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Flow cytometric analysis of circulating endothelial cells and endothelial progenitor cells in pediatric solid tumors: prognostic impact on treatment response and survival

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Abstract

Background and aim

Solid tumors, including pediatric malignancies, depend on angiogenesis for tumor growth, invasion, and metastases. We aimed to evaluate the prognostic impact of circulating endothelial cells (CECs) and endothelial progenitor cells (EPCs) on treatment response and survival of pediatric patients with solid tumors.

Methods

A prospective study included 70 patients with different pediatric solid tumors treated with different types of chemotherapy and 20 age and sex-matched healthy children as controls. Blood samples collected at diagnosis then on day 7 and day 21 after chemotherapy. CECs and EPCs were evaluated using flow cytometry.

Results

The mean levels of CECs and EPCs of patients at diagnosis were significantly higher than controls (85.29 ± 24.78 and 26.1 ± 9.11 versus 20.08 ± 6.65; and EPCs; 2.78 ± 1.48, respectively; P < 0.001 for both). The highest levels of CECs were observed in patients with rhabdomyosarcoma (RMS). An overall increase was reported in CECs, and after the first cycle of chemotherapy, that was significantly correlated to treatment response and overall survival.

Conclusion

Pediatric patients with solid tumors have elevated levels of CECs and EPCs with more elevation after chemotherapy. The magnitude of increase of CECs occurred on day 7 after chemotherapy may be considered as an early predictor of response to therapy and outcome in pediatric patients with solid tumors.

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Data availability

Data available on request due to privacy/ethical restrictions.

Abbreviations

CECs:

Circulating endothelial cells

EPCs:

Endothelial progenitor cells

ES:

Ewing sarcoma

HB:

Hepatoblastoma

NB:

Neuroblastoma

RB:

Retinoblastoma

RMS:

Rhabdomyosarcoma

OS:

Osteosarcoma

WT:

Wilms’ tumor

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Acknowledgment

The authors acknowledge the research unit, South Egypt Cancer Institute for supporting this research

Author information

Authors and Affiliations

  1. Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, 71515, Egypt

    Heba Abdel Razik Sayed

  2. Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt

    Helal F. Hetta

  3. Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, 45267-0595, USA

    Helal F. Hetta

  4. Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut, 71515, Egypt

    Engy A. Shafik & Asmaa M. Zahran

Authors
  1. Heba Abdel Razik Sayed
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  2. Helal F. Hetta
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  3. Engy A. Shafik
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  4. Asmaa M. Zahran
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Contributions

HAS, HFH, EAS, AMZ conceived and designed the experiments. HAS recruited patients, carried out the clinical investigations and collected patients’ clinical data. HFH, EAS, AMZ performed the experiments. AMZ, HFH shared in the analysis of the flow cytometry data. HFH, EAS, AMZ performed the statistical analysis. HAS, HFH, EAS, AMZ accomplished the interpretation of results and wrote the initial draft. All authors participated in critical review and revision of the final manuscript. HFH is the corresponding author and managed the submission of the manuscript.

Corresponding author

Correspondence to Helal F. Hetta.

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The authors declare that they have no conflict of interests.

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Sayed, H.A.R., Hetta, H.F., Shafik, E.A. et al. Flow cytometric analysis of circulating endothelial cells and endothelial progenitor cells in pediatric solid tumors: prognostic impact on treatment response and survival. Cancer Immunol Immunother 70, 755–761 (2021). https://doi.org/10.1007/s00262-020-02719-0

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  • DOI: https://doi.org/10.1007/s00262-020-02719-0

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