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Worel N, Holbro A, Vrielink H, Ootjers C, Le Poole K, Beer-Wekking I, Rintala T, Lozano M, Bonig H. A guide to the collection of T-cells by apheresis for ATMP manufacturing-recommendations of the GoCART coalition apheresis working group. Bone Marrow Transplant 2023; 58:742-748. [PMID: 37024570 DOI: 10.1038/s41409-023-01957-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/03/2023] [Accepted: 03/13/2023] [Indexed: 04/08/2023]
Abstract
Autologous chimeric antigen receptor-modified T-cells (CAR-T) provide meaningful benefit for otherwise refractory malignancies. As clinical indications for CAR-T cells are expanding, hospitals hitherto not active in the field of immune effector cell therapy will need to build capacity and expertise. The GoCART Coalition seeks to disseminate knowledge and skills to facilitate the introduction of CAR-T cells and to standardize management and documentation of CAR-T cell recipients, in order to optimize outcomes and to be able to benchmark clinical results against other centers. Apheresis generates the starting material for CAR-T cell manufacturing. This guide provides some initial suggestions for patient's apheresis readiness and performance to collect starting material and should thus facilitate the implementation of a CAR-T-starting material apheresis facility. It cannot replace, of course, the extensive training needed to perform qualitative apheresis collections in compliance with national and international regulations and assess their cellular composition and biological safety.
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Affiliation(s)
- Nina Worel
- Department for Transfusion Medicine and Cell Therapy, Medical University of Vienna, Vienna, Austria.
| | - Andreas Holbro
- Regional Blood Transfusion Service, Swiss Red Cross, Basel, Switzerland
- Division of Hematology, University Hospital Basel and University Basel, Basel, Switzerland
- Innovation Focus Cell Therapies, University Hospital Basel, Basel, Switzerland
| | - Hans Vrielink
- Department for Transfusion Medicine, Sanquin Blood Supply, Amsterdam, The Netherlands
| | - Claudia Ootjers
- Department of Hematology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Kaatje Le Poole
- Department for Transfusion Medicine, Sanquin Blood Supply, Amsterdam, The Netherlands
| | - Ingrid Beer-Wekking
- Department of Hematology, Leiden University Medical Centre, Leiden, The Netherlands
| | | | - Miquel Lozano
- Apheresis and Cellular Therapy Unit, Department of Hemotherapy and Hemostasis, University Clinic Hospital, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Halvard Bonig
- Institute for Transfusion Medicine and Immunohematology, Goethe University, Frankfurt a.M., Germany
- Department of Medicine, Division of Hematology, University of Washington, Seattle, WA, USA
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2
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Chung Y, Kong JH, Hu Y, Lee SN, Shim H, Eom HS, Kong SY. Comparison of spectra optia and amicus cell separators for autologous peripheral blood stem cell collection. J Clin Apher 2020; 36:28-33. [PMID: 32882095 DOI: 10.1002/jca.21835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 08/09/2020] [Accepted: 08/10/2020] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Autologous peripheral blood stem cell (PBSC) transplantation has become a standard treatment option for many oncology patients. The aim of this study was to evaluate the performance of two cell separators, Spectra Optia (Terumo BCT, Japan) and Amicus (Fresenius-Kabi) for autologous PBSC collection. METHODS We retrospectively evaluated 56 apheresis by Spectra Optia with Continuous Mononuclear Cell Collection (cMNC) from 20 patients, and 50 apheresis by Amicus from 27 patients between December 2018 and December 2019. CD34+ collection efficiency (CE2) and platelet (PLT) loss were evaluated. RESULTS There was no significant difference in CD34+ CE2 between Spectra Optia with cMNC (median, 28.8%) and Amicus (median, 33.1%; P = 0.537). PLT loss was significantly lower in Amicus (median, 28.6%) than in Spectra Optia with cMNC (median, 37.8%; P = 0.009). CONCLUSION CD34+ CE2 was comparable between Spectra Optia and Amicus, and PLT loss was significantly lower in Amicus. To the best of our knowledge, this is the first report comparing autologous PBSC collection of the Spectra Optia and Amicus. These results may provide general guidance with regard to device selection to apheresis clinics that use both separators for optimal outcomes depending on each patient's characteristics.
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Affiliation(s)
- Yousun Chung
- Department of Laboratory Medicine, Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Jung Hee Kong
- Department of Laboratory Medicine, National Cancer Center, Goyang, South Korea
| | - Youmi Hu
- Department of Laboratory Medicine, National Cancer Center, Goyang, South Korea
| | - Se-Na Lee
- Department of Laboratory Medicine, National Cancer Center, Goyang, South Korea
| | - Hyoeun Shim
- Department of Laboratory Medicine, National Cancer Center, Goyang, South Korea
| | - Hyeon-Seok Eom
- Department of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer Center, Goyang, South Korea
| | - Sun-Young Kong
- Department of Laboratory Medicine, National Cancer Center, Goyang, South Korea
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3
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Jarisch A, Rettinger E, Sörensen J, Klingebiel T, Schäfer R, Seifried E, Bader P, Bonig H. Unstimulated apheresis for chimeric antigen receptor manufacturing in pediatric/adolescent acute lymphoblastic leukemia patients. J Clin Apher 2020; 35:398-405. [PMID: 32750197 DOI: 10.1002/jca.21812] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/22/2020] [Accepted: 06/22/2020] [Indexed: 12/30/2022]
Abstract
Autologous unstimulated leukapheresis product serves as starting material for a variety of innovative cell therapy products, including chimeric antigen receptor (CAR)-modified T-cells. Although it may be reasonable to assume feasibility and efficiency of apheresis for CAR-T cell manufacture, several idiosyncrasies of these patients warrant their separate analysis: target cells (mononuclear cells [MNC] and T-cells) are relatively few which may instruct the selection of apheresis technology, low body weight, and, hence, low total blood volume (TBV) can restrict process and product volume, and patients may be in compromised health. We here report outcome data from 46 consecutive leukaphereses in 33 unique pediatric patients performed for the purpose of CD19-CAR-T-cell manufacturing. Apheresis targets of 2×109 MNC/1×109 T-cells were defined by marketing authorization holder specification. Patient weight was 8 to 84 kg; TBV was 0.6 to 5.1 L. Spectra Optia apheresis technology was used. For 23 patients, a single apheresis sufficed to generate enough cells and manufacture CAR-T-cells, the remainder required two aphereses to meet target dose and/or two apheresis series because of production failure. Aphereses were technically feasible and clinically tolerable without serious adverse effects. The median collection efficiencies for MNC and T-cells were 53% and 56%, respectively. In summary, CAR apheresis in pediatric patients, including the very young, is feasible, safe and efficient, but the specified cell dose targets can be challenging in smaller children. Continuous monitoring of apheresis outcomes is advocated in order to maintain quality.
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Affiliation(s)
- Andrea Jarisch
- Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Children and Adolescents, Goethe University, Frankfurt/Main, Germany
| | - Eva Rettinger
- Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Children and Adolescents, Goethe University, Frankfurt/Main, Germany
| | - Jan Sörensen
- Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Children and Adolescents, Goethe University, Frankfurt/Main, Germany
| | - Thomas Klingebiel
- Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Children and Adolescents, Goethe University, Frankfurt/Main, Germany
| | - Richard Schäfer
- German Red Cross Blood Service Baden-Württemberg-Hessen, Institute Frankfurt/Main, Frankfurt/Main, Germany
| | - Erhard Seifried
- German Red Cross Blood Service Baden-Württemberg-Hessen, Institute Frankfurt/Main, Frankfurt/Main, Germany.,Institute for Transfusion Medicine and Immunohematology, Goethe University, Frankfurt/Main, Germany
| | - Peter Bader
- Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Children and Adolescents, Goethe University, Frankfurt/Main, Germany
| | - Halvard Bonig
- German Red Cross Blood Service Baden-Württemberg-Hessen, Institute Frankfurt/Main, Frankfurt/Main, Germany.,Institute for Transfusion Medicine and Immunohematology, Goethe University, Frankfurt/Main, Germany.,Division of Hematology, Department of Medicine, University of Washington, Seattle, Washington, USA
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4
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Fesnak AD. The Challenge of Variability in Chimeric Antigen Receptor T cell Manufacturing. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2019; 6:322-329. [PMID: 33313382 DOI: 10.1007/s40883-019-00124-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Autologous Chimeric Antigen Receptor (CAR) T cell manufacturing involves the modification and expansion of T cells obtained by apheresis collection from a patient. The mechanism of apheresis collection and the specific clinical features seen in these patients combine to generate apheresis products with high variability of content. Manufacturers often attempt to minimize this variability such that processes can be standardize in accordance with Good Manufacturing Practices (GMP). Such standardization improves efficiency and helps to ensure robustness of the overall process. Apheresis product variability can negatively impact T cell manufacturing success. Patient and collection driven variability often leads to non-T cells entering the apheresis product. Many of these cells can directly or indirectly impair T cell activation and expansion, decreasing the manufacturing success rate. Therefore, patient driven variability observed in apheresis products, must be mitigated through downstream processing. T cell enrichment is one step in the manufacturing cycle that can reduce process variability by generating more uniform downstream material. However, current T cell enrichment methods have limitations. Much of this type of variability can be avoided by collecting patients earlier in their disease or treatment course, this is not current, widespread or standard practice. While variability poses challenges to successful CAR T cell manufacturing and mitigation strategies can be successful, more work is needed in this area.
