Summary:The marrow hematopoietic stem cell is currently being redefined as to all aspects of its phenotype and its total differentiation capacity. This redefinition now includes its plasticity as to production of nonhematopoietic and hematopoietic cell types, the determinants of its in vivo engraftment potential and its expression of stem cell functional characteristics. Bone Marrow Transplantation (2003) 32, S19-S22. doi:10.1038/sj.bmt.1703938 Keywords: stem cell; progenition cell cycle
Engraftment phenotypeThe marrow pluripotent stem cell has been defined by its ability to engraft and restore in vivo hematopoiesis in lethally irradiated mice. Dogma has held that space must be cleared for engraftment to occur. This view has strongly influenced many investigators' approaches to the study of stem cell biology. This view is, however, simply wrong. In a series of definitive manuscripts, we have shown that essentially all stem cells engraft in a nontreated host mouse model and that the final donor host chimerism is simply determined by the ratio of donor-to-host stem cells. 1,2 If host stem cell are reduced by cytotoxic therapy, then there will be a higher percentage of donor stem cells and their progeny. 3 We were not the first to report engraftment in nonmyeloablated mice. Although interpretations of results may have differed, Micklem et al 4 reported similar data in the 1960s and Brecher et al, 5 subsequently, using higher cell levels, showed that significant engraftment could be obtained. We modeled our studies on those of Brecher et al. 5 We subsequently showed that therapy that would selectively reduce host stem cells without impacting significantly on marrow cellularity would markedly increase donor chimerism and allow for a reduction in the number of donor marrow cells necessary for engraftment. Exposure of mice to 100 cGy proved to be an ideal nonmyeloablative/stem cell ablative regimen. 3 Thus, high levels of chimerism could be obtained without toxicity in a syngeneic setting. This approach could be extended to allogeneic transplantation with the addition of a tolerizing treatment, initially the use of antigen pre-exposure and administration of anti-CD40 ligand antibody in the peritransplant period. 6 More recent studies have allowed for the omission of irradiation and the reduction of CD40 ligand antibody in an H2-mismatched murine transplant when the administration of marrow cells was scheduled over time. 7 These concepts are presented schematically in Figure 1.These approaches formed a base for the current wave of nonmyeloablative treatments, probably first published by Kolb et al 8 and effectively followed up by others. [9][10][11] We have used our murine engraftment studies as a base for treating resistant cancers using 100 cGy whole body irradiation and infusion of mixtures of CD3 T cells and CD34+ peripheral blood cells in both HLA-matched and haplo-identical transplants. 12,13 Encouraging results with complete remissions have been obtained in patients with refractory marrow malignancies.
Cell cycle...