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Baranovskii DS, Klabukov ID, Arguchinskaya NV, Yakimova AO, Kisel AA, Yatsenko EM, Ivanov SA, Shegay PV, Kaprin AD. Adverse events, side effects and complications in mesenchymal stromal cell-based therapies. Stem Cell Investig 2022; 9:7. [PMID: 36393919 PMCID: PMC9659480 DOI: 10.21037/sci-2022-025] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/28/2022] [Indexed: 07/22/2023]
Abstract
Numerous clinical studies have shown a wide clinical potential of mesenchymal stromal cells (MSCs) application. However, recent experience has accumulated numerous reports of adverse events and side effects associated with MSCs therapy. Furthermore, the strategies and methods of MSCs therapy did not change significantly in recent decades despite the clinical impact and awareness of potential complications. An extended understanding of limitations could lead to a wider clinical implementation of safe cell therapies and avoid harmful approaches. Therefore, our objective was to summarize the possible negative effects observed during MSCs-based therapies. We were also aimed to discuss the risks caused by weaknesses in cell processing, including isolation, culturing, and storage. Cell processing and cell culture could dramatically influence cell population profile, change protein expression and cell differentiation paving the way for future negative effects. Long-term cell culture led to accumulation of chromosomal abnormalities. Overdosed antibiotics in culture media enhanced the risk of mycoplasma contamination. Clinical trials reported thromboembolism and fibrosis as the most common adverse events of MSCs therapy. Their delayed manifestation generally depends on the patient's individual phenotype and requires specific awareness during the clinical trials with obligatory inclusion in the patient' informed consents. Finally we prepared the safety checklist, recommended for clinical specialists before administration or planning of MSCs therapy.
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Affiliation(s)
- Denis S. Baranovskii
- National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia
- Peoples’ Friendship University of Russia (RUDN University), Moscow, Russia
| | - Ilya D. Klabukov
- National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia
- Peoples’ Friendship University of Russia (RUDN University), Moscow, Russia
- Obninsk Institute for Nuclear Power Engineering of the National Research Nuclear University MEPhI, Obninsk, Russia
| | - Nadezhda V. Arguchinskaya
- National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia
| | - Anna O. Yakimova
- National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia
| | - Anastas A. Kisel
- National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia
| | - Elena M. Yatsenko
- National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia
| | - Sergei A. Ivanov
- National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia
| | - Peter V. Shegay
- National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia
| | - Andrey D. Kaprin
- National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk, Russia
- Peoples’ Friendship University of Russia (RUDN University), Moscow, Russia
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Howell A, Letcher B, Murphy K, Elmoazzen H, Petraszko T, Acker JP, Pineault N, Holovati JL. Automated closed volume reduction process for apheresis stem cell grafts: From development to clinical implementation. Transfusion 2022; 62:1818-1828. [DOI: 10.1111/trf.17022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 06/07/2022] [Accepted: 06/12/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Anita Howell
- Canadian Blood Services, Innovation and Portfolio Management Ottawa Ontario Canada
| | - Brenda Letcher
- Canadian Blood Services, Cord Blood Bank and Stem Cell Manufacturing Ottawa Ontario Canada
| | - Kelly Murphy
- Canadian Blood Services, Cord Blood Bank and Stem Cell Manufacturing Ottawa Ontario Canada
| | - Heidi Elmoazzen
- Canadian Blood Services, Cord Blood Bank and Stem Cell Manufacturing Ottawa Ontario Canada
| | - Tanya Petraszko
- Canadian Blood Services, Cord Blood Bank and Stem Cell Manufacturing Ottawa Ontario Canada
- Department of Medicine University of British Columbia Vancouver British Columbia Canada
| | - Jason P. Acker
- Canadian Blood Services, Innovation and Portfolio Management Ottawa Ontario Canada
- Department of Laboratory Medicine and Pathology University of Alberta Edmonton Alberta Canada
| | - Nicolas Pineault
- Canadian Blood Services, Innovation and Portfolio Management Ottawa Ontario Canada
- Department of Biochemistry, Microbiology and Immunology University of Ottawa Ottawa Ontario Canada
| | - Jelena L. Holovati
- Canadian Blood Services, Cord Blood Bank and Stem Cell Manufacturing Ottawa Ontario Canada
- Department of Laboratory Medicine and Pathology University of Alberta Edmonton Alberta Canada