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Affiliation(s)
- Andrew D Fesnak
- Perelman School Of Medicine, University of Pennsylvania, 3400 Spruce Street, 3 Ravdin Building - R3067, Philadelphia, PA 19104
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5
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Ali S, Chiang K, Even‐Or E, Di Mola M, Schechter T, Ali M, McDougall E, Svajger G, Licht C, Krueger J. Comparison between intermittent and continuous leukapheresis protocols for autologous hematopoietic stem cell collections in children. J Clin Apher 2019; 34:646-655. [DOI: 10.1002/jca.21741] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 02/03/2019] [Accepted: 08/02/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Salah Ali
- Division of Hematology/Oncology/BMTThe Hospital for Sick Children Ontario Canada
| | - Kuang‐Yueh Chiang
- Division of Hematology/Oncology/BMTThe Hospital for Sick Children Ontario Canada
- Department of PaediatricsUniversity of Toronto Toronto Ontario Canada
| | - Ehud Even‐Or
- Department of Bone Marrow TransplantationHadassah Medical Center Jerusalem Israel
| | - Maria Di Mola
- Division of NephrologyThe Hospital for Sick Children Toronto, Ontario Canada
| | - Tal Schechter
- Division of Hematology/Oncology/BMTThe Hospital for Sick Children Ontario Canada
- Department of PaediatricsUniversity of Toronto Toronto Ontario Canada
| | - Muhammad Ali
- Division of Hematology/Oncology/BMTThe Hospital for Sick Children Ontario Canada
- Department of PaediatricsUniversity of Toronto Toronto Ontario Canada
| | - Elizabeth McDougall
- Department of Pediatric Laboratory Medicine and PathobiologyThe Hospital for Sick Children Toronto, Ontario Canada
| | - Gordana Svajger
- Division of Hematology/Oncology/BMTThe Hospital for Sick Children Ontario Canada
| | - Christoph Licht
- Department of PaediatricsUniversity of Toronto Toronto Ontario Canada
- Division of NephrologyThe Hospital for Sick Children Toronto, Ontario Canada
| | - Joerg Krueger
- Division of Hematology/Oncology/BMTThe Hospital for Sick Children Ontario Canada
- Department of PaediatricsUniversity of Toronto Toronto Ontario Canada
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Mielcarek‐Siedziuk M, Gajek K, Musiał J, Rybka B, Ryczan‐Krawczyk R, Stachowiak M, Ussowicz M. Safety and efficacy of autologous mononuclear cell and stem cell apheresis in very low‐weight children—Experience at a single center. J Clin Apher 2019; 34:563-570. [DOI: 10.1002/jca.21713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 02/24/2019] [Accepted: 05/17/2019] [Indexed: 12/24/2022]
Affiliation(s)
- Monika Mielcarek‐Siedziuk
- Department of Pediatric Bone Marrow Transplantation, Oncology, and HematologyWroclaw Medical University Wroclaw Poland
| | - Kornelia Gajek
- Department of Pediatric Bone Marrow Transplantation, Oncology, and HematologyWroclaw Medical University Wroclaw Poland
| | - Jakub Musiał
- Department of Pediatric Oncology and HematologyClinical Hospital No. 2 Rzeszow Poland
| | - Blanka Rybka
- Department of Pediatric Bone Marrow Transplantation, Oncology, and HematologyWroclaw Medical University Wroclaw Poland
| | - Renata Ryczan‐Krawczyk
- Department of Pediatric Bone Marrow Transplantation, Oncology, and HematologyWroclaw Medical University Wroclaw Poland
| | | | - Marek Ussowicz
- Department of Pediatric Bone Marrow Transplantation, Oncology, and HematologyWroclaw Medical University Wroclaw Poland
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Bailén R, Pérez-Corral AM, Pascual C, Kwon M, Serrano D, Gayoso J, Balsalobre P, Muñoz C, Díez-Martín JL, Anguita J. Factors predicting peripheral blood progenitor cell mobilization in healthy donors in the era of related alternative donors: Experience from a single center. J Clin Apher 2019; 34:373-380. [DOI: 10.1002/jca.21685] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 01/03/2019] [Accepted: 01/09/2019] [Indexed: 01/30/2023]
Affiliation(s)
- Rebeca Bailén
- Hematology and Hemotherapy Department; Hospital General Universitario Gregorio Marañón; Madrid Spain
| | - Ana María Pérez-Corral
- Hematology and Hemotherapy Department; Hospital General Universitario Gregorio Marañón; Madrid Spain
- Gregorio Marañón Health Research Institute; Madrid Spain
| | - Cristina Pascual
- Hematology and Hemotherapy Department; Hospital General Universitario Gregorio Marañón; Madrid Spain
- Gregorio Marañón Health Research Institute; Madrid Spain
| | - Mi Kwon
- Hematology and Hemotherapy Department; Hospital General Universitario Gregorio Marañón; Madrid Spain
- Gregorio Marañón Health Research Institute; Madrid Spain
| | - David Serrano
- Hematology and Hemotherapy Department; Hospital General Universitario Gregorio Marañón; Madrid Spain
- Gregorio Marañón Health Research Institute; Madrid Spain
| | - Jorge Gayoso
- Hematology and Hemotherapy Department; Hospital General Universitario Gregorio Marañón; Madrid Spain
- Gregorio Marañón Health Research Institute; Madrid Spain
| | - Pascual Balsalobre
- Hematology and Hemotherapy Department; Hospital General Universitario Gregorio Marañón; Madrid Spain
- Gregorio Marañón Health Research Institute; Madrid Spain
| | - Cristina Muñoz
- Hematology and Hemotherapy Department; Hospital General Universitario Gregorio Marañón; Madrid Spain
| | - José Luis Díez-Martín
- Hematology and Hemotherapy Department; Hospital General Universitario Gregorio Marañón; Madrid Spain
- Gregorio Marañón Health Research Institute; Madrid Spain
- Medicine Department; Universidad Complutense de Madrid; Madrid Spain
| | - Javier Anguita
- Hematology and Hemotherapy Department; Hospital General Universitario Gregorio Marañón; Madrid Spain
- Gregorio Marañón Health Research Institute; Madrid Spain
- Medicine Department; Universidad Complutense de Madrid; Madrid Spain
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Doberschuetz N, Soerensen J, Bonig H, Willasch A, Rettinger E, Pfirrmann V, Salzmann-Manrique E, Schäfer R, Klingebiel T, Bader P, Jarisch A. Mobilized peripheral blood stem cell apheresis via Hickman catheter in pediatric patients. Transfusion 2019; 59:1061-1068. [PMID: 30610749 DOI: 10.1111/trf.15113] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 10/24/2018] [Accepted: 10/30/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Autologous stem cell transplantation remains an integral treatment tool for certain childhood malignancies. In children, a central venous catheter is typically necessary to provide adequate flow rates for preparative apheresis. In this study, the feasibility and efficiency of collecting CD34+ cells via an indwelling Hickman catheter, preimplanted for chemotherapy, instead of placing an additional temporary central venous catheter was evaluated. STUDY DESIGN AND METHODS Forty-eight pediatric leukaphereses for autologous hematopoietic stem cell transplantation using Spectra Optia MNC, Version 3.0 were reviewed. We compared preimplanted Hickman catheters with a temporary Shaldon catheter, inserted for apheresis. Apheresis was considered successful if a dose of 2 × 106 CD34+ peripheral blood stem cells/kg BW was achieved. RESULTS In 43 (89.6%) of the 48 patients, a Hickman catheter was used for leukapheresis. Only 5 patients (10.4%) received a temporary Shaldon catheter. In both groups, apheresis was performed without apparent adverse reactions. The dose of collected CD34+ peripheral blood stem cells was 12.7 × 106 (range, 2.3-70.7 × 106 ) cells/kg BW in the Hickman group and 16.2 × 106 (range, 3.8-48.4 × 106 ) cells/kg BW in the Shaldon group, showing no statistically significant difference (p = 0.58). In both groups, the primary endpoint of a minimal CD34+ cell concentration of 2 × 106 cells/kg BW was achieved at a maximum of two leukapheresis sessions. Apheresis efficacy was further confirmed by the collection efficiency of 40.2% in the Hickman group and 27.8% in the Shaldon group (p = 0.32). CONCLUSION These data indicate the reliable feasibility and efficacy of mobilized apheresis via an indwelling Hickman catheter. In light of this, the routine insertion of a dialysis catheter for the purpose of leukapheresis should be critically reconsidered.
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Affiliation(s)
- Nora Doberschuetz
- Department for Children and Adolescents, Division for Pediatric Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Jan Soerensen
- Department for Children and Adolescents, Division for Pediatric Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Halvard Bonig
- Institute for Transfusion Medicine and Immunohematology, Goethe University, Frankfurt, Germany.,Department for Cellular Therapeutics, German Red Cross Blood Service Baden-Württemberg-Hesse, Frankfurt am Main, Germany
| | - Andre Willasch
- Department for Children and Adolescents, Division for Pediatric Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Eva Rettinger
- Department for Children and Adolescents, Division for Pediatric Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Verena Pfirrmann
- Department for Children and Adolescents, Division for Pediatric Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Emilia Salzmann-Manrique
- Department for Children and Adolescents, Division for Pediatric Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Richard Schäfer
- Department for Cellular Therapeutics, German Red Cross Blood Service Baden-Württemberg-Hesse, Frankfurt am Main, Germany
| | - Thomas Klingebiel
- Department for Children and Adolescents, Division for Pediatric Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Peter Bader
- Department for Children and Adolescents, Division for Pediatric Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Andrea Jarisch
- Department for Children and Adolescents, Division for Pediatric Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany
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Pascual C, González‐Arias E, Pérez‐Corral AM, Bailén R, Gayoso J, Besson N, Serrano D, Kwon M, Anguita J, Díez‐Martín JL. Mononuclear cell collection for extracorporeal photopheresis by using the
“
off‐line
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system: A comparative study between COBE Spectra and Spectra Optia devices. J Clin Apher 2018; 34:359-366. [DOI: 10.1002/jca.21679] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 11/23/2018] [Accepted: 11/28/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Cristina Pascual
- Hemathology and Hemotherapy DepartmentHospital General Universitario Gregorio Marañón Madrid Spain
- Instituto de Investigación Sanitaria Gregorio Marañón Madrid Spain
| | - Elena González‐Arias
- Hemathology and Hemotherapy DepartmentHospital General Universitario Gregorio Marañón Madrid Spain
| | - Ana María Pérez‐Corral
- Hemathology and Hemotherapy DepartmentHospital General Universitario Gregorio Marañón Madrid Spain
- Instituto de Investigación Sanitaria Gregorio Marañón Madrid Spain
| | - Rebeca Bailén
- Hemathology and Hemotherapy DepartmentHospital General Universitario Gregorio Marañón Madrid Spain
- Instituto de Investigación Sanitaria Gregorio Marañón Madrid Spain
| | - Jorge Gayoso
- Hemathology and Hemotherapy DepartmentHospital General Universitario Gregorio Marañón Madrid Spain
- Instituto de Investigación Sanitaria Gregorio Marañón Madrid Spain
| | - Nelly Besson
- Medical Affairs Department TerumoBCT Zaventem Belgium
| | - David Serrano
- Instituto de Investigación Sanitaria Gregorio Marañón Madrid Spain
| | - Mi Kwon
- Hemathology and Hemotherapy DepartmentHospital General Universitario Gregorio Marañón Madrid Spain
- Instituto de Investigación Sanitaria Gregorio Marañón Madrid Spain
| | - Javier Anguita
- Hemathology and Hemotherapy DepartmentHospital General Universitario Gregorio Marañón Madrid Spain
- Instituto de Investigación Sanitaria Gregorio Marañón Madrid Spain
- Universidad Complutense de Madrid Madrid Spain
| | - José Luis Díez‐Martín
- Hemathology and Hemotherapy DepartmentHospital General Universitario Gregorio Marañón Madrid Spain
- Instituto de Investigación Sanitaria Gregorio Marañón Madrid Spain
- Universidad Complutense de Madrid Madrid Spain
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10
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Azzouqa AGM, Jouni K, Roy V, Zubair AC. Impact of good and poor mobilizers on hematopoietic progenitor cell collection efficiency and product quality. J Clin Apher 2018; 34:39-43. [PMID: 30426567 DOI: 10.1002/jca.21672] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 09/16/2018] [Accepted: 10/11/2018] [Indexed: 11/08/2022]
Abstract
BACKGROUND Mobilization regimen choice is a significant contributing factor for successful hematopoietic progenitor cell (HPC) collection by leukocytapheresis and reaching the target CD34+ cell dose. How mobilization regimen affects collection efficiency and the quality of products collected using the Spectra Optia apheresis instrument is not fully known. METHODS We evaluated the impact of granulocyte-colony stimulating factor (GCSF) and GCSF/plerixafor mobilization regimens on CE and product composition. We studied 373 leukocytapheresis HPC collections for 147 autologous transplants from January 1, 2010 to December 31, 2014. Patients were categorized in two groups; good mobilizers, mobilized with GCSF only (GM) and poor mobilizers, mobilized with GCSF and Plerixafor (PM). RESULTS Overall, compared with PM group, total nucleated cell (TNC) yield was significantly lower in GM group (P = <.001). In contrast, median percent mononuclear cell (MNC) collected from GM (86.5%) was significantly higher than products collected from PM group (79.5%; P < .001). Compared with GM group, CD34+ cell CE was about 10% lower in PM group (P < .008). In addition, daily CD34+ cell/Kg yield was significantly higher in GM (2.08 × 10/Kg) compared with PM group (1.64 x 10/Kg, P = .019). Overall, the median number of collections per patient was two for GM and three for PM (P = .004). CONCLUSION Products collected from PM group contained higher TNC content relative to GM group but had lower MNC enrichment, CD34+ cell CE and daily CD34+ cell yield per Kg.
