CD34+++ Stem/Progenitor Cells Purified from Cryopreserved Normal Cord Blood can be Transduced with High Efficiency by a Retroviral Vector and Expanded Ex Vivo with Stable Integration and Expression of Fanconi Anemia Complementation C Gene

The assessment of human erythroid output in NOD/SCID mice reconstituted with human hematopoietic stem cells

The third-generation NOD/LtSz-scid/IL2Rγ(null) (NOD/SCID IL2Rγ(null)) mouse represents a significantly improved xenograft model allowing high levels of human leukocyte engraftment over extended follow up. One remaining limitation of this mouse model, however, is the low level of circulating human erythrocytes. We established a practical ex vivo erythroid culture system of xenograft marrow progenitors to enrich for human erythroid progeny. At various time points after transplant, erythroid cells were easily assayed after 17 days of ex vivo culture of xenograft marrow, with nearly all nucleated cells of human origin and approximately 60% human GPA or CD71 positive. We then transplanted cord blood CD34(+) cells marked with a lentiviral vector encoding green fluorescent protein (GFP). Three months later, ex vivo culture of xenograft marrow progenitors showed 41.3% of the cultured erythroid cells were positive for GFP and human CD71, and 56.2% were positive for GFP and human GPA, similar to that of circulating leukocytes at the same time point. Next, G-CSF mobilized peripheral blood CD34(+) cells from a sickle cell trait subject were infused in this mouse model to determine if the hemoglobin pattern could be modeled. CD34(+) cells from the sickle cell trait subject engrafted equally compared to CD34(+) cells from normal subjects, establishing the sickle cell trait phenotype. Lastly, a comparison of adult-derived peripheral blood CD34(+) cells and cord blood-derived CD34(+) cells xenografted mice was made, and long term follow-up demonstrated a recapitulation of the fetal to adult hemoglobin switch. This approach should prove a useful tool for testing strategies for genetic manipulation of erythroid progeny and the study of hemoglobin switching.

High-efficiency recovery of functional hematopoietic progenitor and stem cells from human cord blood cryopreserved for 15 years

Transplanted cord blood (CB) hematopoietic stem cells (HSC) and progenitor cells (HPC) can treat malignant and nonmalignant disorders. Because long-term cryopreservation is critical for CB banking and transplantation, we assessed the efficiency of recovery of viable HSCHPC from individual CBs stored frozen for 15 yr. Average recoveries (+/- 1 SD) of defrosted nucleated cells, colony-forming unit-granulocyte, -macrophage (CFU-GM), burst-forming unit-erythroid (BFU-E), and colony-forming unit-granulocyte, -erythrocyte, -monocyte, and -megakaryocyte (CFU-GEMM) were, respectively, 83 +/- 12, 95 +/- 16, 84 +/- 25, and 85 +/- 25 using the same culture conditions as for prefreeze samples. Proliferative capacities of CFU-GM, BFU-E, and CFU-GEMM were intact as colonies generated respectively contained up to 22,500, 182,500, and 292,500 cells. Self-renewal of CFU-GEMM was also retained as replating efficiency of single CFU-GEMM colonies into 2 degrees dishes was >96% and yielded 2 degrees colonies of CFU-GM, BFU-E, and CFU-GEMM. Moreover, CD34(+)CD38(-) cells isolated by FACS after thawing yielded >250-fold ex vivo expansion of HPC. To assess HSC capability, defrosts from single collections were bead-separated into CD34(+) cells and infused into sublethally irradiated nonobese diabetic (NOD)severe combined immunodeficient (SCID) mice. CD45(+) human cell engraftment with multilineage phenotypes was detected in mice after 11-13 wk; engrafting levels were comparable to that reported with fresh CB. Thus, immature human CB cells with high proliferative, replating, ex vivo expansion and mouse NODSCID engrafting ability can be stored frozen for >15 yr, can be efficiently retrieved, and most likely remain effective for clinical transplantation.

