Purging of contaminating breast cancer cells from hematopoietic progenitor cell preparations using activation enhanced cell death.

Activation enhanced cell death (AECD) involves stimulating cells with growth or activation signals while concurrently blocking calcium influx. In this study, we have evaluated the effect of AECD on human breast cancer cells. MCF-7 or MDA-MB-231 cells treated with Ca2+ influx blockers econazole or ketotifen for 24 h underwent a dose-dependent, irreversible loss of viability, and clonogenicity. Two-hour treatment of these cells with higher concentrations of the drugs also resulted in loss of clonogenicity, but morphological indicators of cell death were apparent only after longer incubation. Loss of clonogenicity could be enhanced almost 10-fold by co-stimulation of the cells with the agonists EGF or bombesin. Econazole was also effective in inducing cell death in multi-drug resistant MCF-7adr cells. Human hemopoietic progenitor cell sensitivity to econazole or ketotifen was evaluated by colony assay. Under conditions resulting in 2.5-3 logs of breast cancer cell loss, 60-70% of hemopoietic progenitors could be recovered. We further evaluated the effect of econazole on breast cancer cells present in mobilized hemopoietic cells obtained from patients undergoing high dose chemotherapy with autologous stem cell support. In six of eight samples evaluated, cytokeratin-positive breast cancer cells could be detected by immunofluorescence microscopy and colony formation. Breast cancer colonies were reduced 60-500-fold or more after exposure to econazole while hemopoietic colonies were typically reduced only 2-fold. In all cases, addition of EGF as an activator either had no evaluable effect or enhanced breast cancer cell loss. We conclude that Ca2+ influx blockade with concurrent EGF stimulation is a promising approach for purging breast cancer cells from hemopoietic progenitor cell preparations.