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Affiliation(s)
| | - Kinda Jouni
- Division of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, Florida
| | - Vivek Roy
- Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, Florida
| | - Abba C Zubair
- Division of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, Florida
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Solmaz S, Kahraman S, Sevindik OG, Acar C, Turkyilmaz M, Alacacioglu I, Piskin O, Ozcan MA, Ozsan HG, Undar B, Demirkan F. A Comparison of Fresenius Com.Tec Cell and Spectra Optia Cell Separators for Autologous and Allogeneic Stem Cell Collections: Single Center Experience. Indian J Hematol Blood Transfus 2018; 34:677-683. [PMID: 30369740 DOI: 10.1007/s12288-018-0922-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 01/10/2018] [Indexed: 11/25/2022] Open
Abstract
Peripheral blood is the prefered source for hematopoietic stem cells for hematopoietic stem cell transplantation. The efficiency of peripheral blood stem cell (PBSC) collection can vary among devices. In this study we aimed to compare feasibility and effectivity of apheresis procedures of the different systems. Two apheresis systems [Com.Tec (Fresenius Healthcare) and Spectra Optia (Caridian BCT)] were used in our center for the collection of PBSCs for autologous and allogeneic transplantation. We retrospectively analysed 190 apheresis procedures performed in healthy donors and patients between June 2012 and November 2014 in Department of Hematology, Dokuz Eylul University. PBSCS were collected by Fresenius cell separator (64 procedure) or Spectra Optia cell separator (126 procedure). Mobilization treatments were G-CSF (26.8%), cyclophosphamide plus G-CSF (48.4%), prelixafor plus G-CSF (14.7%), ESHAP (10%) and others. Patient and donor characteristics (age, weight, volume processed, disease, mobilization regimes) were similar in Fresenius and Spectra Optia apheresis groups. Altough both collected PBSCs efficiently, the amount of CD34+ cell in product collected by Spectra Optia device was significantly higher (p < 0.05) and product volume was lower than Fresenius Com.Tec significantly (p < 0.05). "CD34+ collection efficiency" with Spectra Optia was significantly higher than Fresenius Com.Tec (CE2: 87%, 70%, p = 0.033) regarding all procedures. High collection efficiency and low product volume may be a significant characteristic of Spectra Optia device (mean 187 mL, product CD34+ cell: 1576 µL).
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Affiliation(s)
- Serife Solmaz
- Department of Hematology, Bozyaka Teaching and Research Hospital, Izmir, Turkey
| | - Selda Kahraman
- Department of Hematology, Medical Park Hospital, Izmir, Turkey
| | | | - Celal Acar
- Department of Hematology, Bozyaka Teaching and Research Hospital, Izmir, Turkey
| | - Munire Turkyilmaz
- 4Department of Hematology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Inci Alacacioglu
- 4Department of Hematology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Ozden Piskin
- 4Department of Hematology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Mehmet Ali Ozcan
- 4Department of Hematology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Hayri Guner Ozsan
- 4Department of Hematology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Bulent Undar
- 4Department of Hematology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Fatih Demirkan
- 4Department of Hematology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
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Spoerl S, Wäscher D, Nagel S, Peschel C, Verbeek M, Götze K, Krackhardt AM. Evaluation of the new continuous mononuclear cell collection protocol versus an older version on two different apheresis machines. Transfusion 2018; 58:1772-1780. [DOI: 10.1111/trf.14644] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 02/04/2018] [Accepted: 02/08/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Silvia Spoerl
- 3rd Medical Department, Hematology and OncologyKlinikum rechts der Isar, Technische Universität MünchenMünchen Germany
| | - Dagmar Wäscher
- 3rd Medical Department, Hematology and OncologyKlinikum rechts der Isar, Technische Universität MünchenMünchen Germany
| | - Stefanie Nagel
- 3rd Medical Department, Hematology and OncologyKlinikum rechts der Isar, Technische Universität MünchenMünchen Germany
| | - Christian Peschel
- 3rd Medical Department, Hematology and OncologyKlinikum rechts der Isar, Technische Universität MünchenMünchen Germany
| | - Mareike Verbeek
- 3rd Medical Department, Hematology and OncologyKlinikum rechts der Isar, Technische Universität MünchenMünchen Germany
| | - Katharina Götze
- 3rd Medical Department, Hematology and OncologyKlinikum rechts der Isar, Technische Universität MünchenMünchen Germany
| | - Angela M. Krackhardt
- 3rd Medical Department, Hematology and OncologyKlinikum rechts der Isar, Technische Universität MünchenMünchen Germany
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14
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Pandey S, Cottler-Fox M. Optia® continuous mononuclear collection (CMNC) system is a safe and efficient system for hematopoietic progenitor cells-apheresis (HPC-a) collection and yields a lower product hematocrit (HCT%) than the COBE® spectra system: A retrospective study. J Clin Apher 2018; 33:505-513. [DOI: 10.1002/jca.21629] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 03/19/2018] [Accepted: 03/20/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Soumya Pandey
- Department of Pathology; University of Arkansas for Medical Sciences; Little Rock Arkansas 72205
| | - Michele Cottler-Fox
- Department of Pathology; University of Arkansas for Medical Sciences; Little Rock Arkansas 72205
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15
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Besson N, Topholm Bruun M, Stauffer Larsen T, Nielsen C. Impact of apheresis automation on procedure quality and predictability of CD34+cell yield. J Clin Apher 2018; 33:494-504. [DOI: 10.1002/jca.21625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 02/26/2018] [Accepted: 03/03/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Nelly Besson
- Medical Affairs Department Terumo BCT; Zaventem Belgium
| | - Mie Topholm Bruun
- Department of Clinical Immunology; Odense University Hospital; Odense Denmark
| | | | - Christian Nielsen
- Department of Clinical Immunology; Odense University Hospital; Odense Denmark
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16
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The healthy donor profile of immunoregulatory soluble mediators is altered by stem cell mobilization and apheresis. Cytotherapy 2018; 20:740-754. [PMID: 29576502 DOI: 10.1016/j.jcyt.2018.02.366] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 02/08/2018] [Accepted: 02/11/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Peripheral blood stem cells from healthy donors mobilized by granulocyte colony-stimulating factor (G-CSF) and thereafter harvested by leukapheresis are commonly used for allogeneic stem cell transplantation. METHODS Plasma levels of 38 soluble mediators (cytokines, soluble adhesion molecules, proteases, protease inhibitors) were analyzed in samples derived from healthy stem cell donors before G-CSF treatment and after 4 days, both immediately before and after leukapheresis. RESULTS Donors could be classified into two main subsets based on their plasma mediator profile before G-CSF treatment. Seventeen of 36 detectable mediators were significantly altered by G-CSF; generally an increase in mediator levels was seen, including pro-inflammatory cytokines, soluble adhesion molecules and proteases. Several leukocyte- and platelet-released mediators were increased during apheresis. Both plasma and graft mediator profiles were thus altered and showed correlations to graft concentrations of leukocytes and platelets; these concentrations were influenced by the apheresis device used. Finally, the mediator profile of the allotransplant recipients was altered by graft infusion, and based on their day +1 post-transplantation plasma profile our recipients could be divided into two major subsets that differed in overall survival. DISCUSSION G-CSF alters the short-term plasma mediator profile of healthy stem cell donors. These effects together with the leukocyte and platelet levels in the graft determine the mediator profile of the stem cell grafts. Graft infusion also alters the systemic mediator profile of the recipients, but further studies are required to clarify whether such graft-induced alterations have a prognostic impact.
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17
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Wang T, Remberger M, Axdorph Nygell U, Sundin M, Björklund A, Mattsson J, Uhlin M, Watz E. Change of apheresis device decreased the incidence of severe acute graft-versus-host disease among patients after allogeneic stem cell transplantation with sibling donors. Transfusion 2018. [PMID: 29536557 DOI: 10.1111/trf.14579] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The composition of the graft used for allogeneic hematopoietic stem cell transplantation (HSCT) is important for the treatment outcome. Different apheresis devices may yield significant differences in peripheral blood stem cell graft cellular composition. We compared stem cell grafts produced by Cobe Spectra (Cobe) and Spectra Optia (Optia) with use of the mononuclear cell (MNC) protocol, and evaluated clinical outcome parameters such as graft-versus-host disease (GvHD), transplant-related mortality (TRM), relapse, and overall survival. STUDY DESIGN AND METHODS During 5 years, 31 Cobe Spectra and 40 Spectra Optia grafts were analyzed for CD34, CD3, CD4, CD8, CD19, and CD56 cell content. Clinical outcome parameters were correlated and compared between the two patient groups using different apheresis devices. RESULTS Optia grafts contained fewer lymphocytes compared to Cobe (p < 0.001). Optia grafts had a significantly lower incidence of acute GvHD Grades II through IV (Cobe 45% vs. Optia 23%; p = 0.039) and TRM (16% vs. 2.5%; p < 0.05) but higher chronic GvHD (32% vs. 67%; p = 0.005) compared to Cobe grafts. Finally, the multivariate analysis showed a significant correlation among the different apheresis devices and both acute GvHD II through IV and severe chronic GvHD. The multivariate analysis also showed a significant correlation between the CD3+ cell dose and the incidence of severe acute GvHD. CONCLUSION Optia-obtained grafts yielded a lower acute GvHD Grades II-IV and TRM risk, but had no impact on relapse or overall survival in this study. Understanding and further improvement of peripheral blood stem cell (PBSC) apheresis techniques may be used in the future to personalize HSCT by, for example, fine-tuning the GvHD incidence.