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Lauvrud AT, Gümüscü R, Wiberg R, Brohlin M, Kelk P, Wiberg M, Kingham PJ. Water jet-assisted lipoaspiration and Sepax cell separation system for the isolation of adipose stem cells with high adipogenic potential. J Plast Reconstr Aesthet Surg 2021; 74:2759-2767. [PMID: 33994109 DOI: 10.1016/j.bjps.2021.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/05/2021] [Accepted: 03/11/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Water jet-assisted liposuction has gained popularity due to favourable fat grafting outcomes. In this study, we compared stem cells obtained from fat isolated with manual or the water jet-assisted procedure. METHODS Liposuction of abdominal fat was performed using the two methods on each donor (n = 10). Aspirate samples were collagenase digested and the isolated cells seeded in vitro prior to proliferation, adipogenic differentiation and angiogenic activity analyses. RESULTS Cells from either procedure proliferated at similar rates and exhibited a similar colony-forming ability. The cells expressed stem cell markers CD73, CD90 and CD105. In the water jet cell preparations, there were higher numbers of cells expressing CD146. Robust adipogenic differentiation was observed in cultures expanded from both manual and water jet lipoaspirates. Gene analysis showed higher expression of the adipocyte markers aP2 and GLUT4 in the adipocyte-differentiated water jet cell preparations, and ELISA indicated increased secretion of adiponectin from these cells. Both cell groups expressed vasculogenic factors and the water jet cells promoted the highest levels of in vitro angiogenesis. Given these positive results, we further characterised the water jet cells when prepared using an automated closed cell processing unit, the Sepax-2 system (Cytiva). The growth and stem cell properties of the Sepax-processed cells were similar to the standard centrifugation protocol, but there was evidence for greater adipogenic differentiation in the Sepax-processed cells. CONCLUSIONS Water jet lipoaspirates yield cells with high adipogenic potential and angiogenic activity, which may be beneficial for use in cell-assisted lipotransfers.
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Affiliation(s)
- Anne Therese Lauvrud
- Department of Integrative Medical Biology, Umeå University, Sweden; Department of Surgical and Perioperative Sciences, Umeå University, Umeå 907 37, Sweden.
| | - Rojda Gümüscü
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå 907 37, Sweden
| | - Rebecca Wiberg
- Department of Integrative Medical Biology, Umeå University, Sweden; Department of Surgical and Perioperative Sciences, Umeå University, Umeå 907 37, Sweden
| | - Maria Brohlin
- Department of Clinical Microbiology, Infection and Immunity, Umeå University, Sweden
| | - Peyman Kelk
- Department of Integrative Medical Biology, Umeå University, Sweden
| | - Mikael Wiberg
- Department of Integrative Medical Biology, Umeå University, Sweden; Department of Surgical and Perioperative Sciences, Umeå University, Umeå 907 37, Sweden
| | - Paul J Kingham
- Department of Integrative Medical Biology, Umeå University, Sweden
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Trummer T, Fox R, Koç JR, de Lima M, Otegbeye F. Cryopreservation of hematopoietic cells using a pre-constituted, protein-free cryopreservative solution with 5% dimethyl sulfoxide. Cytotherapy 2020; 22:613-616. [PMID: 32600975 DOI: 10.1016/j.jcyt.2020.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND AIMS Adequate cryopreservation techniques are critical to ensure optimal recovery of functional progenitor cells in hematopoietic cell (HC) transplantation, minimize risk of contamination and prevent infusion-related adverse events (irAEs). In this article, we provide graft function and infusion safety results observed by decreasing the concentration of dimethyl sulfoxide (DMSO) in cryopreservative media and by minimizing processor-dependent formulation. METHODS Ten HC products, collected after standard mobilization of multiple myeloma patients, were cryopreserved with PRIME-XV FreezIS (FreezIS) and compared with products previously cryopreserved with media formulated in-house to achieve a final DMSO concentration of 10% (Std10) and 5% (Std5). At infusion, HCs were analyzed for recovery of CD34+ cells and viability; irAEs and time to engraftment of neutrophils and platelets were also monitored. RESULTS Median CD34+ cell recovery for HC cryopreserved with Std10, Std5 and FreezIS was 38%, 78% and 68%, respectively (P = 0.0002). There were less frequent irAEs with Std5 and FreezIS (10%) compared with Std10 (80%) (P ≤ 0.0001). Median time to neutrophil engraftment was comparable (11 days) for all three groups, while platelet engraftment occurred at a median of 20, 19 and 17 days, respectively (p-values not significant). CONCLUSIONS FreezIS, a Good Manufacturing Practice-grade, pre-constituted cryopreservative with low DMSO content, maintains functional viability of the HC product while reducing the incidence of irAEs compared with 10% DMSO solutions. The pre-constituted nature of this agent also decreases processor-dependent handling, hence decreasing the risk of variability and infection.
