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Matos DM. "Protein-resistant vanishing counting bead" phenomenon: a new problem with single-platforms for CD34 + quantification? Cytotherapy 2024; 26:649-651. [PMID: 38456855 DOI: 10.1016/j.jcyt.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/09/2024]
Affiliation(s)
- Daniel Mazza Matos
- Flow Cytometry Section, Cell Processing Center (CPC), Center of Hematology and Hemotherapy of Ceará (HEMOCE), Fortaleza, Ceará, Brazil.
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Servain-Viel S, Aknin ML, Domenichini S, Perlemuter G, Cassard AM, Schlecht-Louf G, Moal VLL. A flow cytometry method for safe detection of bacterial viability. Cytometry A 2024; 105:146-156. [PMID: 37786349 DOI: 10.1002/cyto.a.24794] [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: 06/19/2023] [Revised: 08/18/2023] [Accepted: 09/04/2023] [Indexed: 10/04/2023]
Abstract
Flow cytometry is a relevant tool to meet the requirements of academic and industrial research projects aimed at estimating the features of a bacterial population (e.g., quantity, viability, activity). One of the remaining challenges is now the safe assessment of bacterial viability while minimizing the risks inherent to existing protocols. In our core facility at the Paris-Saclay University, we have addressed this issue with two objectives: measuring bacterial viability in biological samples and preventing bacterial contamination and chemical exposure of the staff and cytometers used on the platform. Here, we report the development of a protocol achieving these two objectives, including a viability labeling step before bacteria fixation, which removes the risk of biological exposure, and the decrease of the use of reagents such as propidium iodide (PI), which are dangerous for health (CMR: carcinogenic, mutagenic, and reprotoxic). For this purpose, we looked for a non-CMR viability dye that can irreversibly label dead bacteria before fixation procedures and maintain intense fluorescence after further staining. We decided to test on the bacteria, eFluor Fixable Viability dyes, which are usually used on eukaryotic cells. Since the bacteria had size and granularity characteristics very similar to those associated with flow cytometry background signals, a step of bacterial DNA labeling with SYTO or DRAQ5 was necessarily added to differentiate them from the background. Three marker combinations (viability-DNA) were tested on LSR Fortessa and validated on pure bacterial populations (Gram+ , Gram- ) and polybacterial cultures. Any of the three methods can be used and adapted to the needs of each project and allow users to adapt the combination according to the configuration of their cytometer. Having been tested on six bacterial populations, validated on two cytometers, and repeated at least two times in each evaluated condition, we consider this method reliable in the context of these conditions. The reliability of the results obtained in flow cytometry was successfully validated by applying this protocol to confocal microscopy, permeabilization, and also to follow cultures over time. This flow cytometry protocol for measuring bacterial viability under safer conditions also opens the prospect of its use for further bacterial characterization.
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Affiliation(s)
- S Servain-Viel
- Plateforme CYM - UMS-IPSIT, Université Paris-Saclay, Inserm, CNRS, Ingénierie et Plateformes au Service de l'Innovation Thérapeutique, Orsay, France
| | - M-L Aknin
- Plateforme CYM - UMS-IPSIT, Université Paris-Saclay, Inserm, CNRS, Ingénierie et Plateformes au Service de l'Innovation Thérapeutique, Orsay, France
| | - S Domenichini
- Plateforme MIPSIT - UMS-IPSIT, Université Paris-Saclay, Inserm, CNRS, Ingénierie et Plateformes au Service de l'Innovation Thérapeutique, Orsay, France
| | - G Perlemuter
- Inflammation, Microbiome and Immunosurveillance, UMR-996, Université Paris-Saclay, Inserm, Orsay, France
- Service d'Hépato-Gastroentérologie Et Nutrition, Hôpital Antoine-Béclère, AP- HP Université Paris-Saclay, Clamart, France
| | - A-M Cassard
- Inflammation, Microbiome and Immunosurveillance, UMR-996, Université Paris-Saclay, Inserm, Orsay, France
| | - G Schlecht-Louf
- Inflammation, Microbiome and Immunosurveillance, UMR-996, Université Paris-Saclay, Inserm, Orsay, France
| | - V Lievin-Le Moal
- Inflammation, Microbiome and Immunosurveillance, UMR-996, Université Paris-Saclay, Inserm, Orsay, France
