Use of dextran 75 as a macromolecular agent in centrifugal leukapheresis

Twenty-five leukaphereses were done by the Haemonetics system using citrated Dextran 75 in normal saline as anticoagulant, and were compared with a much larger series using hydroxyethyl starch (HES) with and without steroid premedication. The granulocyte and platelet yields were only minimally different between the two agents. Both were inferior in granulocyte collection to the group that was premedicated with a steroid. Dextran is thus a satisfactory substitute for HES in leukapheresis with this system.

Ex vivo expansion of mobilized peripheral blood stem cells

The scarcity of donors for allogeneic bone marrow transplantation, the limited number of haematopoietic stem cell (HSC)/progenitors in cord blood samples and the sometimes insufficient number of mobilized peripheral blood cells collected from heavily treated cancer patients may benefit from ex vivo expansion of these cells for clinical transplantation. Depending on the clinical application, expansion of different haematopoietic cell subsets is required. HSC transplantation requires expansion of all cellular subsets including precursors, progenitors and HSCs for the short and long-term engraftment of patients. Quiescent HSCs may also be required for gene therapy by retrovirus. Finally, amplification of cells such as dendritic cells (DC) and different subsets of T and natural killer (NK) cells is required for immunotherapy. The different haematopoietic lineages are produced under different experimental conditions and the starting population is a critical parameter for the proposed clinical application. So it is essential to define the aims of haematopoietic cell expansion and to adapt the experimental conditions to obtain the required cell population. Mobilized peripheral blood cells are increasingly used as a source of haematopoietic cells. We review the biological characteristics of mobilized peripheral blood and the expansion of the different components according to the aims of their clinical use in the context of the progress currently achieved.

Optimal method for isolation of human peritoneal mesothelial cells from clinical samples of omentum

INTRODUCTION

Human peritoneal mesothelial cells (HPMC) are a valuable research tool for understanding the molecular biology of several pathologies, in both monolayer and three dimensional models. We compared different methods of HPMC isolation and assessed their outcome as well as fibroblast contamination, a common problem encountered during isolation.

METHODS

1-3cm(3) samples of omentum were collected from 40 consenting patients undergoing elective gastrointestinal surgery. A total of 11 samples were incubated in 0.05% trypsin solution for 20 minutes at 37 degrees C (group A) and 29 in 0.25% trypsin (15 samples for 10 minutes (group B) and 14 for 20 minutes (group C)). Following digestion cells were re-suspended and cultured in supplemented Ham's F-12 medium containing 10% foetal calf serum (FCS), penicillin-streptomycin, glutamine, insulin, transferrin and hydrocortisone. Positive outcomes were absence of fibroblast contamination and satisfactory HPMC growth to confluence in a characteristic cobblestone pattern. Cytokeratins 5, 8, 18, Vimentin, Ber-Ep4 and Factor VIII were used to characterise HPMC and fibroblasts by immunohistochemistry.

RESULTS

None of the 11 samples in group A yielded HPMC. 14 of 29 samples digested with 0.25% trypsin yielded HPMC: 10 of 14 yielded HPMC in group C versus four of 15 samples in group B (p = 0.02). Fibroblast contamination occurred in eight samples in group B versus three in group C.

CONCLUSION

Optimal results are achieved with a 20 minute digestion in 0.25% trypsin. Fibroblast contamination could not be avoided completely. Other factors may minimise fibroblast contamination such as minimal tissue manipulation and early collection during surgery.

Lymphocyte subsets in inline filtered packed red blood cell units: comparison between low and high spin procedures

Lymphocyte subsets were determined in 20 packed red blood cell units (PRC) before and after filtration (FPRC) with the Pall Leukotrap RC inline filter system; 10 units were prepared by low spin and platelet rich plasma (PRP) removal (Group A) and 10 with high spin, plasma and buffy-coat (BC) removal (Group B). Flow cytometry was employed for white blood cell (WBC) enumeration and phenotype analysis. Median WBCs in prefiltered units was 2.08 x 10(9) (Group A) vs. 0.8 x 10(9) (Group B) (p < 0.0001). Five Group A and three Group B filtered units had WBC counts above the limit of detection (LD), median values being 25.59 and 3.08 x 10(3), respectively. Whereas CD3+, CD3+CD4+ and CD3+CD8+ lymphocyte subsets were assessable in 20-40% of Group A units, inline filtration of Group B units lowered lymphocytes below the LD of the present study. Post-filtration CD19+ lymphocytes were below the LD in all the 20 units.

[A novel model for isolation of Walker's tumoral cells using the Ficoll-Hypaque gradient]

PURPOSE

The purpose was to evaluate a novel technique for isolation of Walker's tumoral cells using a Ficoll-Hypaque gradient and its further influence on tumor development.

