Supplementary Materials for

Hematopoietic stem cell transplantation in immunocompetent hosts

without radiation or chemotherapy

Akanksha Chhabra, Aaron M. Ring, Kipp Weiskopf, Peter John Schnorr,

Sydney Gordon, Alan C. Le, Hye-Sook Kwon, Nan Guo Ring, Jens Volkmer, Po Yi Ho,

Serena Tseng, Irving L. Weissman, Judith A. Shizuru*

*Corresponding author. Email: jshizuru@stanford.edu

Published 10 August 2016, Sci. Transl. Med. 8, 351ra105 (2016)

DOI: 10.1126/scitranslmed.aae0501

The PDF file includes:

Fig. S1. Expression of c-Kit during hematopoiesis.

Fig. S2. ACK2 treatment does not affect functional HSC levels in Fcer1g−/− mice.

Fig. S3. FcgRIIb and FcgRIII blocking antibody 2.4G2 treatment alone does not

deplete effector cells in Rag2−/−c−/− mice.

Fig. S4. Anti–c-Kit antibody and CD47 antagonism suppress peripheral blood

counts and are dependent on FcR function.

Fig. S5. Bone marrow composition after various doses of radiation.

Fig. S6. Preconditioning with anti–c-Kit and CV1mb enables long-term

multilineage congenic hematopoietic engraftment in immunocompetent mice 20

weeks after transplantation.

Fig. S7. Preconditioning with anti–c-Kit and CV1mb enables stable multilineage

chimerism in peripheral blood.

Fig. S8. Comparison of conditioning by combined anti–c-Kit and CD47 blockade

versus radiation.

Fig. S9. Anti–c-Kit antibody ACK2 combined with additional CD47-blocking

reagents enhances depletion of functional HSC in immunocompetent mice.

Fig. S10. Anti–c-Kit antibody ACK2 combined with additional CD47-blocking

reagents enables granulocyte and lymphoid chimerism in transplanted

immunocompetent recipients.

Fig. S11. Transient depletion of RBC parameters is observed using the

combination of ACK2 and anti-CD47 antibody.

www.sciencetranslationalmedicine.org/cgi/content/full/8/351/351ra105/DC1

Fig. S12. Preconditioning with anti–c-Kit and anti-CD47 in combination with T

cell–depleting antibodies enables stable multilineage chimerism in peripheral

blood in an mHC-mismatched model of HSC allotransplantation.

Fig. S13. Preconditioning with anti–c-Kit, anti-CD47, and T cell–depleting

antibodies enables long-term multilineage chimerism in immunocompetent mice

24 weeks after transplantation in an mHC-mismatched model of HSC

allotransplantation.

Other Supplementary Material for this manuscript includes the following:

(available at

www.sciencetranslationalmedicine.org/cgi/content/full/8/351/351ra105/DC1)

Table S1 (Microsoft Excel format). Source data.

Supplementary Materials

Supplementary Figures

Fig. S1. Expression of c-Kit during hematopoiesis. Summary of c-Kit expression in

hematopoietic stem and progenitor cells and differentiated cells in major hematopoietic organs

from Gene Expression Commons. Hematopoietic Stem Cells (HSC), Multi-potent Progenitor

subset A (MPPa), Multi-potent Progenitor subset B (MPPb), Granulo/Macrophage/Lymphoid

Progenitor subset A (GMPLa), Granulo/Macrophage/Lymphoid Progenitor subset B (GMPLb),

pre Megakaryocyte/Erythrocyte Progenitor (pMEP), Strict Common Myeloid Progenitor (sCMP),

preGranulocyte/Macrophage Progenitor subset A (pGMPa), preGranulocyte/Macrophage

Progenitor subset B (pGMPb), Megakaryocyte/Erythrocyte Progenitor (MEP), Megakaryocyte

Progenitor (MkP), preCFU-E (pCFU-E), Granulocyte/Macrophage Progenitor (GMP),

Granulocyte (Gra Gr+), Monocyte (Mono), Common Lymphoid Progenitor Ly6d- (CLP),

Earliest B-lymphoid Progenitor (BLP), pre pro B cell (prepro B), Fraction B B-cell (FrB),

Fraction C B-cell (FrC), Fraction D B-cell (FrD), Fraction E B-cell (FrE), T1 B-cell (T1B), T2