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Jeon Y, Kim TY, Min GJ, Park SS, Park S, Yoon JH, Lee SE, Cho BS, Eom KS, Kim YJ, Kim HJ, Lee S, Min CK, Lee JW, Cho SG. Efficacy of ex vivo purging with CD34+ selection to maximize the effects of autologous stem cell transplantation in peripheral T-cell lymphoma patients. Cytotherapy 2023; 25:1307-1316. [PMID: 37542512 DOI: 10.1016/j.jcyt.2023.07.005] [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: 03/14/2023] [Revised: 07/07/2023] [Accepted: 07/14/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND AIMS Peripheral T-cell lymphomas (PTCLs) are rare and aggressive tumors with uncertain optimal treatment. This study investigated the clinical outcomes of high-dose chemotherapy (HDT) followed by autologous stem cell transplantation (ASCT) after CD34+ selective purging in PTCL patients. METHODS Retrospective analysis included 67 PTCL patients who achieved remission and underwent HDT/ASCT. CD34+ selective purging was performed using CliniMACS® (Miltenyi Biotec, Bergisch Gladbach, Germany). Survival outcomes, engraftment, lymphocyte subsets and viral infections were evaluated. RESULTS CD34+ selective purged autografts were associated with significantly improved overall survival (OS) and disease-free survival (DFS) compared with unpurged autografts (5-year OS, 73.3% versus 37.8%, 5-year DFS, 73.8% versus 33.4%). The cumulative incidence of relapse was also lower in the purged group (31.5% versus 73.3%). Subgroup analysis revealed significant survival benefits in the high-risk group receiving purged autografts. Lymphocyte subset analysis showed increased natural killer (NK) cell counts in the purged group after ASCT. Higher post-ASCT lymphocyte-to-monocyte ratio (LMR) was associated with improved OS and DFS. CONCLUSIONS CD34+ selective purging in PTCL patients undergoing HDT/ASCT improved survival outcomes and reduced relapse risk. The procedure increased NK cell counts and post-ASCT LMR. CD34+ selective purging may minimize autograft tumor cell contamination and enhance efficacy in T-cell lymphomas.
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Affiliation(s)
- Youngwoo Jeon
- Lymphoma and Cell Therapy-Research Center, Yeouido St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea; Catholic University Lymphoma Group, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Tong-Yoon Kim
- Lymphoma and Cell Therapy-Research Center, Yeouido St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea; Catholic University Lymphoma Group, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea; Catholic Hematology Hospital, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Gi June Min
- Catholic University Lymphoma Group, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea; Catholic Hematology Hospital, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Soo Park
- Catholic Hematology Hospital, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Silvia Park
- Catholic Hematology Hospital, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Jae-Ho Yoon
- Catholic Hematology Hospital, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Eun Lee
- Catholic Hematology Hospital, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Byung-Sik Cho
- Catholic Hematology Hospital, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Ki-Seong Eom
- Catholic Hematology Hospital, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo-Jin Kim
- Catholic Hematology Hospital, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Hee-Je Kim
- Catholic Hematology Hospital, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Seok Lee
- Catholic Hematology Hospital, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Chang-Ki Min
- Catholic Hematology Hospital, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Jong-Wook Lee
- Catholic Hematology Hospital, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Seok-Goo Cho
- Lymphoma and Cell Therapy-Research Center, Yeouido St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea; Catholic University Lymphoma Group, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea; Catholic Hematology Hospital, Seoul St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea.
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Rimac V, Bojanić I, Dabelić S, Ćepulić BG. The impact of cryoprotectant exposure time on post-thaw viability of autologous and allogeneic hematopoietic stem cells and leukocyte subpopulations. ACTA PHARMACEUTICA (ZAGREB, CROATIA) 2023; 73:655-672. [PMID: 38147484 DOI: 10.2478/acph-2023-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 12/28/2023]
Abstract
Although the use of cryoprotectant dimethyl sulfoxide (DMSO) is the gold standard in cryopreservation of hematopoietic stem cells, it is well known that it has a negative effect on cell viability. The aim of this prospective study was to examine how the length of post-thaw exposure to DMSO affects the cell viability and stability of peripheral blood stem cell (PBSC) samples. Additionally, the effects of donor type and pre-cryopreservation storage time on post-thaw viability during the stability study were evaluated. In 30 autologous and 30 allogeneic PBSC samples viable CD34+, CD14+, CD19+, CD16+/56+, and CD3+ cells were determined immediately after thawing, and one-and three-hours post-thaw. Analysis of the absolute count of viable cells in thawed samples showed a significant difference between all measurement points for CD34+ (p < 0.001), CD14+ (p < 0.001), and CD19+ cells (p < 0.001). No significant differences were observed for post-thaw stability of allogeneic samples analysed between products stored before cryopreservation ≥ 24 hours (N = 20), and those stored < 24 hours (N = 10), except for viable CD3+/CD4+ cells after three hours post-thaw (p = 0.028). In conclusion, DMSO had different effects on leukocyte subpopulations in cryopre-served PBSC samples. The type of donors and the length of storage before cryopreservation did not affect the post-thaw stability of cryopreserved PBSC samples.