METHODS

Twenty male Wistar rats have been divided in 2 groups: G1= without ficoll, G2= with ficoll. Tumor was excised, homogenized and suspended in lactate ringer. A sample of the cell suspension was adjusted at a concentration of 1x10(6) cells/ml (G1). A second sample was centrifuged on a Ficoll-Hypaque gradient and the cell concentration was then adjusted (G2). Tumor was implanted by subcutaneous injection of 1.0 ml in the right armpit of rats. Tumor volume (TV) and tumor weight (TW) were compared in two groups.

RESULTS

There were no differences between the two groups in TV (G1=17.9+/-3.8 cm3 vs. G2=17.2+/-4.4 cm3; p=0.190) and TW (G1=7.0+/-1.8 g vs. G2=7.3+/-2.8 g; p=0.569). The histological analysis showed similar patterns of infiltration by small-undifferentiated cells and necrosis in both groups. However, a mild to moderate granulocytic exudate was more frequent in the animals whose tumors derived from Ficoll-isolated cells. Hemorrhage from slight to moderate was only observed in this group.

CONCLUSION

A Ficoll-Hypaque gradient can provide more adequate isolation of Walker's tumor and the cell suspension obtained by this technique has lower contamination by other cell types.

An in vitro method for predicting the efficacy of WBC separation using different starch preparations and anticoagulant ratios

BACKGROUND

Separation of blood components depends on a number of factors, including the viscosity of the plasma and the number and size of the various cellular elements. To enhance granulocyte collection, it is common practice to alter the plasma environment by the addition of sedimenting agents such as hydroxyethyl starch. Recently, because of its prolonged persistence in the circulation, the higher-molecular-weight form of hydroxyethyl starch, Hespan (HP), has been replaced by the lower-molecular-weight form, pentastarch (PS). However, the yield appears to be lower. A rapid in vitro approach was used to permit comparison of the efficiency of separation of WBCs by the use of PS and HP and different ratios of anticoagulants that also alter the sedimenting characteristics of blood.

STUDY DESIGN AND METHOD

Blood from individual persons was collected into sodium citrate at ratios of 1:8, 1:12, and 1:16. Samples were evaluated either before or after the addition of PS or HP and after centrifugation.

RESULTS

The addition of HP increased the sedimentation rate to at least four times that of plasma (10.9 vs. 47.9 mm); PS approximately doubled the rate. Viscosity was altered by the introduction of either starch. These changes (ranging from a rate of 4.2 in HP with a 1:16 anticoagulant to 3.6 in PS with a 1:8 ratio of anticoagulant) reflected the anticipated effects of anticoagulant dilution and carbohydrate addition. Granulocyte recovery was highest, with a 1:12 anticoagulant ratio in all tests with HP producing the greatest yield (HP, 101%; PS, 89%; control, 78%).

CONCLUSION

HP is far more effective than its lower-molecular-weight substitute PS in the generation of granulocytes in the buffy coat of whole blood. This method provides a simple, rapid, in vitro approach to evaluating the separating efficiency of solutions.

High gradient magnetic cell sorting and internal standardisation substantially improve the assay for somatic mutations at the glycophorin A (GPA) locus

In the MACS-BR6 version of the GPA assay [Int. J. Radiat. Res. 70 (1996) 131] variant red blood cells (RBC) are isolated from 5 x 10(8) normal RBC by magnetic cell separation (MACS) before detection and quantification by immunolabelling and flow cytometry as in the classical BR6 assay. In the present work it is described how the MACS-BR6 assay is improved by internal standardisation with FITC-labelled RBC. This modification of the assay has the advantage that (i) the analysis of variants is not disturbed by the overwhelming number of normal RBC that (ii) the precision of the assay is improved and finally that (iii) a sufficient number of variants is available for further investigations. Tn positive RBC behave in MACS like variants. It is demonstrated that in normal individuals Tn cells (frequency: approximately 2 x 10(-8)) do not disturb the assay.