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Affiliation(s)
- T Wang
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden.,Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - M Remberger
- Department of Oncology and Pathology, Karolinska Institute, Stockholm, Sweden.,Centre for Allogeneic Stem Cell Transplantation (CAST), Karolinska University Hospital, Huddinge, Sweden
| | - U Axdorph Nygell
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden.,Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden.,Department of Haematology, Karolinska University Hospital, Huddinge, Sweden
| | - M Sundin
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden
| | - A Björklund
- Department of Haematology, Karolinska University Hospital, Huddinge, Sweden
| | - J Mattsson
- Department of Oncology and Pathology, Karolinska Institute, Stockholm, Sweden.,Centre for Allogeneic Stem Cell Transplantation (CAST), Karolinska University Hospital, Huddinge, Sweden
| | - M Uhlin
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden.,Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden.,Department of Applied Physics, Royal Institute of Technology, Stockholm, Sweden
| | - E Watz
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden.,Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
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18
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Lee SN, Sohn JY, Kong JH, Eom HS, Lee H, Kong SY. Comparison of Two Apheresis Systems of COBE and Optia for Autologous Peripheral Blood Stem Cell Collection. Ann Lab Med 2018; 37:327-330. [PMID: 28445013 PMCID: PMC5409026 DOI: 10.3343/alm.2017.37.4.327] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 12/12/2016] [Accepted: 03/16/2017] [Indexed: 12/02/2022] Open
Abstract
Peripheral blood stem cell (PBSC) transplantation following myeloablative therapy is a mainstay of treatment for various types of malignancies. This study aimed to evaluate the differences between the Optia MNC and COBE Spectra MNC systems (Terumo BCT, Japan) according to apheresis procedures and the parameters of apheresis, products, and collection. The clinical data of 74 patients who underwent autologous PBSC collection from July 2012 to July 2015 were reviewed retrospectively. The patients comprised 48 (65%) men and 26 (35%) women with a median age of 56 yr (range, 23–66 yr). Of 216 procedures, 111 (51%) and 105 (49%) were processed by using COBE and Optia MNC, respectively. PBSC collection rates, throughput, numbers of stem cells retrieved, collection efficacy, and platelet loss were compared. There were no significant differences in the median CD34+ cell counts of collected products (0.61×108 vs 0.94×108), CD34 collection efficiency (43.5% vs 42.1%), and loss of platelets (40.1% vs 44.7%). The Spectra Optia MNC apheresis system was comparable to the COBE Spectra system in collecting autologous CD34+ hematopoietic stem cells and retention of platelets.
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Affiliation(s)
- Se Na Lee
- Department of Laboratory Medicine, Center for Diagnostic Oncology, National Cancer Center, Goyang, Korea
| | - Ji Yeon Sohn
- Department of Laboratory Medicine, Center for Diagnostic Oncology, National Cancer Center, Goyang, Korea
| | - Jung Hee Kong
- Department of Laboratory Medicine, Center for Diagnostic Oncology, National Cancer Center, Goyang, Korea
| | - Hyeon Seok Eom
- Center for Hematologic Malignancy, National Cancer Center, Goyang, Korea.,Department of System Cancer Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Hyewon Lee
- Center for Hematologic Malignancy, National Cancer Center, Goyang, Korea
| | - Sun Young Kong
- Department of Laboratory Medicine, Center for Diagnostic Oncology, National Cancer Center, Goyang, Korea.,Translational Epidemiology Branch, Hospital and Research Institute, National Cancer Center, Goyang, Korea.,Department of System Cancer Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
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19
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Pfeiffer H, Achenbach S, Strobel J, Zimmermann R, Eckstein R, Strasser EF. First comparative analysis concerning the plasma platelet contamination during MNC collection. Transfus Apher Sci 2017; 56:535-538. [PMID: 28800844 DOI: 10.1016/j.transci.2017.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 02/13/2017] [Accepted: 06/29/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Monocytes can be cultured into dendritic cells with addition of autologous plasma, which is highly prone to platelet contamination due to the apheresis process. Since platelets affect the maturation process of monocytes into dendritic cells and might even lead to a diminished harvest of dendritic cells, it is very important to reduce the platelet contamination. A new collection device (Spectra Optia) was analyzed, compared to two established devices (COM.TEC, Cobe Spectra) and evaluated regarding the potential generation of source plasma. MATERIALS AND METHODS Concurrent plasma collected during leukapheresis was analyzed for residual cell contamination in a prospective study with the new Spectra Optia apheresis device (n=24) and was compared with COM.TEC and Cobe Spectra data (retrospective analysis, n=72). Donor pre-donation counts of platelets were analyzed for their predictive value of contaminating PLTs in plasma harvests. RESULTS The newest apheresis device showed the lowest residual platelet count of the collected concurrent plasma (median 3.50×109/l) independent of pre-donation counts. The other two devices and sets had a higher platelet contamination. The contamination of the plasma with leukocytes was very low (only 2.0% were higher than 0.5×109/l). CONCLUSIONS This study showed a significant reduction of platelet contamination of the concurrent plasma collected with the new Spectra Optia device. This plasma product with low residual platelets and leukocytes might also be used as plasma for fractionation.
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Affiliation(s)
- Hella Pfeiffer
- Transfusion Medicine and Haemostaseology Department, University Hospital Erlangen, Germany.
| | - Susanne Achenbach
- Transfusion Medicine and Haemostaseology Department, University Hospital Erlangen, Germany.
| | - Julian Strobel
- Transfusion Medicine and Haemostaseology Department, University Hospital Erlangen, Germany.
| | - Robert Zimmermann
- Transfusion Medicine and Haemostaseology Department, University Hospital Erlangen, Germany.
| | - Reinhold Eckstein
- Transfusion Medicine and Haemostaseology Department, University Hospital Erlangen, Germany.
| | - Erwin F Strasser
- Transfusion Medicine and Haemostaseology Department, University Hospital Erlangen, Germany.
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20
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Kim-Wanner SZ, Bug G, Steinmann J, Ajib S, Sorg N, Poppe C, Bunos M, Wingenfeld E, Hümmer C, Luxembourg B, Seifried E, Bonig H. Erythrocyte depletion from bone marrow: performance evaluation after 50 clinical-scale depletions with Spectra Optia BMC. J Transl Med 2017; 15:174. [PMID: 28800741 PMCID: PMC5553998 DOI: 10.1186/s12967-017-1277-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 08/01/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Red blood cell (RBC) depletion is a standard graft manipulation technique for ABO-incompatible bone marrow (BM) transplants. The BM processing module for Spectra Optia, "BMC", was previously introduced. We here report the largest series to date of routine quality data after performing 50 clinical-scale RBC-depletions. METHODS Fifty successive RBC-depletions from autologous (n = 5) and allogeneic (n = 45) BM transplants were performed with the Spectra Optia BMC apheresis suite. Product quality was assessed before and after processing for volume, RBC and leukocyte content; RBC-depletion and stem cell (CD34+ cells) recovery was calculated there from. Clinical engraftment data were collected from 26/45 allogeneic recipients. RESULTS Median RBC removal was 98.2% (range 90.8-99.1%), median CD34+ cell recovery was 93.6%, minimum recovery being 72%, total product volume was reduced to 7.5% (range 4.7-23.0%). Products engrafted with expected probability and kinetics. Performance indicators were stable over time. DISCUSSION Spectra Optia BMC is a robust and efficient technology for RBC-depletion and volume reduction of BM, providing near-complete RBC removal and excellent CD34+ cell recovery.
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Affiliation(s)
- Soo-Zin Kim-Wanner
- Institute Frankfurt, German Red Cross Blood Service Baden-Württemberg-Hessen, Sandhofstr. 1, 60528, Frankfurt, Germany
| | - Gesine Bug
- Division of Stem Cell Transplantation, Department of Medicine II, Goethe University, Frankfurt, Germany
| | - Juliane Steinmann
- Division of Stem Cell Transplantation, Department of Medicine II, Goethe University, Frankfurt, Germany
| | - Salem Ajib
- Division of Stem Cell Transplantation, Department of Medicine II, Goethe University, Frankfurt, Germany
| | - Nadine Sorg
- Institute Frankfurt, German Red Cross Blood Service Baden-Württemberg-Hessen, Sandhofstr. 1, 60528, Frankfurt, Germany
| | - Carolin Poppe
- Institute Frankfurt, German Red Cross Blood Service Baden-Württemberg-Hessen, Sandhofstr. 1, 60528, Frankfurt, Germany
| | - Milica Bunos
- Institute Frankfurt, German Red Cross Blood Service Baden-Württemberg-Hessen, Sandhofstr. 1, 60528, Frankfurt, Germany
| | - Eva Wingenfeld
- Institute Frankfurt, German Red Cross Blood Service Baden-Württemberg-Hessen, Sandhofstr. 1, 60528, Frankfurt, Germany
| | - Christiane Hümmer
- Institute Frankfurt, German Red Cross Blood Service Baden-Württemberg-Hessen, Sandhofstr. 1, 60528, Frankfurt, Germany
| | - Beate Luxembourg
- Department of Hemostaseology, Deutsche Klinik für Diagnostik, Wiesbaden, Germany
| | - Erhard Seifried
- Institute Frankfurt, German Red Cross Blood Service Baden-Württemberg-Hessen, Sandhofstr. 1, 60528, Frankfurt, Germany.,Institute for Transfusion Medicine and Immunohematology, Goethe University Medical Center, Sandhofstr. 1, 60528, Frankfurt, Germany
| | - Halvard Bonig
- Institute Frankfurt, German Red Cross Blood Service Baden-Württemberg-Hessen, Sandhofstr. 1, 60528, Frankfurt, Germany. .,Institute for Transfusion Medicine and Immunohematology, Goethe University Medical Center, Sandhofstr. 1, 60528, Frankfurt, Germany. .,Department of Medicine/Hematology, University of Washington, Seattle, WA, USA.
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21
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Even-Or E, Di Mola M, Ali M, Courtney S, McDougall E, Alexander S, Schechter T, Whitlock JA, Licht C, Krueger J. Optimizing autologous nonmobilized mononuclear cell collections for cellular therapy in pediatric patients with high-risk leukemia. Transfusion 2017; 57:1536-1542. [DOI: 10.1111/trf.14094] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 01/24/2017] [Accepted: 02/01/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Ehud Even-Or
- Division of Haematology/Oncology/Bone Marrow Transplantation; The Hospital for Sick Children; Toronto Ontario Canada
| | - Maria Di Mola
- Division of Nephrology; The Hospital for Sick Children; Toronto Ontario Canada
| | - Muhammad Ali
- Division of Haematology/Oncology/Bone Marrow Transplantation; The Hospital for Sick Children; Toronto Ontario Canada
| | - Sarah Courtney
- Division of Haematology/Oncology/Bone Marrow Transplantation; The Hospital for Sick Children; Toronto Ontario Canada
| | - Elizabeth McDougall
- Department of Paediatric Laboratory Medicine; The Hospital for Sick Children; Toronto Ontario Canada
| | - Sarah Alexander
- Division of Haematology/Oncology/Bone Marrow Transplantation; The Hospital for Sick Children; Toronto Ontario Canada
| | - Tal Schechter
- Division of Haematology/Oncology/Bone Marrow Transplantation; The Hospital for Sick Children; Toronto Ontario Canada
| | - James A. Whitlock
- Division of Haematology/Oncology/Bone Marrow Transplantation; The Hospital for Sick Children; Toronto Ontario Canada
| | - Christoph Licht
- Division of Nephrology; The Hospital for Sick Children; Toronto Ontario Canada
| | - Joerg Krueger
- Division of Haematology/Oncology/Bone Marrow Transplantation; The Hospital for Sick Children; Toronto Ontario Canada
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22
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Even-Or E, Eden-Walker A, Di Mola M, McDougall E, Schechter T, Ali M, Svajger G, Gassas A, Licht C, Krueger J. Comparison of two apheresis systems for autologous stem cell collections in pediatric oncology patients. Transfusion 2016; 57:122-130. [PMID: 27696435 DOI: 10.1111/trf.13859] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 08/17/2016] [Accepted: 08/18/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Peripheral stem cell collections can be challenging in the pediatric population and respective experience is limited. Since February 2015 our institution is utilizing the new Spectra Optia (Optia) apheresis device, which has replaced the former COBE Spectra (COBE) device. As a quality initiative we collected and compared collection efficiency (CE2) and other collection variables between the two devices. STUDY DESIGN AND METHODS In this retrospective study we collected and compared clinical, laboratory, and technical collection data from stem cell collection procedures done with the Optia and COBE devices. The collected data included patient demographics, precollection peripheral CD34+ cell counts, total CD34+ cells collected, complete blood count, electrolytes before and after collection, side effects attributed to the collection, total blood volumes processed (TBVs), collection times, and calculated CE2 and collection ratios. RESULTS Forty-one collection procedures performed on 29 pediatric patients with the Optia device were compared to 41 collections performed on 27 patients with the COBE device. The TBVs through the Optia device were significantly smaller than the COBE (3.9 ± 0.2 × TBV vs. 5.5 ± 0.1 × TBV, respectively; p < 0.001), requiring significantly less anticoagulant and providing similar amounts of stem cells while collection times were significantly shorter (mean, 238 ± 9 min vs. 264 ± 9 min, respectively; p < 0.05). Collections on the Optia caused significantly smaller reductions of plasma calcium and magnesium. No significant side effects attributed to the procedure were noted. CONCLUSION Stem cell apheresis with the Optia device in children is safe and feasible with smaller blood volumes with shorter collection times.
