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

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


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.

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

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • ADP-ribosyl Cyclase 1 / metabolism
  • Adult
  • Aged
  • Aged, 80 and over
  • Aldehyde Dehydrogenase / metabolism
  • Antigens, CD34 / metabolism
  • Biomarkers
  • Cell Count
  • Cell Separation*
  • Colony-Forming Units Assay
  • Enzyme Activation
  • Female
  • Hematopoietic Stem Cells / cytology*
  • Hematopoietic Stem Cells / metabolism*
  • Humans
  • Immunophenotyping
  • Male
  • Middle Aged
  • Phenotype
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / diagnosis
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / metabolism*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy


  • Antigens, CD34
  • Biomarkers
  • Aldehyde Dehydrogenase
  • ADP-ribosyl Cyclase 1