Use of a tumor-cell enrichment column for the enhanced detection of minimal residual disease in the BM or apheresis peripheral blood transplant products of breast-cancer patients

Background Contaminating tumor, cells present in the BM or apheresis peripheral blood (APB) autologous transplant products have been shown to contribute to relap se following high-dose chemotherapy and stem-cell rescue (HDC/ASCR). Enhanc ed methods for tumor detection in BM or APE products for breast-cancer pati ents are Methods We evaluated a laboratory-scale tumor-cell enrichment column (TEC) as all e nhanced method of detecting tumor cells in APE or BM of breast-cancer patie nts. Seventeen women with breast cancer (14 Stage IV and three Stage III) w ere evaluated using the TEC for residual tumor cells present in 20 samples of APB or Bill biopsies following HDC/ASCR. Results Using conventional histological staining methods without TEC), only one pat ient had evidence of tumor cells present in the Bill biopsy, while 16 patie nts had negative biopsies. Using the TEC for tumor cell capture and immunoc ytochemical (ICC) staining with anti-cytokeratin MAb (CAM 5.2) for tumor de tection, we were able to positively identify tumor cells in 20 samples (14 BM aspirates and six APE products). In 15 samples (nine BM and six APE), we used CAM 5.2 to positively identify cytokeratin(+) cells prior to using th e TEC. However positive cells were detected only after using the TEC in the remaining Jive samples. The level of sensitivity was significantly enhance d (p less than or equal to 0.05) by 100-400 fold in the post-TEC (absorbed) fraction compared with the plp-TEC (post-Ficoll) fraction. Discussion We conclude from this Study that the use of TEC improves our ability to det ect residual breast-cancer cells in the APE or Bill and could be potentiall y utilized to purge contaminating tumor. cells from the stem-cell transplan t.