Negative selection of autologous peripheral blood stem cells

The use of chemotherapy and/or haematopoietic growth factor-mobilized peripheral blood stem cells (PBSC) has been shown to induce a more rapid haematopoietic recovery than the reinfusion of bone marrow (BM)-derived haematopoietic cells, thus reducing the morbidity and mortality of autologous stem cell transplantation (ASCT). PBSC collections were initially believed to have a lower incidence of tumour cells involvement than BM harvests. However, recent studies have shown that mobilized blood cell products of cancer patients eligible for autografting are frequently contaminated with tumour cells. Whereas positive selection of haematopoietic CD34+ stem cells has been largely used as a means of indirect purging of circulating CD34+ neoplastic cells, few groups have addressed the issue of tumour cell removal by direct targeting of cancer cells using physical or pharmacological strategies. In this chapter we review the available data concerning the contamination of tumour cells in PBSC collections from cancer patients, the functional and kinetic characteristics of primed CD34+ cells which may affect the haematopoietic toxicity of purging procedures developed to eliminate the minimal residual disease (MRD) from BM samples, and the preclinical and clinical results of the selective killing of residual tumour cells from leukaphereses. The limited amount of data published so far do not allow any firm conclusion on the clinical usefulness of purging protocols. Nonetheless, the successful extension of ex vivo purging to PBSC collections may improve the feasibility of randomized studies aimed at determining the importance of tumour-free autografts.

T-cell depletion of allogeneic peripheral blood stem cells

The high content of immunocompetent T-cells in apheresis products may expose recipients of allogeneic peripheral blood stem cells (PBSC) to an elevated risk of acute and chronic graft-versus-host disease (GvHD). Thus, the use of an appropriate T-cell reduction or depletion technique might reduce this risk. The hazards of rejection and of a higher relapse rate should be avoided by maintaining a portion of the T-cells in the graft or by increasing the number of transplanted stem cells. The positive selection of CD34+ cells from peripheral blood preparations simultaneously provides an approximately 1,000-fold reduction of T-cells. Purified CD34+ cells containing committed and pluripotent stem cells are suitable for allogeneic transplantation. In transplantation from HLA-mismatched or three HLA-loci different family donors the amount of stem cells can be increased for reducing the incidence of rejection without increasing the T-cell number. In cases of poor marrow graft function a 'boost' with stem cells from the same family donor can be given. The risk of GvHD in transplantation from volunteer-matched unrelated donors might be reduced by T-cell depletion. If T-cells are used for enhancing the graft-versus-leukaemia effect, CD34+ enriched cells can be given for haematopoietic engraftment.

White blood cell subsets in buffy coat-derived platelet concentrates: the effect of pre- and poststorage filtration

BACKGROUND AND OBJECTIVES

Our objective was to study the effect of storage time on the filtration of platelet concentrates (PCs). We compared the total number of white blood cells (WBC), as well as the distribution of WBC subsets, in units filtered before and after storage.

MATERIALS AND METHODS

Buffy coat-derived PCs were filtered either fresh or after 5 days of storage, and total WBC were enumerated by flow cytometry. WBC subsets were analyzed by flow cytometry with three-color fluorescence.

RESULTS

The total number of white cells before filtration was significantly higher in fresh units compared with stored units, whereas in postfiltration samples the number of white cells was significantly lower in the fresh compared with the stored units. Although absolute numbers were significantly reduced, filtration also induced significant changes in the proportions of subsets in both fresh and stored units; the percentage of T cells was decreased, whereas the percentage of B cells and monocytes was increased after filtration.

CONCLUSION

Our results suggest that prestorage WBC filtration of platelet concentrates is superior in reducing the absolute numbers of WBC. However, both pre- and poststorage WBC filtration significantly affect the proportions of WBC in the final product, decreasing the number of T cells while apparently increasing the proportion of MHC class II-positive cell populations.

[Quality control management. Application to the production of unstable blood components]

The quality controls of blood components, realised in Transfusion Centres, are necessary to check the true conformity of products in accordance with official standards. This controls are insufficient to enhance blood components quality. The practical application of the quality management allows us to reach this aim easier. After the quality display, after it efficiency and regulatory measurement and after a quality objectives selection, we consider that the professional training and the data presentation contribute to the necessary confidence for a better quality management. Finally, standardization and automatization of production processes constitute the only ways to improve the real quality, to decrease waste products and, of course, to increase the productivity.

Fetal cells in the maternal circulation

The analysis of fetal cells from the maternal circulation would be the least invasive method of prenatal diagnosis. Potential fetal cell types to enter the maternal circulation are lymphocytes, trophoblast cells and nucleated erythrocytes. With conventional methods, such as cytology and interphase or metaphase cytogenetics, the ratio of fetal to maternal cells was overestimated in the past. Currently most groups use polymerase chain reaction-based Y-sequence analysis for the detection of fetal cells in pregnancies with male fetuses, either with or without prior enrichment of fetal cells. For fetal cell separation, fluorescence-activated cell sorting and immunomagnetic beads have been applied, and recently our group has used discontinuous density gradient centrifugation for this purpose. We have shown that the transferrin receptor antigen alone is not sufficient for enrichment of fetal nucleated erythrocytes. Despite some initial promising results with fluorescence in situ hybridization, the reproducibility and reliability of the techniques are still limited, mainly due to the lack of very specific cell markers and the very low and variable concentrations of fetal cells among numerous maternal cells.