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Affiliation(s)
- Tabatha Trummer
- University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
| | - Robert Fox
- University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
| | - Jane Reese Koç
- University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
| | - Marcos de Lima
- University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA
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Fantin L, Olivieri CV, Spirito-Daffara F, Doglio A, Olivero S. A comparison of two protocols for optimal red blood cell depletion using Sepax-2 device for ABO-major incompatible transplantation in adults. Curr Res Transl Med 2019; 67:107-111. [PMID: 30935875 DOI: 10.1016/j.retram.2019.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 02/21/2019] [Accepted: 03/19/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE OF THE STUDY In ABO-incompatible bone marrow transplantation, an efficient depletion of red blood cells (RBC) within the graft is mandatory to avoid adverse events in transplanted patients. Using non therapeutic products, we evaluated the substitution of the standard density gradient-based separation (DGBS) over Ficoll-Paque with the use of an automated procedure intended for buffy coat only (SmartRedux software) introducing modifications within the settings to achieve a drastic reduction of the initial volume of the product. Both methods were conducted on the Sepax-2 device. SAMPLES AND METHODS RBC depletion rates and CD34+ cells recoveries from eight procedures with SmartRedux software using "in-house" settings (method A) were compared to those obtained from four procedures using NeatCell software, an automated DGBS over Ficoll-Paque (method B). RESULTS Median erythrocyte depletion of 95,4% (92,7%-99,0%) and 99,8% (99,0%-99,9%) were observed using methods A and B, respectively. Median residual RBC volumes in the final product were 19 mL (4,4 mL-31,2 mL) and 0,7 mL (0,4 mL-4,7 mL), respectively (p = 0,014). CD34+ cells recoveries of 90,9% (62,7%-102,1%) and 78,4% (64,1%-86,2%) were achieved for methods A and B. Median platelet depletion was 16,6% (10%-42,7%) and 89,8% (88,5%-92,4%) using methods A and B, respectively (p = 0,004). Processing duration was shorter using method A (168 ± 29 min) than method B (295 ± 21 min) (p = 0,004). CONCLUSION Both methods achieved satisfactory erythrocyte depletion and CD34+ recovery. The use of Sepax-2 device in association with SmartRedux software could be extended to efficiently deplete RBC from large-volume BM in a raw instead of DGBS.
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Affiliation(s)
- L Fantin
- Centre Hospitalier Universitaire de Nice, Unité de Thérapie Cellulaire et Génique, Nice, France
| | - C V Olivieri
- Université Côte d'Azur, EA 7354 MICORALIS, UFR Odontologie, Nice, France
| | - F Spirito-Daffara
- Centre Hospitalier Universitaire de Nice, Unité de Thérapie Cellulaire et Génique, Nice, France
| | - A Doglio
- Centre Hospitalier Universitaire de Nice, Unité de Thérapie Cellulaire et Génique, Nice, France; Université Côte d'Azur, EA 7354 MICORALIS, UFR Odontologie, Nice, France
| | - S Olivero
- Centre Hospitalier Universitaire de Nice, Unité de Thérapie Cellulaire et Génique, Nice, France.
