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Ex vivo expansion of haematopoietic cells in the treatment of accidental irradiation-induced aplasia. Feasibility studies.



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Thierry, D.; Bertho, J.M.; Chapel, A.; Gourmelon, P. IRPA-10: 10. international congress of the International Radiation Protection Association Hiroshima (Japan) 14-19 May 2000, P-4b-105.


The lessons learnt from the treatment of previous radiation accidents using either bone marrow transplantation or growth factor therapy suggest that it is of importance to investigate new therapeutic regiments. Ex vivo expansion of haematopoietic stem cells, precursors and differentiated cells is a new approach of growth factor therapy which may be of interest for the treatment of patients with irradiation-induced bone marrow aplasia. Ex vivo expanded maturing cells could be used to limit the early risks bound to aplasia (infections related to granulocytopaenia, bleedings associated with thrombocytopaenia), whereas expanded immature cells could hasten haematopoietic recovery. Indeed, it is possible to culture from the blood or bone marrow the cells able to proliferate and differentiate. A sufficient quantity of cells to cover the transfusion needs of a radiation victim through an aplasia episode can be produced, in presence of a specific growth factor combination. Qualitative studies shows that the expanded cells exhibit a close to normal functionality. Long-term culture techniques demonstrate the expansion of immature cells. We have set up a high dose total body irradiation non-human primate model in order to study the therapeutic potential of ex vivo expansion of autologous progenitors and differentiating cells. All the steps of the process (sampling, positive selection of the immature cells, ex vivo expansion, irradiation of the animals, reinjection of the cultured cells and study of the outcome) are established. In order to allow the long term follow up of the ex vivo expanded haematopoietic cells (homing to the bone marrow or localization to specific organs for example), a retroviral gene transfer technique for transduction of green fluorescence protein (GFP) gene toward the selected immature blood or bone marrow cells is under development in this model. Taken together these elements will allow establishing the feasibility of ex vivo expansion of haematopoietic cells for the treatment of accidental irradiation-induced aplasia.