Patients with head and neck squamous cell carcinoma (HNSCC) have profound immune deficiencies. In 65% of these patients, there is an increased intra-tumoral presence of immune-suppressive CD34(+) progenitor cells. The goal of the present study was to determine whether CD34(+) cell levels were also increased in the peripheral blood of HNSCC patients and if these immune-suppressive cells could be differentiated into dendritic cells. Our results showed that CD34(+) cell levels are increased in the peripheral blood of HNSCC patients. To assess if these CD34(+) cells could differentiate into dendritic cells, they were isolated from the blood of HNSCC patients and cultured for 12 days with various cytokine combinations. Culturing CD34(+) cells with stem cell factor (c-kit ligand) plus granulocyte-macrophage colony-stimulating factor resulted in the appearance of a significant proportion of cells expressing phenotypic markers characteristic of dendritic cells. Also, including tumor necrosis factor-alpha yielded a significant proportion of cells resembling the bi-potential precursor cells for dendritic cells and monocytes (CD14(+)CD1a(+)), in addition to the dendritic-like cells. When the differentiation inducer 1 alpha,25-dihydroxyvitamin D-3 [1,25(OH)(2)D-3] was added along with the cytokine combinations, the yield of cells having characteristics of dendritic cells was further increased. Cells that were derived from CD34(+) cell cultures containing 1,25(OH)(2)D-3 had a more potent capacity to present the recall antigen tetanus toxoid to autologous peripheral blood leukocytes and to stimulate a mixed leukocyte response compared to cultures to which 1,25(OH)2D, had not been added. Our results show that CD34(+) cells, whose frequency is increased in HNSCC patients, can be differentiated into cells that phenotypically and functionally resemble dendritic cells and that 1,25(OH)(2)D-3 accentuates this differentiation. (C) 1997 Wiley-Liss, Inc.