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López-Lucas MD, Pachón-Peña G, García-Hernández AM, Parrado A, Sánchez-Salinas D, García-Bernal D, Algueró MDC, Martinez FI, Blanquer M, Cabañas-Perianes V, Molina-Molina M, Asín-Aguilar C, Moraleda JM, Sackstein R. Production via good manufacturing practice of exofucosylated human mesenchymal stromal cells for clinical applications. Cytotherapy 2018; 20:1110-1123. [PMID: 30170815 DOI: 10.1016/j.jcyt.2018.07.001] [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: 11/09/2017] [Revised: 05/25/2018] [Accepted: 07/03/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND The regenerative and immunomodulatory properties of human mesenchymal stromal cells (hMSCs) have raised great hope for their use in cell therapy. However, when intravenously infused, hMSCs fail to reach sites of tissue injury. Fucose addition in α(1,3)-linkage to terminal sialyllactosamines on CD44 creates the molecule known as hematopoietic cell E-/L-selectin ligand (HCELL), programming hMSC binding to E-selectin that is expressed on microvascular endothelial cells of bone marrow (BM), skin and at all sites of inflammation. Here we describe how this modification on BM-derived hMSCs (BM-hMSCs) can be adapted to good manufacturing practice (GMP) standards. METHODS BM-hMSCs were expanded using xenogenic-free media and exofucosylated using α(1,3)-fucosyltransferases VI (FTVI) or VII (FTVII). Enforced fucosylation converted CD44 into HCELL, and HCELL formation was assessed using Western blot, flow cytometry and cell-binding assays. Untreated (unfucosylated), buffer-treated and exofucosylated BM-hMSCs were each analyzed for cell viability, immunophenotype and differentiation potential, and E-selectin binding stability was assessed at room temperature, at 4°C, and after cryopreservation. Cell product safety was evaluated using microbiological testing, karyotype analysis, and c-Myc messenger RNA (mRNA) expression, and potential effects on genetic reprogramming and in cell signaling were analyzed using gene expression microarrays and receptor tyrosine kinase (RTK) phosphorylation arrays. RESULTS Our protocol efficiently generates HCELL on clinical-scale batches of BM-hMSCs. Exofucosylation yields stable HCELL expression for 48 h at 4°C, with retained expression after cell cryopreservation. Cell viability and identity are unaffected by exofucosylation, without changes in gene expression or RTK phosphorylation. DISCUSSION The described exofucosylation protocol using xenogenic-free reagents enforces HCELL expression on hMSCs endowing potent E-selectin binding without affecting cell viability or native phenotype. This described protocol is readily scalable for GMP-compliant clinical production.
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Affiliation(s)
- María Dolores López-Lucas
- Red de Terapia Celular (TerCel), Instituto de Salud Carlos III. University of Murcia; Stem Cell Transplant and Cell Therapy Unit, Virgen de la Arrixaca Clinic University Hospital and Institute for Biohealth Research (IMIB-Arrixaca), Ctra. Madrid-Cartagena s/n, El Palmar, Murcia, Spain
| | - Gisela Pachón-Peña
- The Program of Excellence in Glycosciences, Harvard Medical School, Boston, Massachusetts, and the Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ana María García-Hernández