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Affiliation(s)
- Ehud Even-Or
- Division of Hematology/Oncology/BMT, Division of Nephrology, and the Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Alexandra Eden-Walker
- Division of Hematology/Oncology/BMT, Division of Nephrology, and the Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Maria Di Mola
- Division of Hematology/Oncology/BMT, Division of Nephrology, and the Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Elizabeth McDougall
- Division of Hematology/Oncology/BMT, Division of Nephrology, and the Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tal Schechter
- Division of Hematology/Oncology/BMT, Division of Nephrology, and the Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Muhammad Ali
- Division of Hematology/Oncology/BMT, Division of Nephrology, and the Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Gordana Svajger
- Division of Hematology/Oncology/BMT, Division of Nephrology, and the Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Adam Gassas
- Division of Hematology/Oncology/BMT, Division of Nephrology, and the Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Christoph Licht
- Division of Hematology/Oncology/BMT, Division of Nephrology, and the Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Joerg Krueger
- Division of Hematology/Oncology/BMT, Division of Nephrology, and the Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
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23
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Becker P, Schwebig A, Brauninger S, Bialleck H, Luxembourg B, Schulz M, Tsamadou C, Wiesneth M, Reinhardt P, Mytilineos J, Seidl C, Gattu S, Kaliakina N, Singh P, Schrezenmeier H, Seifried E, Bonig H. Healthy donor hematopoietic stem cell mobilization with biosimilar granulocyte-colony-stimulating factor: safety, efficacy, and graft performance. Transfusion 2016; 56:3055-3064. [PMID: 27633122 DOI: 10.1111/trf.13853] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 08/11/2016] [Accepted: 08/15/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Biosimilar granulocyte-colony-stimulating factors (G-CSFs) have been available in the European Union since 2008, and Sandoz' biosimilar filgrastim was approved in the United States in March 2015 for all of the reference product's indications except acute radiation syndrome. Biosimilar G-CSFs have been largely embraced by the medical community, except for some reservations about healthy-donor stem cell mobilization, for which use outside of clinical studies was cautioned against by some members of the scientific community. STUDY DESIGN AND METHODS In a two-center safety surveillance study (National Clinical Trial NCT01766934), 245 healthy volunteer stem cell donors were enrolled. Of 244 donors who began mobilization with twice-daily Sandoz biosimilar filgrastim, 242 received a full (n = 241) or partial (n = 1) course of G-CSF and underwent apheresis. Efficacy and safety were assessed and are reported here. RESULTS Biosimilar filgrastim was accompanied by the typical G-CSF class-related adverse effects of expected frequency and severity. Median mobilization for CD34-positive stem cells was 97/µL (range, 20-347/µL); after one apheresis (91%) or two aphereses (9%) from all but three donors (1.2%), cell doses in excess of the typical 4 × 106 CD34-positive cells/kg of the recipient had been collected (range, 3-52 × 106 /kg). Biochemical and hematologic alterations were consistent with previous reports; all had normalized by the first follow-up 1 month after mobilization. Stem cell products engrafted with typical probability and kinetics for G-CSF-mobilized stem cell products. CONCLUSION These data support the use of biosimilar filgrastim for healthy-donor stem cell mobilization as safe and effective.
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Affiliation(s)
- Petra Becker
- Institute for Transfusion Medicine and Immunohematology of Goethe University and German Red Cross Blood Donor Service, Frankfurt am Main, Germany
| | | | - Susanne Brauninger
- Institute for Transfusion Medicine and Immunohematology of Goethe University and German Red Cross Blood Donor Service, Frankfurt am Main, Germany
| | - Heike Bialleck
- Institute for Transfusion Medicine and Immunohematology of Goethe University and German Red Cross Blood Donor Service, Frankfurt am Main, Germany
| | - Beate Luxembourg
- Institute for Transfusion Medicine and Immunohematology of Goethe University and German Red Cross Blood Donor Service, Frankfurt am Main, Germany
| | - Miriam Schulz
- Institute for Transfusion Medicine and Immunohematology of Goethe University and German Red Cross Blood Donor Service, Frankfurt am Main, Germany
| | - Chrysanthi Tsamadou
- Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Donor Service and University Hospital Ulm, Ulm, Germany
| | - Markus Wiesneth
- Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Donor Service and University Hospital Ulm, Ulm, Germany
| | - Peter Reinhardt
- Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Donor Service and University Hospital Ulm, Ulm, Germany
| | - Joannis Mytilineos
- Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Donor Service and University Hospital Ulm, Ulm, Germany
| | - Christian Seidl
- Institute for Transfusion Medicine and Immunohematology of Goethe University and German Red Cross Blood Donor Service, Frankfurt am Main, Germany
| | | | | | | | - Hubert Schrezenmeier
- Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Donor Service and University Hospital Ulm, Ulm, Germany
| | - Erhard Seifried
- Institute for Transfusion Medicine and Immunohematology of Goethe University and German Red Cross Blood Donor Service, Frankfurt am Main, Germany
| | - Halvard Bonig
- Institute for Transfusion Medicine and Immunohematology of Goethe University and German Red Cross Blood Donor Service, Frankfurt am Main, Germany.,Department of Medicine/Hematology, University of Washington, Seattle, Washington
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24
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Korur A, Kozanoglu I, Buyukkurt N, Yeral M, Kandemir F, Gereklioglu C, Sariturk C, Asma S, Solmaz S, Boga C, Ozdogu H. QTc prolongation during peripheral stem cell apheresis in healthy volunteers. J Clin Apher 2016; 32:240-245. [PMID: 27543914 DOI: 10.1002/jca.21504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 07/14/2016] [Accepted: 08/10/2016] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND AIM Today, voluntary donation of peripheral blood stem cells by healthy donors for allogeneic hemopoietic cell transplantation is common worldwide. Such donations are associated with small but measurable risks of morbidity and mortality. Most complications are associated with citrate infusion during cell collection. We studied the effects of citrate infusion on the QTc and other vital parameters during and after peripheral stem cell apheresis in volunteers. METHOD To ensure that donors were healthy, screening included taking a detailed medical history, physical examination, and laboratory measurements of plasma calcium and magnesium. Corrected QT (QTc) values were assessed using a 12-lead electrocardiographic platform that derived QTc values automatically. RESULTS In all, 141 apheresis procedures were performed. The mean QTc values at baseline, at 2 and 4 h during the procedure, and at 30 min after the procedure, were 347.6 ± 59.5, 349.9 ± 52.8, 391.8 ± 54.0, and 404.8 ± 59.2 ms, respectively. The baseline and 2 h QTcs did not differ significantly, but the baseline QTc did differ significantly from the 4 h and 30 min after the procedure values. The plasma levels of calcium and magnesium did not significantly differ before and after the procedure. CONCLUSION QTc prolongation may develop during leukopheresis, particularly if the procedure takes more than 2 h. Thus, to enhance donor safety, QTc measurement should be standard for all donors. In addition, any family history of sudden death should be noted, to prevent the development of possible fatal arrhythmia in susceptible donors.