Comparing cooling systems for the COBE 2991 cell separator used in the purification of human pancreatic islets of Langerhans

Two different approaches of controlled cooling of the COBE 2991 cell-separator for islet purification were evaluated. The first method is the new Geneva COBE cooling system (GCCS), which consists of an electronically controlled liquid nitrogen injection system. The second is the University of Illinois at Chicago cooling system (UICCS), which consists of a specially designed "Cold Room" maintained at 1-8 C. For the GCCS, the mean temperatures of the gradient solutions were measured at the beginning and end of centrifugation were found to be 7 +/-0.7 C and 6.8 +/-0.6 C respectively. For the UICCS, the mean temperature of the gradients at the beginning and end of centrifugation were 4.7 +/-0.53 C and 7.03 C+/-0.91 C respectively. The presented COBE cooling systems can easily be adapted to a COBE 2991 cell-separator and are efficient in maintaining gradient solutions at a defined low temperature during centrifugation.

Validation of an acrosomal stain for equine sperm that differentiates between living and dead sperm

An acrosomal staining technique that can differentiate between living and dead sperm was developed for equine sperm. The fluoresceinated lectin Pisum sativum agglutinin (FITC-PSA) was used to identify the presence or absence of acrosomal contents, while the supravital nuclear dye Hoechst 33258 (H258) was used to assess viability. The accuracy of the FITC-PSA acrosomal stain was tested by comparing the percentage of sperm that had lost their acrosomal contents, detected by the staining method, with that detected by transmission electron microscopy (TEM). Following capacitation in vitro, the acrosomal status of sperm induced to acrosome react with A23187 and of control sperm were very similar with the staining technique and TEM, confirming the accuracy of the FITC-PSA acrosomal stain. We investigated the relationship between viability as measured by exclusion of H258 and motility as measured by three methods: one subjective and two objective. Although there was a good correlation between viability and motility as measured by all three methods (r = 0.88, 0.85, 0.75), there was always a proportion of viable sperm that were nonmotile. The physiology of the viable, nonmotile sperm was further investigated by comparing for individual sperm the viability as measured by exclusion of H258 with the mitochondrial function as measured by rhodamine 123. A good correlation (r = 0.99) was found to exist between viability and mitochondrial function, indicating that viable, nonmotile sperm possess functional mitochondria and confirming the ability of supravital staining to distinguish between living and dead sperm. We determined that 29-81% of the sperm in semen that had lost their acrosomal contents were in fact dead. Thus, this acrosomal staining technique can provide more relevant endpoints for future investigations of capacitation, the acrosome reaction, and sperm handling techniques in the horse.

Increased anticoagulant osmolality improves separation of leukocytes from red blood cells (RBC)

BACKGROUND

The bottom-and-top (BAT) procedure separates the buffy coat (BC) from plasma and red blood cells (RBC). The contents of mononuclear cells (MNC) remaining in the RBC are about 1 x 10(6) cells/unit, whereas the granulocytes are removed less effectively, 500-800 x 10(6) or more remaining in the RBC unit. The aim was to improve the separation efficacy by collecting the blood in an hyperosmolar anticoagulant, followed by BAT separation. It was expected that the red cells would shrink, thereby increasing their density, while the granulocytes would not change volume and density.

STUDY DESIGN AND METHODS

18 donors were included in the study, 12 in the test group and 6 in the control group. CPD-SAGM bags were used, with a modification of the anticoagulant by removal of 20-ml CPD from all units and addition of 20-ml mannitol (test group) or 20 ml of isotonic saline (control group). The collected blood units were cooled on butanediol plates for 2-4 h, then centrifuged and separated into components. The levels of leukocytes in the whole blood, the BC and the RBC were determined by flow cytometry gated for intact CD45+ cells. A number of other tests were performed during 42-day storage.

RESULTS

The plasma yield was slightly higher in the test group than in the control group (ns). The contents of leukocytes (CD 45+ intact cells) in the RBC units were 32 +/- 20 x 10(6) in the test group and 573 +/- 241 x 10(6) in the control group. The numbers of MNC were 1.2 +/- 0.6 x 10(6) and 2.6 +/- 1.8 x 10(6), respectively. The RBC 2,3-DPG concentration was slightly better maintained in the test group at day 7 of refrigerated storage (p = 0.0027), but most other tested parameters showed no difference during 42-day storage. It was possible to prepare platelet concentrates with good yield using the pooled-BC method.

CONCLUSION

This study indicates that considerable improvement in the BAT procedure can be obtained if the anticoagulant is made hypertonic by the addition of mannitol. This is achieved without altering the already low levels of MNC and keeping the same quality.