- Red de Terapia Celular (TerCel), Instituto de Salud Carlos III. University of Murcia; Stem Cell Transplant and Cell Therapy Unit, Virgen de la Arrixaca Clinic University Hospital and Institute for Biohealth Research (IMIB-Arrixaca), Ctra. Madrid-Cartagena s/n, El Palmar, Murcia, Spain
| | - Antonio Parrado
- Immunology Service, Virgen de la Arrixaca Clinic University Hospital, Institute for Biohealth Research (IMIB-Arrixaca), Ctra. Madrid-Cartagena s/n, El Palmar, Murcia, Spain
| | - Darío Sánchez-Salinas
- Red de Terapia Celular (TerCel), Instituto de Salud Carlos III. University of Murcia; Stem Cell Transplant and Cell Therapy Unit, Virgen de la Arrixaca Clinic University Hospital and Institute for Biohealth Research (IMIB-Arrixaca), Ctra. Madrid-Cartagena s/n, El Palmar, Murcia, Spain
| | - David García-Bernal
- Red de Terapia Celular (TerCel), Instituto de Salud Carlos III. University of Murcia; Stem Cell Transplant and Cell Therapy Unit, Virgen de la Arrixaca Clinic University Hospital and Institute for Biohealth Research (IMIB-Arrixaca), Ctra. Madrid-Cartagena s/n, El Palmar, Murcia, Spain
| | - Maria Del Carmen Algueró
- Red de Terapia Celular (TerCel), Instituto de Salud Carlos III. University of Murcia; Stem Cell Transplant and Cell Therapy Unit, Virgen de la Arrixaca Clinic University Hospital and Institute for Biohealth Research (IMIB-Arrixaca), Ctra. Madrid-Cartagena s/n, El Palmar, Murcia, Spain
| | - Francisca Iniesta Martinez
- Red de Terapia Celular (TerCel), Instituto de Salud Carlos III. University of Murcia; Stem Cell Transplant and Cell Therapy Unit, Virgen de la Arrixaca Clinic University Hospital and Institute for Biohealth Research (IMIB-Arrixaca), Ctra. Madrid-Cartagena s/n, El Palmar, Murcia, Spain
| | - Miguel Blanquer
- Red de Terapia Celular (TerCel), Instituto de Salud Carlos III. University of Murcia; Stem Cell Transplant and Cell Therapy Unit, Virgen de la Arrixaca Clinic University Hospital and Institute for Biohealth Research (IMIB-Arrixaca), Ctra. Madrid-Cartagena s/n, El Palmar, Murcia, Spain
| | - Valentín Cabañas-Perianes
- Red de Terapia Celular (TerCel), Instituto de Salud Carlos III. University of Murcia; Stem Cell Transplant and Cell Therapy Unit, Virgen de la Arrixaca Clinic University Hospital and Institute for Biohealth Research (IMIB-Arrixaca), Ctra. Madrid-Cartagena s/n, El Palmar, Murcia, Spain
| | - Mar Molina-Molina
- Red de Terapia Celular (TerCel), Instituto de Salud Carlos III. University of Murcia; Stem Cell Transplant and Cell Therapy Unit, Virgen de la Arrixaca Clinic University Hospital and Institute for Biohealth Research (IMIB-Arrixaca), Ctra. Madrid-Cartagena s/n, El Palmar, Murcia, Spain
| | - Cira Asín-Aguilar
- Red de Terapia Celular (TerCel), Instituto de Salud Carlos III. University of Murcia; Stem Cell Transplant and Cell Therapy Unit, Virgen de la Arrixaca Clinic University Hospital and Institute for Biohealth Research (IMIB-Arrixaca), Ctra. Madrid-Cartagena s/n, El Palmar, Murcia, Spain
| | - José M Moraleda
- Red de Terapia Celular (TerCel), Instituto de Salud Carlos III. University of Murcia; Stem Cell Transplant and Cell Therapy Unit, Virgen de la Arrixaca Clinic University Hospital and Institute for Biohealth Research (IMIB-Arrixaca), Ctra. Madrid-Cartagena s/n, El Palmar, Murcia, Spain.
