Hematopoietic stem cell (HSC) transplantation is a proven treatment for hematologic/immunologic disorders, including leukemias, immunodeficiencies, and autoimmune diseases. The on-demand production of HSCs from pluripotent stem cells (PSCs) for such therapies is one of the greatest promises of regenerative medicine and, as recent work has shown, is now possible. In this study, we have built on these and other findings to establish a protocol that promotes the reliable and efficient generation of long-term engrafting HSCs from both human embryonic and induced PSCs. Three key differentiation steps were refined and optimized in this work. For the first step, mesoderm induction, the WNT, FGF, ACTIVIN/NODAL, and BMP pathways were manipulated in a staged fashion to yield populations consisting of greater than 90% APJ+ and RALDH2+ cells from all hPSC lines tested. The next step, specification of the hemato-vascular fate, was optimized with precise levels of VEGF/BMP signaling to generate populations of > 90% CD34+ cells. Finally, the differentiation of the CD34+ hemato-vascular cells to CD34+ hematopoietic progenitors was carried out under conditions designed to maintain engraftment potential. Day 15 CD34+ cells generated in this way demonstrate multilineage engraftment (10%–60%) 20 weeks after transplantation into NSG W41 mice. Notably, most mice (> 75%) transplanted with between 5 × 105 and 2 × 106 cells show multilineage engraftment. To characterize the temporal patterns of repopulation, we sampled bone marrow of the recipient animals at different times and found that a graft of > 5% present relatively early is predictive of long-term engraftment (at 20 weeks). The ability to assess engraftment early will significantly decrease the iteration time for further improving the efficiency of HSC production, an essential next step for translation to therapeutic applications.
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