To investigate the effect of recombinant erythropoietin (Epo) on primitive human hematopoietic progenitor cells, we cultured cord blood mononuclear cells (CBMNC) and CB CD34+ cells in a Dexter-type long-term culture system (LTC), to which various concentrations of Epo were added at day 0 or 7, with or without direct contact with irradiated allogeneic human marrow stromal layers. In regular stroma-contact cultures, when CBMNC were inoculated, the addition of Epo at 1 to 10 U/mL induced a significant increase in LTC-initiating cells (LTC-IC), particularly in the myeloid component, compared with the control without Epo. Significantly more LTC-IC were generated by the delayed addition of Epo on day 7 than on day 0. On the other hand, when CD34+ cells were inoculated, physiologic concentrations of Epo (0.1 U/mL) induced a more than twofold increase in LTC-IC, which was attributed equally to both the myeloid and erythroid lineages, only when added on day 0. In stroma-noncontact cultures, which were created using a Transwell 0.4-micron microporous membrane filter, dose-dependent suppression of the myeloid component of LTC-IC was observed with a higher concentration of Epo (1 to 100 U/mL) when CBMNC was inoculated. On the other hand, without Epo, fourfold more LTC-IC was generated from CD34+ cells in stroma-noncontact than in stroma-contact cultures, which was then significantly augmented by the addition of Epo (0.1 or 10 U/mL) on day 0. This increase was due to both the myeloid and erythroid lineages. A higher concentration of Epo (100 U/mL) resulted in a decrease in LTC-IC, mainly in myeloid progeny, in all of the culture conditions. Hence, Epo may play an important physiologic role in the maintenance and proliferation of immature stem/progenitor cells, in close interaction with factors from marrow stromal cells.

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