| | - Robert Sackstein
- The Program of Excellence in Glycosciences, Harvard Medical School, Boston, Massachusetts, and the Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
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7
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Del Fante C, Scudeller L, Recupero S, Viarengo G, Boghen S, Gurrado A, Zecca M, Seghatchian J, Perotti C. Automated red blood cell depletion in ABO incompatible grafts in the pediatric setting. Transfus Apher Sci 2017; 56:895-899. [DOI: 10.1016/j.transci.2017.11.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abonnenc M, Pesse B, Tissot JD, Barelli S, Lion N. Automatic washing of thawed haematopoietic progenitor cell grafts: a preclinical evaluation. Vox Sang 2017; 112:367-378. [DOI: 10.1111/vox.12503] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 12/21/2016] [Accepted: 01/26/2017] [Indexed: 01/07/2023]
Affiliation(s)
- M. Abonnenc
- Laboratoire R&D Produits; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - B. Pesse
- Laboratoire R&D Produits; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - J.-D. Tissot
- Laboratoire R&D Produits; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - S. Barelli
- Laboratoire R&D Produits; Transfusion Interrégionale CRS; Epalinges Switzerland
| | - N. Lion
- Laboratoire R&D Produits; Transfusion Interrégionale CRS; Epalinges Switzerland
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Staley EM, Schwartz J, Pham HP. An update on ABO incompatible hematopoietic progenitor cell transplantation. Transfus Apher Sci 2016; 54:337-44. [PMID: 27211814 DOI: 10.1016/j.transci.2016.05.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Hematopoietic progenitor cell (HPC) transplantation has long been established as the optimal treatment for many hematologic malignancies. In the setting of allogenic HLA matched HPC transplantation, greater than 50% of unrelated donors and 30% of related donors demonstrate some degree of ABO incompatibility (ABOi), which is classified in one of three ways: major, minor, or bidirectional. Major ABOi refers to the presence of recipient isoagglutinins against the donor's A and/or B antigen. Minor ABOi occurs when the HPC product contains the isoagglutinins targeting the recipient's A and/or B antigen. Bidirectional refers to the presence of both major and minor ABOi. Major adverse events associated with ABOi HPC transplantation includes acute and delayed hemolysis, pure red cell aplasia, and delayed engraftment. ABOi HPC transplantation poses a unique challenge to the clinical transplantation unit, the HPC processing lab, and the transfusion medicine service. Therefore, it is essential that these services actively communicate with one another to ensure patient safety. This review will attempt to globally address the challenges related to ABOi HPC transplantation, with an increased focus on aspects related to the laboratory and transfusion medicine services.
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Affiliation(s)
- Elizabeth M Staley
- Department of Pathology, Division of Laboratory Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Joseph Schwartz
- Department of Pathology and Cell Biology, Columbia University Medical Center and the New York-Presbyterian Hospital, New York, NY, USA
| | - Huy P Pham
- Department of Pathology, Division of Laboratory Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
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The processing of stem cell concentrates from the bone marrow in ABO-incompatible transplants: how and when. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2013; 12:150-8. [PMID: 24333081 DOI: 10.2450/2013.0127-13] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 08/07/2013] [Indexed: 11/21/2022]
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Scerpa MC, Rossi C, Daniele N, Lanti A, Adorno G, Picardi A, Arcese W, Amadori S, Isacchi G, Zinno F. A new system for quality control in hematopoietic progenitor cell units before reinfusion in autologous transplant. Transfusion 2013; 54:522-31. [PMID: 23789937 DOI: 10.1111/trf.12307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 05/09/2013] [Accepted: 05/10/2013] [Indexed: 12/29/2022]
Abstract
BACKGROUND In our Center, the cell viability, the integrity of the bag, and the clonogenic assay were evaluated before the reinfusion of hematopoietic progenitor cells-apheresis (HPC-A). This quality control (QC) should be made 14 days before the reinfusion to the patient to have the result of the functional test on the proliferative capacity of hematopoietic progenitors. STUDY DESIGN AND METHODS This study was designed to assess the potential of an automatic cell counting system (NucleoCounter NC-3000, ChemoMetec) in our clinical routine as a support of the clonogenic assay and the cytofluorimetric analysis for the QC of the cryopreserved HPC-A. The cell viability was evaluated by flow cytometry using the modified International Society of Hematotherapy and Graft Engineering protocol. The proliferative potential was assessed by specific clonogenic tests using a commercial medium. Furthermore, we evaluated the cellular functionality with NucleoCounter NC-3000, by using two protocols: "vitality assay" and "mitochondrial potential assay." RESULTS The evaluation of the total nucleated cells in preapoptosis measured by 5,5,6,6-tetrachloro-1,1,3,3-tetraethylbenzimidazol-carbocyanine iodide (JC-1) assay showed a negative correlation (r=-0.43) with the total number of colonies (colony-forming unit [CFU]-granulocyte-macrophage progenitors plus burst-forming unit-erythroid progenitors plus CFU-granulocyte, erythroid, macrophage, megakaryocyte progenitors) obtained after seeding of 50 × 10(6) /L viable total nucleated cells. We observed a significant difference (p<0.0001) comparing the median number of colonies (166.70; SD, ± 136.36) obtained with a value of JC-1 less than 30% to the number of colonies (61.75; SD, ± 59.76) obtained with a value of JC-1 more than 30%. CONCLUSION The evaluation of cell functionality by the use of the NucleoCounter NC-3000 is in agreement with results from clonogenic assay and can be considered an effective alternative in the routine laboratory.