Evaluation of the effect of cryopreservation on ex vivo expansion of hematopoietic progenitors from cord blood

In previous studies, we identified a cytokine cocktail including thrombopoietin, Flt-3 ligand, interleukin (IL)-6 and IL-11 in serum-free medium, suitable to induce significant and sustained ex vivo expansion of primitive hematopoietic stem cells (HSCs) from cord blood (CB) for up to 10 weeks. The aim of the present study was to evaluate the effects of cryopreservation on ex vivo expansion of HSCs and their committed progenitors. CD34+ cells were purified from CB units, each of which was processed in part as such and in part as cryopreserved and thawed, then expanded for 5 weeks in serum-free medium with the cytokine cocktail described above. We determined the number of nucleated cells (NC), CD34+, CD34+/38(-)/33(-), CD34+/61+, CD61+ cells and the clonogenic potential. After 2 weeks the median fold expansion of NC, CD34+ and CD34+/38(-)/33(-) cells was around two log both with fresh and cryopreserved CB and the expansion continued similarly until week 5. Our data suggest that this serum free protocol induces similar ex vivo expansion of HSCs and their committed progenitors from both fresh and cryopreserved CB. Our findings can be useful in view of clinical applications, since CB used for transplantation is stored in the cryopreserved state.

Preserved long-term repopulation and differentiation properties of hematopoietic grafts subjected to ex vivo expansion with stem cell factor and interleukin 11

BACKGROUND

The ex vivo expansion of hematopoietic grafts has been proposed as an efficient procedure for improving the hematological recovery of recipients. The fate of the long-term repopulating cells during the ex vivo manipulation of the graft is, however, a critical issue in ex vivo expansion protocols and ultimately will define the applicability of this new technology in hematopoietic transplants.

METHODS

The repopulating ability of mouse hematopoietic samples was determined by means of bone marrow (BM*) competition assays, using congenic strains that express the pan-leukocyte Ly-5.1 and Ly-5.2 antigens. The generation of potential changes in the repopulating properties of human hematopoietic samples subjected to ex vivo expansion was determined by comparing the engraftment of fresh and ex vivo-manipulated CD34+ cord blood cells in irradiated nonobese diabetic/severe-combined immunodeficient (NOD/SCID) mice.

RESULTS

Under our optimized conditions of mouse BM incubation (stem cell factor plus interleukin-11, either with or without macrophage inflammatory protein-1alpha or Flt3 ligand), both the short-term and the mid-term repopulating ability of the ex vivo-expanded samples were significantly improved when compared with fresh samples. In the long-term, no changes in the repopulation and differentiation properties of the graft were observed as a result of the ex vivo expansion process. As deduced from the analysis of NOD/SCID mice transplanted with fresh and ex vivo expanded human CD34+ cord blood cells, the in vitro stimulation mediated by SCF/IL-11/FLT3L was capable of preserving the ability of the grafts to repopulate the lympho-hematopoiesis of recipients for at least 3 months.

CONCLUSION

These results indicate that under our optimized conditions of ex vivo expansion, the amplification of the hematopoietic progenitors responsible for the short- and mid-term repopulating properties of the graft can take place without compromising the long-term lympho-hematopoietic repopulating properties.

Human umbilical cord blood myeloid progenitor cells are relatively chemoresistant: a potential model for autologous transplantations in HIV-infected newborns

Vertical transmission from mother to child occurs in 15-39% of women infected with the human immunodeficiency virus (HIV). Stem cell transplantation has recently been suggested as a potential therapy for patients with HIV infection. We have examined the possible advantages of human cord blood (HUCB) stem cells over bone marrow (BM) stem cells in the treatment of HIV-infected newborns. HUCB myeloid progenitors were found to be statistically more resistant to interferon-alpha (IFN-alpha), cytarabine (ARA-C), and eilatin than BM myeloid progenitor cells grown with IL-3 (P < 0.05). HUCB treated with IFN-alpha, ARA-C, and eilatin demonstrated a significantly higher capacity for self-renewal manifested by delta assay following 7 days in liquid culture. We, therefore, suggest that HUCB purged by anti-HIV drugs may be a source for autologous transplantation in HIV-infected newborns.

Does the Granulocyte-Macrophage Colony-Forming Unit Content in Ex Vivo–Expanded Grafts Predict the Recovery of the Recipient Leukocytes?

