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Leuk Lymphoma. 2017 Jun;58(6):1446-1454. doi: 10.1080/10428194.2016.1236378. Epub 2016 Oct 13.

Hematopoietic stem cells can be separated from leukemic cells in a subgroup of adult acute lymphoblastic leukemia patients.

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a Department of Medicine V , University of Heidelberg , Im Neuenheimer Feld 410 , Heidelberg , Germany.
b Department of Applied Sciences , University of Applied Sciences Coburg , Friedrich-Streib-Straße 2 , Coburg , Germany.
c Institute of Human Genetics, University of Heidelberg , Im Neuenheimer Feld 366 D , Heidelberg , Germany.


In B-cell acute lymphoblastic leukemia (B-ALL) separation of normal hematopoietic stem cells (HSC) has so far been limited to a subgroup of patients. As aldehyde dehydrogenase (ALDH)-activity is enriched in various stem cells we investigated its value for HSC isolation in adult B-ALL. Based on ALDH-activity patients could be stratified in ALDH-numerous (≥1.9% ALDH+ cells) and ALDH-rare (<1.9% ALDH+ cells) cases. In ALDH-rare B-ALL clonal-marker negative HSC could be separated by the CD34+CD38-ALDH+  phenotype, whereas this separation was not possible in ALDH-numerous B-ALL. Functional analysis confirmed the HSC-potential of isolated cells, which were uniformly CD19-negative. However, addition of ALDH-activity further improved HSC-purity. In summary, we provide a method to separate functionally normal HSC from leukemic cells in a subgroup of B-ALL patients that can be identified prospectively. This protocol thereby facilitates comparative analyses of matched HSC and leukemic cells in order to improve our understanding of leukemia evolution.


B-cell acute lymphoblastic leukemia; aldehyde dehydrogenase; hematopoietic stem cells

[Indexed for MEDLINE]

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