients. (Blood. 2011;118(8): 2362-2365)
IntroductionThe very late antigen (VLA) molecules, first described in 1987 by Takada et al, 1 are heterodimeric molecules that are involved in embryogenesis, leukocyte adhesion, cell migration, inflammation, and extracellular matrix interaction. ␣41/VLA4 (CD49d/CD29), counter-receptor for VCAM-1 and fibronectin, as well as ␣61/ VLA6/laminin receptor (CD49f/CD29) are ubiquitously expressed in human and mouse hematopoietic stem and progenitor cells, and both play a role in homing and engraftment of hematopoietic stem cells (HSCs). [2][3][4][5][6] Recent evidence from murine transplantation models suggests that ␣4-chain deletion 5 or treatment with functionblocking antibodies to ␣4 or ␣6 integrin 4 may impair hematopoietic engraftment. In contrast, it is reported that blockage with ␣6 integrin antibodies improves engraftment efficiency in human HSCs. 2 These data suggest that surface levels and function of VLA4 and VLA6 on stem cells may modulate stem cell engraftment.However, all these experiments refer to stem cell engraftment in isogenic or immunodeficient (HSC) mouse transplantation models. Until now, there is lack of evidence about the role of HSC ␣4 and ␣6 integrin expression levels for human peripheral blood stem cell transplantations (PBSCTs) so far.Here we demonstrate that low levels of ␣4 integrin expression on HSCs are associated with a longer engraftment period in patients receiving autologous PBSCT. We found no correlation of ␣6 integrin expression on HSC engraftment velocity in this patient collective.
Methods
Patients and sample preparationAll patients were treated with autologous PBSCT at the Department of Hematology, Oncology, and Immunology of the University Hospital Marburg, Marburg, Germany. Patients had given written informed consent to donate aliquots of the leukapheresis product according to the guidelines of the local Ethics Committee and in compliance with the Declaration of Helsinki. Frozen leukapheresis ...