title: High levels of circulating VEGFR2+ Bone marrow-derived progenitor cells correlate with metastatic disease in patients with pediatric solid malignancies.
abstract: OBJECTIVE
  Pediatric solid malignancies display important angiogenic potential, and blocking tumor angiogenesis represents a new therapeutic approach for these patients. Recent studies have evidenced rare circulating cells with endothelial features contributing to tumor neovascularization and have shown the pivotal role of bone marrow-derived (BMD) progenitor cells in metastatic disease progression. We measured these cells in patients with pediatric solid malignancies as a prerequisite to clinical trials with antiangiogenic therapy.
  
  
  METHODS
  Peripheral blood was drawn from 45 patients with localized (n = 23) or metastatic (n = 22) disease, and 20 healthy subjects. Subsets of circulating vascular endothelial growth factor receptor (VEGFR)2+-BMD progenitor cells, defined as CD45-CD34+VEGFR2(KDR)+7AAD- and CD45(dim)CD34+VEGFR2+7AAD- events, were measured in progenitor-enriched fractions by flow cytometry. Mature circulating endothelial cells (CEC) were measured in whole blood as CD31+CD146+CD45-7AAD- viable events. Data were correlated with VEGF and sVEGFR2 plasma levels.
  
  
  RESULTS
  The CD45-CD34+VEGFR2(KDR)+7AAD- subset represented <0.003% of circulating BMD progenitor cells (< or =0.05 cells/mL). However, the median level (range) of the CD45(dim)CD34+VEGFR2+7AAD- subset was higher in patients compared with healthy subjects, 1.5% (0%-10.3%) versus 0.3% (0%-1.6%) of circulating BMD progenitors (P < 0.0001), and differed significantly between patients with localized and metastatic disease, 0.7% (0%-8.6%) versus 2.9% (0.6%-10.3%) of circulating BMD progenitors (P < 0.001). Median CEC value was 7 cells/mL (0-152 cells/mL) and similar in all groups. Unlike VEGFR2+-BMD progenitors, neither CECs, VEGF, or sVEGFR2 plasma levels correlated with disease status.
  
  
  CONCLUSIONS
  High levels of circulating VEGFR2+-BMD progenitor cells correlated with metastatic disease. Our study provides novel insights for angiogenesis mechanisms in pediatric solid malignancies for which antiangiogenic targeting of VEGFR2+-BMD progenitors could be of interest.
authors: Laboratory of Translational Research, University of Paris-Sud, UPRES EA 3535, Pharmacology and New Treatments in Cancer, France.
authors: Melissa
authors: M
authors: Taylor
authors: Jochen
authors: J
authors: Rössler
authors: Birgit
authors: B
authors: Geoerger
authors: Agnès
authors: A
authors: Laplanche
authors: Olivier
authors: O
authors: Hartmann
authors: Gilles
authors: G
authors: Vassal
authors: Françoise
authors: F
authors: Farace
mesh_terms: D018952:Antigens, CD34 / Q000097:blood; D001854:Bone Marrow Cells / Q000378:metabolism* / Q000473:pathology; D051929:CD146 Antigen / Q000097:blood; D002648:Child; D002675:Child, Preschool; D042783:Endothelial Cells / Q000378:metabolism / Q000473:pathology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007223:Infant; D017493:Leukocyte Common Antigens / Q000097:blood; D008297:Male; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000097:blood* / Q000098:blood supply / Q000473:pathology; D009389:Neovascularization, Pathologic / Q000097:blood / Q000473:pathology; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000097:blood; D042461:Vascular Endothelial Growth Factor A / Q000097:blood; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000097:blood*; D055815:Young Adult
chemical_list: D018952:Antigens, CD34; D051929:CD146 Antigen; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D042461:Vascular Endothelial Growth Factor A; D040301:Vascular Endothelial Growth Factor Receptor-2; D017493:Leukocyte Common Antigens