Effective removal of SCLC cells from human bone marrow. Use of four monoclonal antibodies and immunomagnetic beads.

High dose chemotherapy with autologous bone marrow transplantation (ABMT) has shown promise in several types of cancer. There is, however, a risk of transfusing contaminating tumour cells with the bone marrow cells, e.g. in patients with small cell lung carcinoma (SCLC). To eliminate SCLC cells from normal human bone marrow, four monoclonal antibodies reactive with SCLC cells were used with immunomagnetic beads in model experiments. With two cycles of immunomagnetic elimination the individual antibodies removed 2.5-4.4 log of H-146 tumour cells from a single cell suspension, as assessed in a highly reproducible soft agar assay. Different combinations of two antibodies were only marginally more effective than the individual MAbs, whereas 5-6 log removal was obtained with a combination of all four antibodies. The method was equally effective when the tumour cells were mixed with bone marrow cells at a ratio of 1:10. The immunomagnetic procedure did not significantly affect the survival of normal progenitor cells, assessed in CFU-GM and CFU-GEMM assays. The results indicate that the procedure safely and effectively can be used to eliminate tumour cells from the bone marrow in conjunction with ABMT in patients with SCLC.