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Affiliation(s)
- Aslı Korur
- Baskent University Adana Adult Bone Marrow Transplantation Center Clinical Unit.,Department of Family Medicine, Baskent University Medical Faculty
| | - Ilknur Kozanoglu
- Baskent University Adana Adult Bone Marrow Transplantation Center Apheresis and Cell Collecting Unit.,Department of Physiology, Baskent University Medical Faculty
| | - Nurhilal Buyukkurt
- Baskent University Adana Adult Bone Marrow Transplantation Center Clinical Unit
| | - Mahmut Yeral
- Baskent University Adana Adult Bone Marrow Transplantation Center Clinical Unit
| | - Fatih Kandemir
- Baskent University Adana Adult Bone Marrow Transplantation Center Apheresis and Cell Collecting Unit
| | - Cigdem Gereklioglu
- Baskent University Adana Adult Bone Marrow Transplantation Center Clinical Unit.,Department of Family Medicine, Baskent University Medical Faculty
| | | | - Suheyl Asma
- Baskent University Adana Adult Bone Marrow Transplantation Center Clinical Unit.,Department of Family Medicine, Baskent University Medical Faculty
| | - Soner Solmaz
- Baskent University Adana Adult Bone Marrow Transplantation Center Clinical Unit
| | - Can Boga
- Baskent University Adana Adult Bone Marrow Transplantation Center Clinical Unit
| | - Hakan Ozdogu
- Baskent University Adana Adult Bone Marrow Transplantation Center Clinical Unit
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25
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Li Y, Li J, Reeves HM, Reyes R, Maitta RW. Comparison of two apheresis systems during hematopoietic progenitor stem cell collections at a tertiary medical center. Transfusion 2016; 56:2833-2838. [DOI: 10.1111/trf.13754] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 06/14/2016] [Accepted: 06/21/2016] [Indexed: 02/02/2023]
Affiliation(s)
- Yanchun Li
- Department of Pathology; University Hospitals Case Medical Center; and the; Cleveland Ohio
- Case Western Reserve University School of Medicine; Cleveland Ohio
| | - Jie Li
- Department of Pathology; University Hospitals Case Medical Center; and the; Cleveland Ohio
- Case Western Reserve University School of Medicine; Cleveland Ohio
| | - Hollie M. Reeves
- Department of Pathology; University Hospitals Case Medical Center; and the; Cleveland Ohio
- Case Western Reserve University School of Medicine; Cleveland Ohio
| | - Ramil Reyes
- Department of Pathology; University Hospitals Case Medical Center; and the; Cleveland Ohio
| | - Robert W. Maitta
- Department of Pathology; University Hospitals Case Medical Center; and the; Cleveland Ohio
- Case Western Reserve University School of Medicine; Cleveland Ohio
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26
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Lisenko K, Pavel P, Bruckner T, Puthenparambil J, Hundemer M, Schmitt A, Witzens-Harig M, Ho AD, Wuchter P. Comparison between intermittent and continuous spectra optia leukapheresis systems for autologous peripheral blood stem cell collection. J Clin Apher 2016; 32:27-34. [PMID: 27095367 DOI: 10.1002/jca.21463] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 02/18/2016] [Accepted: 03/21/2016] [Indexed: 11/10/2022]
Abstract
Terumo BCT recently introduced a new system for mononuclear cell (MNC) collection that uses a Spectra Optia apheresis machine equipped with a redesigned disposable kit and software program (version 11.2). It allows for the continuous collection of MNCs, unlike the original Spectra Optia system (version 7.2), which included a chamber for two-step cell separation. The aim of this study was to compare the two apheresis systems in regard to specific performance parameters. A retrospective data analysis of 150 patients who had undergone peripheral blood stem cell collection between March of 2014 and May of 2015 at our institution was performed. For the matched comparison, patients were divided into two groups by diagnosis and by previous forms of therapy received: a homogeneous group of patients with multiple myeloma (MM) that had received first line therapy ("MM" group, n = 88) and a heterogeneous group that included all of the other patients ("other" group, n = 62). No significant differences in CD34+ collection yields between both collection regimens were found (pMM = 0.19, pother = 0.74) in either group. Moreover, similar performance ratios (collected/predicted CD34+ cell number in %) were observed (pMM = 0.89, pother = 0.1). No relevant variations in platelet or hemoglobin loss were found between the two systems. We conclude that the new continuous Spectra Optia MNC system is equally efficient in collecting CD34+ cells and can be used without sacrificing collection efficiency levels when treating a broad variety of autologous patients. J. Clin. Apheresis 32:27-34, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Katharina Lisenko
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Petra Pavel
- Stem Cell Laboratory, IKTZ Heidelberg GmbH, Heidelberg, Germany
| | - Thomas Bruckner
- Institute of Medical Biometry and Informatics, Heidelberg University, Heidelberg, Germany
| | | | - Michael Hundemer
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Anita Schmitt
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | | | - Anthony D Ho
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Patrick Wuchter
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
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27
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Hümmer C, Poppe C, Bunos M, Stock B, Wingenfeld E, Huppert V, Stuth J, Reck K, Essl M, Seifried E, Bonig H. Automation of cellular therapy product manufacturing: results of a split validation comparing CD34 selection of peripheral blood stem cell apheresis product with a semi-manual vs. an automatic procedure. J Transl Med 2016; 14:76. [PMID: 26983643 PMCID: PMC4793541 DOI: 10.1186/s12967-016-0826-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 03/01/2016] [Indexed: 11/10/2022] Open
Abstract
Background Automation of cell therapy manufacturing promises higher productivity of cell factories, more economical use of highly-trained (and costly) manufacturing staff, facilitation of processes requiring manufacturing steps at inconvenient hours, improved consistency of processing steps and other benefits. One of the most broadly disseminated engineered cell therapy products is immunomagnetically selected CD34+ hematopoietic “stem” cells (HSCs). Methods As the clinical GMP-compliant automat CliniMACS Prodigy is being programmed to perform ever more complex sequential manufacturing steps, we developed a CD34+ selection module for comparison with the standard semi-automatic CD34 “normal scale” selection process on CliniMACS Plus, applicable for 600 × 106 target cells out of 60 × 109 total cells. Three split-validation processings with healthy donor G-CSF-mobilized apheresis products were performed; feasibility, time consumption and product quality were assessed. Results All processes proceeded uneventfully. Prodigy runs took about 1 h longer than CliniMACS Plus runs, albeit with markedly less hands-on operator time and therefore also suitable for less experienced operators. Recovery of target cells was the same for both technologies. Although impurities, specifically T- and B-cells, were 5 ± 1.6-fold and 4 ± 0.4-fold higher in the Prodigy products (p = ns and p = 0.013 for T and B cell depletion, respectively), T cell contents per kg of a virtual recipient receiving 4 × 106 CD34+ cells/kg was below 10 × 103/kg even in the worst Prodigy product and thus more than fivefold below the specification of CD34+ selected mismatched-donor stem cell products. The products’ theoretical clinical usability is thus confirmed. Conclusions This split validation exercise of a relatively short and simple process exemplifies the potential of automatic cell manufacturing. Automation will further gain in attractiveness when applied to more complex processes, requiring frequent interventions or handling at unfavourable working hours, such as re-targeting of T-cells.
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Affiliation(s)
- Christiane Hümmer
- Department of Cellular Therapeutics (GMP), German Red Cross Blood Service Baden-Württemberg-Hesse, Institute Frankfurt, Frankfurt, Germany
| | - Carolin Poppe
- Department of Cellular Therapeutics (GMP), German Red Cross Blood Service Baden-Württemberg-Hesse, Institute Frankfurt, Frankfurt, Germany
| | - Milica Bunos
- Department of Cellular Therapeutics (GMP), German Red Cross Blood Service Baden-Württemberg-Hesse, Institute Frankfurt, Frankfurt, Germany
| | - Belinda Stock
- Department of Cellular Therapeutics (GMP), German Red Cross Blood Service Baden-Württemberg-Hesse, Institute Frankfurt, Frankfurt, Germany
| | - Eva Wingenfeld
- Department of Cellular Therapeutics (GMP), German Red Cross Blood Service Baden-Württemberg-Hesse, Institute Frankfurt, Frankfurt, Germany
| | | | | | | | - Mike Essl
- Miltenyi Biotec GmbH, Bergisch-Gladbach, Germany
| | - Erhard Seifried
- Department of Cellular Therapeutics (GMP), German Red Cross Blood Service Baden-Württemberg-Hesse, Institute Frankfurt, Frankfurt, Germany.,Institute for Transfusion Medicine and Immunohematology, Goethe University Medical Center, Frankfurt, Germany
| | - Halvard Bonig
- Department of Cellular Therapeutics (GMP), German Red Cross Blood Service Baden-Württemberg-Hesse, Institute Frankfurt, Frankfurt, Germany. .,Institute for Transfusion Medicine and Immunohematology, Goethe University Medical Center, Frankfurt, Germany. .,Department of Medicine, Division of Hematology, University of Washington, Seattle, WA, USA.
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28
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Mobilization of hematopoietic stem cells with highest self-renewal by G-CSF precedes clonogenic cell mobilization peak. Exp Hematol 2016; 44:303-14.e1. [PMID: 26827874 DOI: 10.1016/j.exphem.2016.01.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 01/05/2016] [Accepted: 01/08/2016] [Indexed: 01/10/2023]
Abstract
Harvest of granulocyte colony-stimulating factor (G-CSF)-mobilized hematopoietic stem cells (HSCs) begins at day 5 of G-CSF administration, when most donors have achieved maximal mobilization. This is based on surrogate markers for HSC mobilization, such as CD34(+) cells and colony-forming activity in blood. However, CD34(+) cells or colony-forming units in culture (CFU-C) are heterogeneous cell populations with hugely divergent long-term repopulation potential on transplantation. HSC behavior is influenced by the vascular bed in the vicinity of which they reside. We hypothesized that G-CSF may mobilize sequentially cells proximal and more distal to bone marrow venous sinuses where HSCs enter the blood. We addressed this question with functional serial transplantation assays using blood and bone marrow after specific time points of G-CSF treatment in mice. We found that in mice, blood collected after only 48 hours of G-CSF administration was as enriched in serially reconstituting HSCs as blood collected at 5 days of G-CSF treatment. Similarly, mobilized Lin(-)CD34(+) cells were relatively enriched in more primitive Lin(-)CD34(+)CD38(-) cells at day 2 of G-CSF treatment compared with later points in half of human donors tested (n = 6). This suggests that in both humans and mice, hematopoietic progenitor and stem cells do not mobilize uniformly according to their maturation stage, with most potent HSCs mobilizing as early as day 2 of G-CSF.
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29
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Spohn G, Wiercinska E, Karpova D, Bunos M, Hümmer C, Wingenfeld E, Sorg N, Poppe C, Huppert V, Stuth J, Reck K, Essl M, Seifried E, Bönig H. Automated CD34+ cell isolation of peripheral blood stem cell apheresis product. Cytotherapy 2015; 17:1465-71. [PMID: 25981397 DOI: 10.1016/j.jcyt.2015.04.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 04/10/2015] [Accepted: 04/10/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND AIMS Immunomagnetic enrichment of CD34+ hematopoietic "stem" cells (HSCs) using paramagnetic nanobead coupled CD34 antibody and immunomagnetic extraction with the CliniMACS plus system is the standard approach to generating T-cell-depleted stem cell grafts. Their clinical beneficence in selected indications is established. Even though CD34+ selected grafts are typically given in the context of a severely immunosuppressive conditioning with anti-thymocyte globulin or similar, the degree of T-cell depletion appears to affect clinical outcomes and thus in addition to CD34 cell recovery, the degree of T-cell depletion critically describes process quality. An automatic immunomagnetic cell processing system, CliniMACS Prodigy, including a protocol for fully automatic CD34+ cell selection from apheresis products, was recently developed. We performed a formal process validation to support submission of the protocol for CE release, a prerequisite for clinical use of Prodigy CD34+ products. METHODS Granulocyte-colony stimulating factor-mobilized healthy-donor apheresis products were subjected to CD34+ cell selection using Prodigy with clinical reagents and consumables and advanced beta versions of the CD34 selection software. Target and non-target cells were enumerated using sensitive flow cytometry platforms. RESULTS Nine successful clinical-scale CD34+ cell selections were performed. Beyond setup, no operator intervention was required. Prodigy recovered 74 ± 13% of target cells with a viability of 99.9 ± 0.05%. Per 5 × 10E6 CD34+ cells, which we consider a per-kilogram dose of HSCs, products contained 17 ± 3 × 10E3 T cells and 78 ± 22 × 10E3 B cells. CONCLUSIONS The process for CD34 selection with Prodigy is robust and labor-saving but not time-saving. Compared with clinical CD34+ selected products concurrently generated with the predecessor technology, product properties, importantly including CD34+ cell recovery and T-cell contents, were not significantly different. The automatic system is suitable for routine clinical application.
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Affiliation(s)
- Gabriele Spohn
- German Red Cross Blood Service Baden-Württemberg-Hesse, Institute Frankfurt, Department of Cellular Therapeutics, Frankfurt, Germany
| | - Eliza Wiercinska
- German Red Cross Blood Service Baden-Württemberg-Hesse, Institute Frankfurt, Department of Cellular Therapeutics, Frankfurt, Germany
| | - Darja Karpova
- Goethe University Medical Center, Institute for Transfusion Medicine and Immunohematology, Frankfurt, Germany
| | - Milica Bunos
- German Red Cross Blood Service Baden-Württemberg-Hesse, Institute Frankfurt, Department of Cellular Therapeutics, Frankfurt, Germany
| | - Christiane Hümmer
- German Red Cross Blood Service Baden-Württemberg-Hesse, Institute Frankfurt, Department of Cellular Therapeutics, Frankfurt, Germany
| | - Eva Wingenfeld
- German Red Cross Blood Service Baden-Württemberg-Hesse, Institute Frankfurt, Department of Cellular Therapeutics, Frankfurt, Germany
| | - Nadine Sorg
- German Red Cross Blood Service Baden-Württemberg-Hesse, Institute Frankfurt, Department of Cellular Therapeutics, Frankfurt, Germany
| | - Carolin Poppe
- German Red Cross Blood Service Baden-Württemberg-Hesse, Institute Frankfurt, Department of Cellular Therapeutics, Frankfurt, Germany
| | | | | | | | - Mike Essl
- Miltenyi Biotec GmbH, Bergisch-Gladbach, Germany
| | - Erhard Seifried
- German Red Cross Blood Service Baden-Württemberg-Hesse, Institute Frankfurt, Department of Cellular Therapeutics, Frankfurt, Germany; Goethe University Medical Center, Institute for Transfusion Medicine and Immunohematology, Frankfurt, Germany
| | - Halvard Bönig
- German Red Cross Blood Service Baden-Württemberg-Hesse, Institute Frankfurt, Department of Cellular Therapeutics, Frankfurt, Germany; Goethe University Medical Center, Institute for Transfusion Medicine and Immunohematology, Frankfurt, Germany; University of Washington, Department of Medicine, Division of Hematology, Seattle, Washington, USA.