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Affiliation(s)
- Maria Cristina Scerpa
- Cryolab Center of Biotechnology and Cryobiology, Immunohematology Section, SIMT, Department of Hematology, Tor Vergata University, Rome, Italy; Rome Transplant Network, Department of Hematology, Tor Vergata University, Rome, Italy
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12
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Digiusto DL, Kiem HP. Current translational and clinical practices in hematopoietic cell and gene therapy. Cytotherapy 2013; 14:775-90. [PMID: 22799276 DOI: 10.3109/14653249.2012.694420] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Clinical trials over the last 15 years have demonstrated that cell and gene therapies for cancer, monogenic and infectious disease are feasible and can lead to long-term benefit for patients. However, these trials have been limited to proof-of-principle and were conducted on modest numbers of patients or over long periods of time. In order for these studies to move towards standard practice and commercialization, scalable technologies for the isolation, ex vivo manipulation and delivery of these cells to patients must be developed. Additionally, regulatory strategies and clinical protocols for the collection, creation and delivery of cell products must be generated. In this article we review recent progress in hematopoietic cell and gene therapy, describe some of the current issues facing the field and discuss clinical, technical and regulatory approaches used to navigate the road to product development.
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Affiliation(s)
- David L Digiusto
- Department of Virology and Laboratory for Cellular Medicine, Beckman Research Institute of the City of Hope, Duarte, California 91010, USA.
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Scerpa MC, Daniele N, Rossi C, Ciammetti C, Sodani P, Lanti A, Adorno G, Lucarelli G, Isacchi G, Zinno F. Optimization of the immunomagnetic selection in microcythemic donors enrolled for haploidentical transplantation. Transfus Apher Sci 2013; 48:263-9. [PMID: 23433824 DOI: 10.1016/j.transci.2013.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 10/24/2012] [Accepted: 01/10/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Immunomagnetic cell selection (ICS) cells is increasingly used in allogeneic hematopoietic transplantation in order to reduce the T cells quantity. The aim of this study was to evaluate an protocol based on Ficoll method before ICS. STUDY DESIGN AND METHODS The automated procedure was compared with the standard method. In the group 1 the cell processing involves the extraction of the buffy-coat by Ficoll before incubation with antibodies. This procedure was performed with the Sepax S-100 device. The efficacy of this automated procedure was compared with the group 2. In this group, the cell washing and the incubation were performed through the standard method. The CD34+ cells collected by apheresis (HPC-A) were selected with ICS. RESULTS The results obtained after Ficoll procedure, showed a total nucleated cells (TNCs) and CD34+ cells recovery of 85.73% (75.90-90.63; SD 4.25) and 79.31% (51.77-112.31; SD 18.40), respectively. The TNC and CD34+ cells recovery after the pre-incubation washing performed through the standard method, was 75.54% (38.36-97.76; SD 22.5) and 61.51% (30.87-81.79; SD 19.3), respectively. The CD34+ cells recovery after ICS was 79% (51.77-100; SD 18.40) and 44% (15.57-88.24; SD 25.91) in the group 1 and the group 2, respectively. This difference was statistically significant (p=0.001). CONCLUSION The efficacy of the ICS which resulted to be higher in the group 1 compared to the group 2. Overall, our data suggest that the Ficoll procedure before incubation is suitable for the clinical routine in the ICS for haploidentical transplantation in patients affected by thalassemia.