B-cell (T2B), Marginal Zone B-cell (MzB), Follicular B-cell (FoB), intermediate Natural Killer

Cell (iNK), mature Natural Killer Cell (mNK), Double Negative T-cell 1 (DN1), Double

Negative T-cell 2 (DN2), Double Negative T-cell 3a (DN3a), Double Negative T-cell 3b (DN3b),

Double Negative T-cell 4 (DN4), Double Positive CD69- T-cell (DP CD69-), Double Positive

CD69+ T-cell (DP CD69+), CD4+ CD69+ T-cell (CD4+ CD69+), CD4+ CD69- T-cell (CD4+

CD69-), CD8+ CD69+ T-cell (CD8+ CD69+), CD8+ CD69- T-cell (CD8+ CD69-).

Fig. S2. ACK2 treatment does not affect functional HSC levels in Fcer1g-/- mice. a, Number

of Lin-c-Kit+Sca-1+CD150+Flt3-CD34- LT-HSCs in Fcer1g-/- mice six days post-ACK2

treatment as compared to untreated controls (n=4 untreated, n=6 ACK2). b, Number of Lin-c-

Kit+Sca-1+CD150+Flt3-CD34- LT-HSCs in wild-type mice six days post-ACK2 treatment as

compared to untreated controls (n=4 untreated, n=3 ACK2). c, Frequency of donor-derived Lin-

c-Kit+Sca-1+ HSCs present 18 weeks after transplant into irradiated recipients. Recipients were

transplanted with 1,000,000 whole bone marrow cells from untreated or ACK2 treated mice with

1,000,000 support GFP+ bone marrow cells (n=3, experiment was replicated in duplicate with

similar results each replicate). Data and error bars represent the mean ± s.e.m. NS, not

significant; * p<0.05.

Fig. S3. FcgRIIb and FcgRIII blocking antibody 2.4G2 treatment alone does not deplete

effector cells in Rag2-/-c-/- mice. Total number of Mac-1+Gr-1+ myeloid cells in the a,

peripheral blood and b, bone marrow and c, spleen of Rag2-/-cγ-/- mice 9 days post ACK2

treatment, as compared to either 2.4G2 alone, or ACK2 combined with 2.4G2 as well as

untreated controls. (n=4), data and error bars represent the mean ± s.e.m. * p<0.05; *** p<0.001;

****p<0.0001.

Fig. S4. Anti–c-Kit antibody and CD47 antagonism suppress peripheral blood counts and

are dependent on FcR function. a, Red blood cell and white blood cell parameters as

determined by complete blood counts of peripheral blood of wild-type mice 7 days after

treatment with anti-c-Kit antibody ACK2, CD47 antagonist CV1mb or the combination of ACK2

and CV1mb as compared to untreated controls (n=3, experiment was replicated in duplicate). b,

Frequency of donor Fcer1g-/- derived Mac1+Gr-1+ myeloid cells in the bone marrow 24 weeks

post-transplant into irradiated recipients. Recipients were transplanted with 2,000,000 donor

whole bone marrow cells from treated mice and 1,000,000 support bone marrow cells. Error bars

represent the mean ± s.e.m. * p<0.05, n=4-5.

Fig. S5. Bone marrow composition after various doses of radiation. Hematoxylin and eosin

staining of bone marrow sections depicting loss of bone marrow mono-nuclear cells at 7 days

post 1000 rads radiation as compared to lower doses and untreated controls.

Fig. S6. Preconditioning with anti–c-Kit and CV1mb enables long-term multilineage

congenic hematopoietic engraftment in immunocompetent mice 20 weeks after

transplantation. Donor chimerism of Gr-1+Mac-1+ myeloid cells in a, bone marrow and e,

spleen. b, Donor derived chimerism of CD19+ B cells in bone marrow. Donor derived chimerism

of NK1.1+ natural killer cells in c, bone marrow and g, spleen. d, Donor derived chimerism of

CD3+ T cells in the bone marrow. f, Donor derived CD19+B220+ B cells and h, CD3+TCRβ+ T

cells in spleen. i, CD4+Thy1.1+ T cell chimerism in the thymus. Data and error bars in panels

represent the mean ± s.e.m. **** p<0.0001, *** p<0.005.