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30
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Spínola A, Ferreira S, Amado F, Lopes S, Roncon S. Hematopoietic progenitor cells collection in pediatric patients with brain tumor. J Clin Apher 2015; 31:22-8. [DOI: 10.1002/jca.21398] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 03/26/2015] [Indexed: 11/08/2022]
Affiliation(s)
- Ana Spínola
- Serviço De Terapia Celular; Instituto Português De Oncologia Do Porto Francisco Gentil; EPE Porto Portugal
| | - Sara Ferreira
- Serviço De Terapia Celular; Instituto Português De Oncologia Do Porto Francisco Gentil; EPE Porto Portugal
| | - Fátima Amado
- Serviço De Terapia Celular; Instituto Português De Oncologia Do Porto Francisco Gentil; EPE Porto Portugal
| | - Sérgio Lopes
- Serviço De Terapia Celular; Instituto Português De Oncologia Do Porto Francisco Gentil; EPE Porto Portugal
| | - Susana Roncon
- Serviço De Terapia Celular; Instituto Português De Oncologia Do Porto Francisco Gentil; EPE Porto Portugal
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31
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Flommersfeld S, Sohlbach K, Jaques G, Bein G, Hoffmann J, Kostrewa P, Sachs UJ. Collection of peripheral blood progenitor cells on Day 4 is feasible and effective while reducing granulocyte-colony-stimulating factor exposure to healthy donors. Transfusion 2015; 55:1269-74. [DOI: 10.1111/trf.13002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 11/18/2014] [Accepted: 11/28/2014] [Indexed: 11/28/2022]
Affiliation(s)
| | - Kristina Sohlbach
- Department of Hematology, Oncology, and Immunology; University Hospital Giessen and Marburg, Marburg Campus; Marburg Germany
| | - Gabriele Jaques
- Department of Hematology, Oncology, and Immunology; University Hospital Giessen and Marburg, Marburg Campus; Marburg Germany
| | - Gregor Bein
- Institute for Clinical Immunology and Transfusion Medicine; Justus Liebig University; Giessen Germany
| | - Jörg Hoffmann
- Department of Hematology, Oncology, and Immunology; University Hospital Giessen and Marburg, Marburg Campus; Marburg Germany
| | - Philippe Kostrewa
- Department of Hematology, Oncology, and Immunology; University Hospital Giessen and Marburg, Marburg Campus; Marburg Germany
| | - Ulrich J. Sachs
- Center for Transfusion Medicine and Hemotherapy
- Institute for Clinical Immunology and Transfusion Medicine; Justus Liebig University; Giessen Germany
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32
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Sorg N, Poppe C, Bunos M, Wingenfeld E, Hümmer C, Krämer A, Stock B, Seifried E, Bonig H. Red blood cell depletion from bone marrow and peripheral blood buffy coat: a comparison of two new and three established technologies. Transfusion 2015; 55:1275-82. [PMID: 25647556 DOI: 10.1111/trf.13001] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 11/24/2014] [Accepted: 11/28/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Red blood cell (RBC) depletion is a standard technique for preparation of ABO-incompatible bone marrow transplants (BMTs). Density centrifugation or apheresis are used successfully at clinical scale. The advent of a bone marrow (BM) processing module for the Spectra Optia (Terumo BCT) provided the initiative to formally compare our standard technology, the COBE2991 (Ficoll, manual, "C") with the Spectra Optia BMP (apheresis, semiautomatic, "O"), the Sepax II NeatCell (Ficoll, automatic, "S"), the Miltenyi CliniMACS Prodigy density gradient separation system (Ficoll, automatic, "P"), and manual Ficoll ("M"). C and O handle larger product volumes than S, P, and M. STUDY DESIGN AND METHODS Technologies were assessed for RBC depletion, target cell (mononuclear cells [MNCs] for buffy coats [BCs], CD34+ cells for BM) recovery, and cost/labor. BC pools were simultaneously purged with C, O, S, and P; five to 18 BM samples were sequentially processed with C, O, S, and M. RESULTS Mean RBC removal with C was 97% (BCs) or 92% (BM). From both products, O removed 97%, and P, S, and M removed 99% of RBCs. MNC recovery from BC (98% C, 97% O, 65% P, 74% S) or CD34+ cell recovery from BM (92% C, 90% O, 67% S, 70% M) were best with C and O. Polymorphonuclear cells (PMNs) were depleted from BCs by P, S, and C, while O recovered 50% of PMNs. Time savings compared to C or M for all tested technologies are considerable. CONCLUSION All methods are in principle suitable and can be selected based on sample volume, available technology, and desired product specifications beyond RBC depletion and MNC and/or CD34+ cell recovery.
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Affiliation(s)
- Nadine Sorg
- German Red Cross Blood Service Baden-Württemberg-Hessen, Institute Frankfurt
| | - Carolin Poppe
- German Red Cross Blood Service Baden-Württemberg-Hessen, Institute Frankfurt
| | - Milica Bunos
- German Red Cross Blood Service Baden-Württemberg-Hessen, Institute Frankfurt
| | - Eva Wingenfeld
- German Red Cross Blood Service Baden-Württemberg-Hessen, Institute Frankfurt
| | - Christiane Hümmer
- German Red Cross Blood Service Baden-Württemberg-Hessen, Institute Frankfurt
| | - Ariane Krämer
- German Red Cross Blood Service Baden-Württemberg-Hessen, Institute Frankfurt
| | - Belinda Stock
- Institute for Transfusion Medicine and Immunohematology, Goethe University, Frankfurt, Germany
| | - Erhard Seifried
- German Red Cross Blood Service Baden-Württemberg-Hessen, Institute Frankfurt.,Institute for Transfusion Medicine and Immunohematology, Goethe University, Frankfurt, Germany
| | - Halvard Bonig
- German Red Cross Blood Service Baden-Württemberg-Hessen, Institute Frankfurt.,Institute for Transfusion Medicine and Immunohematology, Goethe University, Frankfurt, Germany.,Department of Medicine/Hematology, University of Washington, Seattle, Washington
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33
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Leitner GC, Kolovratova V, Horvath M, Worel N. Granulocyte collection using a novel apheresis system eases the procedure and provides concentrates of high quality. Transfusion 2014; 55:991-5. [DOI: 10.1111/trf.12928] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 09/16/2014] [Accepted: 09/23/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Gerda C. Leitner
- Department of Blood Group Serology and Transfusion Medicine; Medical University of Vienna; Vienna Austria
| | - Vera Kolovratova
- Department of Blood Group Serology and Transfusion Medicine; Medical University of Vienna; Vienna Austria
| | - Michaela Horvath
- Department of Blood Group Serology and Transfusion Medicine; Medical University of Vienna; Vienna Austria
| | - Nina Worel
- Department of Blood Group Serology and Transfusion Medicine; Medical University of Vienna; Vienna Austria
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34
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Long G, Waller EK, Gregurek S, Tricot G, Marschner S, Bill J. Evaluation of the spectra Optia® mononuclear cell collection procedure in multiple myeloma patients. J Clin Apher 2014; 30:1-7. [DOI: 10.1002/jca.21341] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 05/29/2014] [Accepted: 05/30/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Gwynn Long
- Department of Medicine; Division of Cellular Therapy; Duke University School of Medicine; Durham North Carolina
| | - Edmund K. Waller
- Department of Hematology and Medical Oncology; Division of Stem Cell and Bone Marrow Transplantation; Winship Cancer Institute; Emory University School of Medicine; Atlanta Georgia
| | - Steven Gregurek
- Department of Pathology and Laboratory Medicine; University of Indiana School of Medicine; Indianapolis Indiana
| | - Guido Tricot
- Division of Hematology/BMT/Myeloma Program; University of Utah School of Medicine; Salt Lake City Utah
| | | | - Jerry Bill
- Scientific Affairs; Terumo BCT; Lakewood Colorado
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35
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Karafin MS, Graminske S, Erickson P, Walters MC, Scott EP, Carter S, Padmanabhan A. Evaluation of the spectra optia apheresis system for mononuclear cell (MNC) collection in G-CSF mobilized and nonmobilized healthy donors: Results of a multicenter study. J Clin Apher 2014; 29:273-80. [DOI: 10.1002/jca.21319] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 01/27/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Matthew S. Karafin
- Medical Sciences Institute, Blood Center of Wisconsin; Milwaukee Wisconsin
- Medical College of Wisconsin; Milwaukee Wisconsin
| | - Sharon Graminske
- Applied Research Laboratory, Blood Center of Wisconsin; Milwaukee Wisconsin
| | | | - Mark C. Walters
- LeukoLab; Alameda California
- Children's Hospital & Research Center; Oakland California
| | | | | | - Anand Padmanabhan
- Medical Sciences Institute, Blood Center of Wisconsin; Milwaukee Wisconsin
- Medical College of Wisconsin; Milwaukee Wisconsin
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36
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Schulz M, Bialleck H, Thorausch K, Bug G, Dünzinger U, Seifried E, Bönig H. Unstimulated leukapheresis in patients and donors: comparison of two apheresis systems. Transfusion 2013; 54:1622-9. [PMID: 24299303 DOI: 10.1111/trf.12506] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 10/15/2013] [Accepted: 10/17/2013] [Indexed: 01/12/2023]
Abstract
BACKGROUND Unstimulated mononuclear cell (MNC) apheresis plays a role in the generation of donor lymphocytes (DLIs; healthy donors) and in extracorporeal photopheresis (ECP; patients). The new apheresis system Spectra Optia MNC has been shown in small studies to be capable of performing the desired cell collections, but larger data sets from real-life clinical apheresis procedures are lacking. STUDY DESIGN AND METHODS Presented are comparative data from DLI collections randomly performed with either the new technology or a clinical standard technology, COBE Spectra MNC, as well as data from patients with chronic graft-versus-host disease undergoing MNC collections alternating between the two apheresis systems to generate products for ECP. Target cell yield and collection efficiency, product volume, nontarget cell contamination, platelet (PLT) attrition, and some process variables such as process volume and time were analyzed. RESULTS For most relevant apheresis outcomes, differences between the devices were at best marginal. Spectra Optia MNC collections in patients, but not in donors, took 10% longer to achieve the target process volume. Not unexpectedly, given previous observations for granulocyte-colony-stimulating factor-stimulated leukapheresis, the novel device collected smaller products with less red blood cell contamination. PLT attrition with Spectra Optia MNC was markedly lower in donors. ECP apheresis outcome variability was, to a significant degree, donor dependent, irrespective of the device used. CONCLUSION Based on more than 200 unstimulated apheresis procedures, we conclude that both apheresis systems are safe, robust, and equally suitable for unstimulated MNC collections. Both can be successfully run with manufacturer-recommended settings and algorithms.