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Affiliation(s)
- Maria Cristina Scerpa
- Immunohematology Section, Tor Vergata University and CryoLab-Stem Cells Manipulation and Cryopreservation Laboratory, Rome, Italy
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Scerpa MC, Daniele N, Ciammetti C, Rossi C, Sodani P, Lanti A, Lucarelli G, Isacchi G, Zinno F. Cell processing for haplo-identical hematopoietic stem cell transplantation: automated washing and immunomagnetic-positive selection. Cytotherapy 2012; 14:811-7. [DOI: 10.3109/14653249.2012.678330] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Civriz Bozdag S, Bay M, Ayyıldız E, Topcuoglu P, Ilhan O. Impact of age and diagnosis on viability during centrifugation and cryopreservation of peripheral blood stem cell products. Transfus Apher Sci 2012; 47:117-20. [DOI: 10.1016/j.transci.2012.05.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Güven S, Karagianni M, Schwalbe M, Schreiner S, Farhadi J, Bula S, Bieback K, Martin I, Scherberich A. Validation of an automated procedure to isolate human adipose tissue-derived cells by using the Sepax® technology. Tissue Eng Part C Methods 2012; 18:575-82. [PMID: 22372873 DOI: 10.1089/ten.tec.2011.0617] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The stromal vascular fraction of adipose tissue has gained popularity as a source of autologous progenitor cells for tissue engineering and regenerative medicine applications. The aim of this study was to validate a newly developed, automated procedure to isolate adipose-derived mesenchymal stem/stromal cells (ASCs) from adult human lipoaspirates in a closed and clinical-grade device, based on the Sepax(®) technology. Using a total of 11 donors, this procedure was compared with the standard operator-based manual separation in terms of isolation yield, clonogenic fraction, phenotype, and differentiation potential of ASCs. As compared with the manual process, automation resulted in a 62% higher isolation yield, with 2.6±1.2×10(5) nucleated cells per mL of liposuction, and a 24% higher frequency of clonogenic progenitors. The variability in the isolation yield and clonogenicity across different preparations was reduced by 18% and 50%, respectively. The cytofluorimetric profile and in vitro differentiation capacity into mesenchymal lineages were comparable in the cells isolated using the two procedures. The new Sepax-based process thus allows an efficient isolation of ASCs with higher and more reproducible yields than the standard manual procedure, along with minimal operator intervention. These results are expected to facilitate the use of ASCs for clinical purposes, either within an intraoperative setting or in combination with further in vitro cell expansion/cultivation.
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Affiliation(s)
- Sinan Güven
- Department of Surgery, University Hospital Basel, Basel, Switzerland
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Scerpa MC, Daniele N, Landi F, Caniglia M, Cometa AM, Ciammetti C, Rossi C, Locatelli F, Isacchi G, Zinno F. Automated washing of human progenitor cells: evaluation of apoptosis and cell necrosis. Transfus Med 2011; 21:402-7. [PMID: 22032614 DOI: 10.1111/j.1365-3148.2011.01103.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND High-dose chemotherapy followed by reinfusion of autologous stem cells harvested from peripheral blood has been increasingly applied for a variety of disorders. The critical importance of cell dose in the clinical outcome, after transplant, has motivated the need to develop techniques aimed at reducing cell losses and increasing reproducibility. OBJECTIVES The aim of this study is to evaluate the efficacy of the Sepax S-100 device to process thawed HPC-A products in comparison with manual procedure. METHODS/MATERIALS We have analysed viability, total nucleated cells (TNC), haematopoietic progenitors and CD34+ cells recovery. RESULTS The TNC and CD34+ cells recovery in the automatic procedure was of 91.9% (73-100; SD ± 12.60) and 86.7% (69-100; SD ± 10.21), respectively. Instead the recovery of TNC and CD34+ cells using the manual method was of 84.7% (47-100; SD ± 22.9) and 80.29% (23-100; SD ± 25.96). The results, obtained from the assessment of viability of CD34+ both 7-AAD)+ and AnnV+ showed a high percentage of necrosis and apoptosis in this cell subset by using the manual procedure in respect to the Sepax automated system. CONCLUSION Overall, our data suggest that the automated washing procedure is safe and suitable for processing of thawed HPC-A products and can be daily used in clinical routine.
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Affiliation(s)
- M C Scerpa
- SIMT, IRCCS Bambino Gesù Pediatric Hospital, Rome, Italy.
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