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Can Long-Term Bone Marrow Culture Eliminate Leukemia Cells?
M A Santucci1,2, A Butturini1,2, R P Gale1,2
1a Istituto di Ematologia "L. e A. Seràgnoli", Università di Bologna, Dipartimento di Pediatria, Divisione di Ematologia e Oncologia, Università di Parma, Italy.
Leukemia & Lymphoma
|July 27, 2016
Summary
Long-term bone marrow cultures (LTBMCs) may not effectively reduce leukemia relapse in patients undergoing autotransplantation. Proving the clinical efficacy of LTBMCs for purging leukemia cells is challenging.
Area of Science:
- Hematology
- Oncology
- Stem Cell Biology
Background:
- Experimental studies indicate normal progenitor cells in chronic myeloid leukemia (CML) and acute myeloblastic leukemia (AML) exhibit a growth advantage in long-term culture.
- Long-term bone marrow cultures (LTBMCs) have been explored as a method for purging bone marrow ex vivo before autotransplantation.
Purpose of the Study:
- To review the efficiency of LTBMCs in eliminating leukemia cells and preserving sufficient normal stem/progenitor cells for hematopoietic reconstitution.
- To assess the potential clinical benefit of LTBMCs in reducing leukemia relapse post-autotransplantation.
Main Methods:
- Review of experimental studies and clinical outcomes related to the use of long-term bone marrow cultures for purging leukemia cells.
- Analysis of the dual requirements for LTBMCs: elimination of leukemia cells and maintenance of functional normal hematopoietic stem and progenitor cells.
Main Results:
- The efficiency of LTBMCs in purging leukemia cells and ensuring adequate restoration of hematopoiesis remains complex and not fully understood.
- Clinical outcomes of patients receiving unpurged autografts suggest LTBMCs are unlikely to provide substantial benefit in reducing leukemia relapse.
Conclusions:
- The clinical efficacy of long-term bone marrow cultures as a purging technique for leukemia is difficult to demonstrate.
- LTBMCs may not be a substantial benefit in reducing leukemia relapse in patients undergoing autotransplantation for CML and AML.