We have investigated the leukocyte-repopulating-predictive value of granulocyte-macrophage colony-forming unit (CFU-GM) analyses in ex vivo–expanded versus fresh murine bone marrow (BM) grafts. After the transplantation of graded numbers of normal BM cells (from 15 to 5 × 103 CFU-GMs/mice), a dose-dependent increase in the recipient leukocytes was observed between the first and third weeks posttransplantation. During these stages, increases in the graft size of 100-fold improved the leukocyte counts up to 30-fold and shortened the leukopenia period by 5 to 11 days, depending on the leukocyte threshold considered. To investigate whether similar correlations could be established using ex vivo–expanded samples, the size of the CFU-GM population was maximized by means of the preactivation of the BM with 5-fluorouracil (9-day 5FU-BM), followed by 3 days of incubation with interleukin-1 plus stem cell factor. Under these conditions, the CFU-GM content of the ex vivo–expanded grafts was 73-fold higher than that observed in equivalent femoral fractions of normal fresh BM. When equivalent fractions of both graft types were transplanted, an improved leukocyte recovery was observed in mice transfused with the expanded grafts. However, the leukocyte values obtained after the transplantation of the ex vivo–expanded samples were not as high as expected, based on the number of transplanted CFU-GMs. Analyses performed during the second week posttransplantation showed that, in comparison with normal fresh BM, ex vivo–expanded grafts containing 6 to 50 times more CFU-GMs were required to generate a similar number of leukocytes. These results were confirmed in both the peripheral blood leukocytes and the myeloid Gr1+ cells, when similar numbers of CFU-GMs were transfused in the fresh and the ex vivo–expanded BM. The possibility that the preactivation of the ex vivo–expanded grafts with 5FU had a role in this effect was ruled out, because the leukocyte repopulation capacity of fresh 5FU-treated BM was as high as that observed in normal fresh BM which contained a similar number of CFU-GMs. Neither by extending the ex vivo incubation period nor by using other hematopoietic growth factor combinations was the functional capacity of the expanded grafts improved. The results presented in this study are consistent with the belief that ex vivo expansion procedures will be a useful tool for improving the hematologic recovery of patients who receive hematopoietic transplants. However, our data indicate that predicting the leukocyte repopulating capacity of ex vivo–expanded grafts according to correlations established with numbers of fresh CFU-GMs can lead to overestimations of their function, and therefore to unexpected and delayed hematopoietic engraftments.

Does the Granulocyte-Macrophage Colony-Forming Unit Content in Ex Vivo–Expanded Grafts Predict the Recovery of the Recipient Leukocytes?

We have investigated the leukocyte-repopulating-predictive value of granulocyte-macrophage colony-forming unit (CFU-GM) analyses in ex vivo–expanded versus fresh murine bone marrow (BM) grafts. After the transplantation of graded numbers of normal BM cells (from 15 to 5 × 103 CFU-GMs/mice), a dose-dependent increase in the recipient leukocytes was observed between the first and third weeks posttransplantation. During these stages, increases in the graft size of 100-fold improved the leukocyte counts up to 30-fold and shortened the leukopenia period by 5 to 11 days, depending on the leukocyte threshold considered. To investigate whether similar correlations could be established using ex vivo–expanded samples, the size of the CFU-GM population was maximized by means of the preactivation of the BM with 5-fluorouracil (9-day 5FU-BM), followed by 3 days of incubation with interleukin-1 plus stem cell factor. Under these conditions, the CFU-GM content of the ex vivo–expanded grafts was 73-fold higher than that observed in equivalent femoral fractions of normal fresh BM. When equivalent fractions of both graft types were transplanted, an improved leukocyte recovery was observed in mice transfused with the expanded grafts. However, the leukocyte values obtained after the transplantation of the ex vivo–expanded samples were not as high as expected, based on the number of transplanted CFU-GMs. Analyses performed during the second week posttransplantation showed that, in comparison with normal fresh BM, ex vivo–expanded grafts containing 6 to 50 times more CFU-GMs were required to generate a similar number of leukocytes. These results were confirmed in both the peripheral blood leukocytes and the myeloid Gr1+ cells, when similar numbers of CFU-GMs were transfused in the fresh and the ex vivo–expanded BM. The possibility that the preactivation of the ex vivo–expanded grafts with 5FU had a role in this effect was ruled out, because the leukocyte repopulation capacity of fresh 5FU-treated BM was as high as that observed in normal fresh BM which contained a similar number of CFU-GMs. Neither by extending the ex vivo incubation period nor by using other hematopoietic growth factor combinations was the functional capacity of the expanded grafts improved. The results presented in this study are consistent with the belief that ex vivo expansion procedures will be a useful tool for improving the hematologic recovery of patients who receive hematopoietic transplants. However, our data indicate that predicting the leukocyte repopulating capacity of ex vivo–expanded grafts according to correlations established with numbers of fresh CFU-GMs can lead to overestimations of their function, and therefore to unexpected and delayed hematopoietic engraftments.