Stroma-supported culture in childhood B-lineage acute lymphoblastic leukemia cells predicts treatment outcome. (original) (raw)

Research Article Free access | 10.1172/JCI118474

A Manabe, C H Pui, F G Behm, S C Raimondi, M L Hancock, H Mahmoud, W M Crist, and D Campana

Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38101, USA.

Find articles by Kumagai, M. in:PubMed |Google Scholar

Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38101, USA.

Find articles by Manabe, A. in:PubMed |Google Scholar

Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38101, USA.

Find articles by Pui, C. in:PubMed |Google Scholar

Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38101, USA.

Find articles by Behm, F. in:PubMed |Google Scholar

Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38101, USA.

Find articles by Raimondi, S. in:PubMed |Google Scholar

Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38101, USA.

Find articles by Hancock, M. in:PubMed |Google Scholar

Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38101, USA.

Find articles by Mahmoud, H. in:PubMed |Google Scholar

Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38101, USA.

Find articles by Crist, W. in:PubMed |Google Scholar

Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38101, USA.

Find articles by Campana, D. in:PubMed |Google Scholar

Published February 1, 1996 -More info

Published February 1, 1996 -Version history

View PDF

Abstract

We developed a stroma cell culture system that suppresses apoptosis of malignant cells from cases of B-lineage acute lymphoblastic leukemia. By multiparameter flow cytometric measurements of cell recovery after culture on stromal layers, we assessed the growth potential of 70 cases of newly diagnosed B-lineage acute lymphoblastic leukemia and related the findings of treatment outcome in a single program of chemotherapy. The numbers of leukemic cells recovered after 7 d of culture ranged from < 1 to 292% (median, 91%). The basis of poor cell recoveries from stromal layers appeared to be a propensity of the lymphoblasts to undergo apoptosis. The probability of event-free survival at 4 yr of follow-up was 50 +/- 9% (SE) among patients with higher cell recoveries ( > 91%), and 94 +/- 6% among those with reduced cell recoveries (+/- 91%; P = 0.0003). The prognostic value of leukemic cell recovery after culture exceeded estimates for all other recognized high-risk features and remained the most significant after adjustment with all competing covariates. Thus, the survival ability of leukemic cells on bone marrow-derived stromal layers reflects aggressiveness of the disease and is a powerful, independent predictor of treatment outcome in children with B-lineage acute lymphoblastic leukemia.

Version history