ELIMINATION OF RESIDUAL TUMOR CELLS FROM AUTOLOGOUS BONE MARROW GRAFTS BY DYE‐MEDIATED PHOTOLYSIS: PRECLINICAL DATA*

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Abstract
MC540-mediated photolysis has several features that make it potentially attractive as a clinical purging procedure. (1) The experience with experimental tumors suggests that MC540-mediated photolysis is effective against a broad range of leukemias and solid tumors, including drug-resistant tumors (Sieber et al., 1984b). Drug-resistant tumor cells are likely to occur in heavily pretreated patients. (2) MC540-mediated photolysis is not cell-cycle dependent (Manna and Sieber, 1985). It kills both resting and cycling cells. In this regard, MC540-mediated photolysis is a valuable complement to cell-cycle specific cytotoxic drugs. (3) There is a large differential in sensitivity between normal pluripotent hematopoietic stem cells and leukemia and neuroblastoma cells. (4) The mechanism of action of MC540-mediated photolysis is different from that of lectins, antibodies and most cytotoxic drugs. MC540 binds to the lipid portion of the plasma membrane and membrane lipids are probably a primary target of the toxic photoproducts. Antibodies and lectins react with proteins and carbohydrates and most drugs have intracellular targets (e.g., nuclear DNA). We would therefore expect little cross-resistance if MC540-mediated photolysis were used in combination with other purging procedures.(5) The small amounts of dye that remain associated with the marrow graft and are infused into the patient are approximately 100,000-fold less than the LD(10) (in mice) and therefore unlikely to cause any harm. The outcome of the first clinical application of the technique supports this view (Sieber et al., 1986c). A better understanding of the underlying molecular mechanisms will undoubtedly lead to more effective applications of the technique and perhaps to the identification of more potent analogs of MC540.