Detailed Characterization of Mesenchymal Stem/Stromal Cells from a Large Cohort of AML Patients Demonstrates a Definitive Link to Treatment Outcomes

Stem Cell Reports. 2017 Jun 6;8(6):1573-1586. doi: 10.1016/j.stemcr.2017.04.019. Epub 2017 May 18.

Abstract

Bone marrow mesenchymal stem/stromal cells (BM-MSCs) are key components of the hematopoietic niche thought to have a direct role in leukemia pathogenesis. BM-MSCs from patients with acute myeloid leukemia (AML) have been poorly characterized due to disease heterogeneity. We report a functional, genetic, and immunological characterization of BM-MSC cultures from 46 AML patients, stratified by molecular/cytogenetics into low-risk (LR), intermediate-risk (IR), and high-risk (HR) subgroups. Stable MSC cultures were successfully established and characterized from 40 of 46 AML patients irrespective of the risk subgroup. AML-derived BM-MSCs never harbored tumor-specific cytogenetic/molecular alterations present in blasts, but displayed higher clonogenic potential than healthy donor (HD)-derived BM-MSCs. Although HD- and AML-derived BM-MSCs equally provided chemoprotection to AML cells in vitro, AML-derived BM-MSCs were more immunosuppressive/anti-inflammatory, enhanced suppression of lymphocyte proliferation, and diminished secretion of pro-inflammatory cytokines. Multivariate analysis revealed that the level of interleukin-10 produced by AML-derived BM-MSCs as an independent prognostic factor negatively affected overall survival. Collectively our data show that AML-derived BM-MSCs are not tumor related, but display functional differences contributing to therapy resistance and disease evolution.

Keywords: AML; BM-MSC; IL-10; characterization; chemoprotection; immunosuppression; risk-stratification.

MeSH terms

  • Adult
  • Aged
  • Bone Marrow Cells / cytology
  • CCAAT-Enhancer-Binding Proteins / genetics
  • CCAAT-Enhancer-Binding Proteins / metabolism
  • Cell Differentiation
  • Cell Proliferation / drug effects
  • Cells, Cultured
  • Cytogenetic Analysis
  • Cytokines / metabolism
  • Female
  • Humans
  • Immunosuppression Therapy
  • In Situ Hybridization, Fluorescence
  • Interleukin-10 / metabolism
  • Kaplan-Meier Estimate
  • Leukemia, Myeloid, Acute / mortality
  • Leukemia, Myeloid, Acute / pathology
  • Leukemia, Myeloid, Acute / therapy*
  • Male
  • Mesenchymal Stem Cell Transplantation*
  • Mesenchymal Stem Cells / cytology*
  • Mesenchymal Stem Cells / metabolism
  • Middle Aged
  • Phytohemagglutinins / pharmacology
  • Prognosis
  • Treatment Outcome
  • Tumor Suppressor Protein p53 / genetics
  • Tumor Suppressor Protein p53 / metabolism

Substances

  • CCAAT-Enhancer-Binding Proteins
  • CEBPA protein, human
  • Cytokines
  • Phytohemagglutinins
  • TP53 protein, human
  • Tumor Suppressor Protein p53
  • Interleukin-10