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Affiliation(s)
- Miriam Schulz
- German Red Cross Blood Service Baden-Württemberg-Hessen and Institute for Transfusion Medicine and Immunohematology, Goethe University Hospital, Frankfurt, Germany
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A single center comparison between three different apheresis systems for autologous and allogeneic stem cell collections. Transfus Apher Sci 2013; 49:428-33. [DOI: 10.1016/j.transci.2013.06.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 03/11/2013] [Accepted: 06/04/2013] [Indexed: 11/21/2022]
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Steininger PA, Strasser EF, Weiss D, Achenbach S, Zimmermann R, Eckstein R. First comparative evaluation of a new leukapheresis technology in non-cytokine-stimulated donors. Vox Sang 2013; 106:248-55. [DOI: 10.1111/vox.12102] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 09/19/2013] [Accepted: 09/20/2013] [Indexed: 11/28/2022]
Affiliation(s)
- P. A. Steininger
- Transfusion Medicine and Haemostaseology Department; University Hospital Erlangen; Erlangen Germany
| | - E. F. Strasser
- Transfusion Medicine and Haemostaseology Department; University Hospital Erlangen; Erlangen Germany
| | - D. Weiss
- Transfusion Medicine and Haemostaseology Department; University Hospital Erlangen; Erlangen Germany
| | - S. Achenbach
- Transfusion Medicine and Haemostaseology Department; University Hospital Erlangen; Erlangen Germany
| | - R. Zimmermann
- Transfusion Medicine and Haemostaseology Department; University Hospital Erlangen; Erlangen Germany
| | - R. Eckstein
- Transfusion Medicine and Haemostaseology Department; University Hospital Erlangen; Erlangen Germany
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Cherqaoui B, Rouel N, Auvrignon A, Defachelles AS, Deméocq F, Kanold J, Merlin E. Peripheral blood stem cell collection in low-weight children: retrospective comparison of two apheresis devices. Transfusion 2013; 54:1371-8. [PMID: 24117598 DOI: 10.1111/trf.12448] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 08/20/2013] [Accepted: 08/27/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Apheresis is a major challenge in peripheral stem cell collection from low-weight children with cancer. Comparisons between the new apheresis device Optia (TerumoBCT) and the earlier COBE Spectra (CaridianBCT) have been performed in adults but not in low-weight children. The objective was to compare the performance of these two devices in small children. STUDY DESIGN AND METHODS In this retrospective study, all patients were reviewed weighing less than 15 kg undergoing stem cell collection using the Optia device between April 2011 and April 2012. They were paired on weight in a 3:1 ratio with patients whose cells had been collected with the COBE Spectra since 2006. RESULTS Six patients were treated with the Optia and were matched with 18 patients treated with the Spectra. No side effects occurred. Collection efficiency (CE) was similar between the two groups (50% vs. 47%), but CD34 cell blood clearance was lower with the Optia (0.4 mL/min/kg vs. 0.6 mL/min/kg, p < 0.01). Platelet (PLT) loss and hemoglobin (Hb) loss were significantly reduced with the Optia (respectively, 32% vs. 54%, p < 0.01; and 1.4 g/dL vs. 2.9 g/dL, p < 0.01). Apheresis duration was increased with the Optia (159 min vs. 134 min, p < 0.05). The cell product harvested with the Optia had a lower volume and lower hematocrit, but similar white blood cell and PLT content. CONCLUSION Compared with the Spectra, the Optia allows similar CE with a reduced PLT and Hb loss but with a longer duration.
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Thorausch K, Schulz M, Bialleck H, Luxembourg B, Seifried E, Bonig H. Granulocyte collections: comparison of two apheresis systems. Transfusion 2013; 53:3262-8. [DOI: 10.1111/trf.12197] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 02/04/2013] [Accepted: 02/21/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Kristin Thorausch
- German Red Cross Blood Service and Institute for Transfusion Medicine and Immunohematology; Goethe University Medical School; Frankfurt Germany
- Department of Medicine/Hematology; University of Washington; Seattle WA
| | - Miriam Schulz
- German Red Cross Blood Service and Institute for Transfusion Medicine and Immunohematology; Goethe University Medical School; Frankfurt Germany
- Department of Medicine/Hematology; University of Washington; Seattle WA
| | - Heike Bialleck
- German Red Cross Blood Service and Institute for Transfusion Medicine and Immunohematology; Goethe University Medical School; Frankfurt Germany
- Department of Medicine/Hematology; University of Washington; Seattle WA
| | - Beate Luxembourg
- German Red Cross Blood Service and Institute for Transfusion Medicine and Immunohematology; Goethe University Medical School; Frankfurt Germany
- Department of Medicine/Hematology; University of Washington; Seattle WA
| | - Erhard Seifried
- German Red Cross Blood Service and Institute for Transfusion Medicine and Immunohematology; Goethe University Medical School; Frankfurt Germany
- Department of Medicine/Hematology; University of Washington; Seattle WA
| | - Halvard Bonig
- German Red Cross Blood Service and Institute for Transfusion Medicine and Immunohematology; Goethe University Medical School; Frankfurt Germany
- Department of Medicine/Hematology; University of Washington; Seattle WA
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Schulz M, Bug G, Bialleck H, Serve H, Seifried E, Bönig H. Leucodepletion for hyperleucocytosis--first report on a novel technology featuring electronic interphase management. Vox Sang 2013; 105:47-53. [PMID: 23384315 DOI: 10.1111/vox.12020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 12/07/2012] [Accepted: 12/08/2012] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVES Therapeutic leucodepletion plays an established role in the initial treatment of patients with acute myeloid leukaemia (AML) and possibly other leukaemias presenting with leucostasis. Recently, a new leucodepletion technology, Spectra Optia IDL, has become available that differs from its predecessor, COBE Spectra MNC, by a variety of electronic supports, including by electronic adjustment of buffy coat positioning at the collection port. Given the paucity of patients in need of leucodepletions and marked differences in clinical presentation as well as blast properties (e.g. size, density), formal clinical trials comparing leucodepletion technologies have never been executed. MATERIALS AND METHODS Here, we present aggregate data from eight leucodepletions performed in AML patients with clinical signs of leucostasis between 11/2011 and 07/2012 with the new device and compare the apheresis outcomes with those from fifteen leucodepletions performed with the old technology between 06/2010 and 10/2011. RESULTS Patients did not differ with respect to epidemiological data. Pre-apheresis leucocyte count (WBC) was significantly higher in Spectra Optia IDL patients. Tolerability was excellent with both devices. Basic apheresis denominators such as duration, processed volume, inlet pump rate, ACD-A consumption and product volume were very similar. A negative correlation between pre-apheresis WBC and collection efficiency was noted. Mean collection efficiency for leucocytes with Spectra Optia IDL (47·3%) was similar to that with COBE Spectra MNC (50·5%). Platelet attrition was similar with both devices, approximately 30%. CONCLUSION The novel, electronically guided leukapheresis system is suitable for leucodepletion.
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Affiliation(s)
- M Schulz
- German Red Cross Blood Service Baden-Württemberg-Hessen, Institute for Transfusion Medicine and Immunohematology of the Goethe University Hospital, Frankfurt, Germany
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Del Fante C, Scudeller L, Viarengo G, Cervio M, Perotti C. Mononuclear cell collection for extracorporeal photochemotherapy: a study comparing an automatic and a semiautomatic apheresis device. Transfusion 2013; 53:2027-33. [PMID: 23305183 DOI: 10.1111/trf.12065] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 10/23/2012] [Accepted: 11/05/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Claudia Del Fante
- Immunohaematology and Transfusion Service, Apheresis and Cell Therapy Unit and Scientific Direction; Fondazione IRCCS Policlinico San Matteo; Pavia; Italy
| | - Luigia Scudeller
- Immunohaematology and Transfusion Service, Apheresis and Cell Therapy Unit and Scientific Direction; Fondazione IRCCS Policlinico San Matteo; Pavia; Italy
| | - Gianluca Viarengo
- Immunohaematology and Transfusion Service, Apheresis and Cell Therapy Unit and Scientific Direction; Fondazione IRCCS Policlinico San Matteo; Pavia; Italy
| | - Marila Cervio
- Immunohaematology and Transfusion Service, Apheresis and Cell Therapy Unit and Scientific Direction; Fondazione IRCCS Policlinico San Matteo; Pavia; Italy
| | - Cesare Perotti
- Immunohaematology and Transfusion Service, Apheresis and Cell Therapy Unit and Scientific Direction; Fondazione IRCCS Policlinico San Matteo; Pavia; Italy
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Sörensen J, Jarisch A, Smorta C, Köhl U, Bader P, Seifried E, Bönig H. Pediatric apheresis with a novel apheresis device with electronic interface control. Transfusion 2012; 53:761-5. [DOI: 10.1111/j.1537-2995.2012.03823.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Steininger PA, Smith R, Geier C, Zimmermann R, Eckstein R, Strasser EF. Leukapheresis in non-cytokine-stimulated donors with a new apheresis system: first-time collection results and evaluation of subsequent cryopreservation. Transfusion 2012; 53:747-56. [PMID: 22803702 DOI: 10.1111/j.1537-2995.2012.03787.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Adoptive cell therapy based on mononuclear cells (MNCs) became an important modality of cancer immunotherapy. Data about collection results and donor response of leukapheresis with the Spectra Optia v.5.0 (Terumo BCT) in nonmobilized donors are required. STUDY DESIGN AND METHODS Twelve MNC collections were performed using the Spectra Optia v.5.0 in non-cytokine-stimulated donors. Leukapheresis products and peripheral blood samples from donors were assayed for CD45+, CD34+, CD3+, and CD14+ cells by flow cytometry. Prefreeze and postthaw cell counts, cell viability, and numbers of colony-forming units were assessed in cryobags and compared to data from cryovials. RESULTS Leukapheresis yielded a mean of 5.26×10(9) ±2.2×10(9) CD45+ cells, 1.5×10(9) ±0.77×10(9) CD14+ monocytes, and 2.28×10(9) ±1.2×10(9) CD3+ Tcells by processing 6690±930mL of whole blood. A significant positive correlation between yield of CD3+ Tcells and residual platelets (PLTs) and red blood cells (RBCs) was observed. This did not apply for CD34+ and CD14+ white blood cell subsets. Mean collection efficiencies for CD14+ monocytes and CD3+ Tcells were 61.8±17 and 37.2±18%, respectively. Recovery of CD14+ cells after cryopreservation was 75.2±8.2%, which was significantly lower than recovery of CD45+ cells (81.4±5.5%; p=0.01). CONCLUSION This study of a small cohort demonstrates that the Spectra Optia v.5.0 is capable of collecting low product volumes with satisfactory MNC yields and low residual RBCs and PLTs in non-cytokine-mobilized apheresis. Our data suggest that cryovials can serve as a representative surrogate for the primary product cryobag.
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Affiliation(s)
- Philipp A Steininger
- Transfusion Medicine and Hemostaseology Department, University Hospital Erlangen, Erlangen, Germany
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Brauninger S, Bialleck H, Thorausch K, Felt T, Seifried E, Bonig H. Allogeneic donor peripheral blood “stem cell” apheresis: prospective comparison of two apheresis systems. Transfusion 2011; 52:1137-45. [DOI: 10.1111/j.1537-2995.2011.03414.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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