Fig. S7. Preconditioning with anti–c-Kit and CV1mb enables stable multilineage chimerism

in peripheral blood. Donor chimerism of a, Gr-1+Mac-1+ myeloid cells b, CD19+ B cells and c,

CD3+ T cells in peripheral blood starting at 4 weeks post transplant over the course of 24 weeks.

Lines represent individual mice.

Fig. S8. Comparison of conditioning by combined anti–c-Kit and CD47 blockade versus

radiation. Frequency of donor derived Lin-c-Kit+Sca-1+CD150+ HSCs in the bone marrow 24

weeks after transplant in recipients treated with ACK2 and CV1mb as compared to mice

conditioned with 250, 450, or 750 rads of ionizing radiation (IR) (mean ± s.e.m. ** p<0.01).

C57Bl/6 F1 mice expressing both alleles CD45.1 and CD45.2 were irradiated with respective

doses or treated with 500 μg of ACK2 once and 500 μg of CV1mb daily for 5 days. On the sixth

day post-treatment or 4 hours post irradiation 50,000 LSK HSCs from parental C57Bl/6 mice

were transplanted for 3 consecutive days.

Fig. S9. Anti–c-Kit antibody ACK2 combined with additional CD47-blocking reagents

enhances depletion of functional HSC in immunocompetent mice. a, Schematic depicting

size and structure of CV1 monomer (CV1) and anti-CD47 antibody MIAP410. b, Frequency of

donor derived Mac-1+Gr-1+ myeloid cells in the peripheral blood 8 weeks after transplant into

lethally-irradiated from donors pretreated with ACK2 and the indicated CD47-targeting reagents

as compared to untreated mice (mean ± s.e.m. * p<0.05, n=3-5). Recipients were transplanted

with 1,000,000 whole bone marrow cells from treated donor mice and 1,000,000 support bone

marrow cells to quantify engraftment of functional HSCs.

Fig. S10. Anti–c-Kit antibody ACK2 combined with additional CD47-blocking reagents

enables myeloid and lymphoid chimerism in transplanted immunocompetent recipients.

Frequency of donor derived a, Mac-1+Gr-1+ myeloid cells b, CD19+ B cells and c, CD3+ T cells

in the peripheral blood 24 weeks after transplant in recipients treated with ACK2 and the

indicated CD47-targeting reagents as compared to untreated mice (mean ± s.e.m. * p<0.05, n=3-

5).

Fig. S11. Transient depletion of RBC parameters is observed using the combination of

ACK2 and anti-CD47 antibody. a, Red blood cell count and b, hemoglobin as determined by

complete blood counts of peripheral blood of WT mice following treatment with anti-c-Kit

antibody ACK2, or the combination of ACK2 and anti-CD47 antibody MIAP410 as compared to

untreated controls (n=5 for untreated and ACK2, n=7 for ACK2+MIAP410). Mice treated with

ACK2 + MIAP410 were given supportive blood transfusions at days 6, 7, 8 and 10 post ACK2

treatment.

Fig. S12. Preconditioning with anti–c-Kit and anti-CD47 in combination with T cell–

depleting antibodies enables stable multilineage chimerism in peripheral blood in an mHC-

mismatched model of HSC allotransplantation. Donor chimerism of a, Gr-1+Mac-1+ myeloid

cells b, CD19+ B cells and c, CD3+ T cells in peripheral blood starting at 4 weeks post transplant

over the course of 24 weeks. Lines represent individual mice.

Fig. S13. Preconditioning with anti–c-Kit, anti-CD47, and T cell–depleting antibodies

enables long-term multilineage chimerism in immunocompetent mice 24 weeks after

transplantation in an mHC-mismatched model of HSC allotransplantation. Donor

chimerism of Gr-1+Mac-1+ myeloid cells in a, peripheral blood and f, spleen. Donor derived

chimerism of CD19+ B cells in b, peripheral blood. Donor derived chimerism of Dx5+CD122+

natural killer cells in c, peripheral blood and h, spleen. d, Donor derived chimerism of CD3+ T

cells in the peripheral blood. g, Donor derived CD19+B220+ B cells and i, CD3+TCRβ+ T cells in

spleen. e, CD4+/CD4+CD8+/CD8+ T cell chimerism in the thymus. Data and error bars in panels

represent the mean ± s.e.m. * p<0.05, ** p<0.01.