title: The concentration of CD44 is increased in hematopoietic stem cell grafts of patients with acute myeloid leukemia, plasma cell myeloma, and non-Hodgkin lymphoma.
abstract: BACKGROUND
  In autologous hematopoietic stem cell transplantation (autoHSCT), malignant cells remaining in the graft may re-engraft leading to relapse of the original disease. CD44 is known to play a role in the engraftment of leukemia-initiating cells and is shed from the surface of malignant cells. Soluble CD44 is a cleaved fragment, which is found in the serum of patients with metastasized epithelial and hematologic malignancies and in some other cancers, and has been demonstrated to be correlated with clinical outcome.
  
  
  OBJECTIVE
  To investigate (1) a possible correlation between the concentration of CD44 in an autoHSCT graft and the type of hematologic malignancy and (2) a possible correlation between the concentration of CD44 in the autoHSCT graft with clinical outcome after autoHSCT.
  
  
  METHODS
  We measured CD44 in 157 hematopoietic stem cell grafts from patients with hematologic malignancies and from 43 healthy donors by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Levels of CD44 were almost 2-fold higher in the patients' grafts. Highest levels were found in the grafts of patients with acute myeloid leukemia, diffuse large B-cell lymphoma, and plasma cell myeloma, congruent with known CD44 expression levels in these malignancies. The survival advantage among patients with CD44 levels less than 22 000 ng/mL was highly statistically significant.
  
  
  CONCLUSIONS
  These results show that CD44 levels in an autoHSCT graft may be linked to clinical outcome after autoHSCT.
authors.affiliation: Department of Pathology, Blood Transfusion Service, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA.
authors.forename: Daniela S
authors.initials: DS
authors.lastname: Krause
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Spitzer
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Stowell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001782:Blood Donors; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000276:immunology*; D006801:Humans; D018960:Hyaluronan Receptors / Q000378:metabolism*; D015470:Leukemia, Myeloid, Acute / Q000276:immunology / Q000401:mortality / Q000601:surgery*; D008228:Lymphoma, Non-Hodgkin / Q000276:immunology / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000276:immunology / Q000401:mortality / Q000601:surgery*; D009994:Osmolar Concentration; D012995:Solubility; D015996:Survival Rate; D014182:Transplantation, Autologous; D055815:Young Adult
chemical_list: C497483:CD44 protein, human; D018960:Hyaluronan Receptors