title: Tumor cells are present in stem cell harvests of Ewings sarcoma patients and their persistence following transplantation is associated with relapse.
abstract: BACKGROUND
  Tumor cells frequently contaminate autologous stem cell products in a variety of malignancies, but their clinical significance remains controversial. We retrospectively monitored tumor contamination in stem cell harvests from patients with Ewing family of tumors (EFT) all harboring the specific translocation EWS-FLI-1 that characterize these tumors.
  
  
  METHODS
  Twenty- seven harvests from 11 patients were included in the study. In addition, 6 and 19 bone marrow (BM) or peripheral blood (PBL) samples were available before and after transplantation, respectively, for RT-PCR and nested PCR analyzes.
  
  
  RESULTS
  All 11 patients had contaminating tumor cells in their harvests. All samples prior to transplantation were RT-PCR positive. Two out of the 11 patients who underwent transplantation died of complications. Out of the remaining nine patients, two are alive and well 68 and 84 months from diagnosis, and are the only patients with no detectable tumor cells in their samples after transplantation. One of these patients harbored contaminating tumor cells in only one of the two harvests collected. Seven patients relapsed after transplant, and in four patients BM/PBL samples were available prior to the clinical relapse. All these samples harbored contaminating tumor cells.
  
  
  CONCLUSIONS
  We suggest a possible correlation between the amount of contaminating cells in the harvest and relapse after transplantation. Quantitative RT-PCR studies of the chimeric transcripts are underway to explore this issue.
authors.affiliation: Department of Pediatric Hematology Oncology, Schneider Children's Medical Center of Israel, Israel.
authors.forename: I
authors.initials: I
authors.lastname: Yaniv
authors.forename: I J
authors.initials: IJ
authors.lastname: Cohen
authors.forename: J
authors.initials: J
authors.lastname: Stein
authors.forename: J
authors.initials: J
authors.lastname: Zilberstein
authors.forename: E
authors.initials: E
authors.lastname: Liberzon
authors.forename: O
authors.initials: O
authors.lastname: Atlas
authors.forename: A
authors.initials: A
authors.lastname: Grunshpan
authors.forename: Y
authors.initials: Y
authors.lastname: Sverdlov
authors.forename: S
authors.initials: S
authors.lastname: Ash
authors.forename: R
authors.initials: R
authors.lastname: Zaizov
authors.forename: S
authors.initials: S
authors.lastname: Avigad
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D004268:DNA-Binding Proteins / Q000235:genetics; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D007937:Leukapheresis; D008297:Male; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011379:Prognosis; D051789:Proto-Oncogene Protein c-fli-1; D012334:RNA, Neoplasm / Q000032:analysis; D034802:RNA-Binding Protein EWS / Q000235:genetics; D012008:Recurrence; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000235:genetics / Q000473:pathology* / Q000628:therapy*; D015534:Trans-Activators / Q000235:genetics; D014178:Translocation, Genetic; D014182:Transplantation, Autologous
chemical_list: D004268:DNA-Binding Proteins; C078433:FLI1 protein, human; D051789:Proto-Oncogene Protein c-fli-1; D012334:RNA, Neoplasm; D034802:RNA-Binding Protein EWS; D015534:Trans-Activators