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Affiliation(s)
- Vladimira Rimac
- 1Department of Transfusion Medicine and Transplantation, Biology University Hospital Centre Zagreb 10000 Zagreb, Croatia
| | - Ines Bojanić
- 1Department of Transfusion Medicine and Transplantation, Biology University Hospital Centre Zagreb 10000 Zagreb, Croatia
| | - Sanja Dabelić
- 2University of Zagreb Faculty of Pharmacy and Biochemistry, 10000 Zagreb, Croatia
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Partanen A, Turunen A, Valtola J, Pyörälä M, Kuittinen O, Kuitunen H, Vasala K, Penttilä K, Kuittinen T, Mäntymaa P, Pelkonen J, Jantunen E, Varmavuo V. Loss of CD34 + Cells and Effect of the Number of Viable Cryopreserved CD34 + Cells in the Infused Blood Grafts on Hematologic Recovery, Progression-Free Survival and Overall Survival in NHL Patients After Autologous Stem Cell Transplantation. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2023; 23:e428-e435. [PMID: 37684185 DOI: 10.1016/j.clml.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 08/06/2023] [Accepted: 08/11/2023] [Indexed: 09/10/2023]
Abstract
PATIENTS This post-hoc study aimed to find out factors affecting graft viable CD34+ cell loss during processing and cryopreservation in 129 non-Hodgkin lymphoma (NHL) patients receiving autologous stem cell transplantation (auto-SCT) and the impact of a low (< 2.0 × 106/kg, group A) and a decent number (≥ 2 × 106/kg, group B) of viable CD34+ cells infused on the hematologic recovery, progression-free survival (PFS) and overall survival (OS) after auto-SCT. RESULTS The median loss of viable CD34+ cells during cryopreservation was higher in group A (47% vs. 19%, p < .001). A higher yield of CD34+ cells at the first apheresis in group B (p = .002) was linked with greater loss of viable graft CD34+ cells after cryopreservation. Filgrastim (FIL) use for mobilization seemed to associate with higher viable CD34+ cell loss compared to pegfilgrastim (PEG) or lipegfilgrastim (LIPEG) in both groups (in group A FIL 66 vs. PEG 35%, p = .006; in group B FIL 37 vs. PEG 15 vs. LIPEG 13%, p < .001). Hematologic recovery after auto-SCT was faster in group B. Neither viable CD34+ cell loss during storage nor viable CD34+ cell number < 2.0 × 106/kg infused affected on PFS or OS. CONCLUSIONS G-CSF type used in mobilization and mobilization capacity were found to correlate with viable CD34+ cell loss during processing and storage. Most importantly, low infused viable CD34+ cell count did not seem to impact on PFS or OS.
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Affiliation(s)
- Anu Partanen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland.
| | - Antti Turunen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Jaakko Valtola
- Department of Medicine, Central Hospital of Savonlinna, Savonlinna, Finland
| | - Marja Pyörälä
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Outi Kuittinen
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; Department of Oncology, Kuopio University Hospital, Kuopio, Finland; Cancer Center, Oulu University Hospital, Oulu, Finland
| | | | - Kaija Vasala
- Department of Oncology, Hospital Nova of Central Finland, Jyväskylä, Finland
| | - Karri Penttilä
- Department of Medicine, Central Hospital of Savonlinna, Savonlinna, Finland; Finnish Medicines Agency, Kuopio, Finland
| | - Taru Kuittinen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | | | - Jukka Pelkonen
- ISLAB Welfare Association, Kuopio Finland; Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
| | - Esa Jantunen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland; Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ville Varmavuo
- Department of Medicine, Kymenlaakso Central Hospital, Kotka, Finland
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Al-Riyami AZ, Maryamchik E, Hanna RS, Pashmineh Azar AR, Zheng X, Choudhari S, Finn C, Giacobbe N, Machietto R, Rieser R, Ghasemi Tahrir F, Zhang X, Kadauke S, Wang Y. A machine-learning model that incorporates CD45 surface expression predicts hematopoietic progenitor cell recovery after freeze-thaw. Cytotherapy 2023; 25:1048-1056. [PMID: 37318396 DOI: 10.1016/j.jcyt.2023.05.007] [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: 01/18/2023] [Revised: 05/03/2023] [Accepted: 05/23/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND AIMS Sufficient doses of viable CD34+ (vCD34) hematopoietic progenitor cells (HPCs) are crucial for engraftment. Additional-day apheresis collections can compensate for potential loss during cryopreservation but incur high cost and additional risk. To aid predicting such losses for clinical decision support, we developed a machine-learning model using variables obtainable on the day of collection. METHODS In total, 370 consecutive autologous HPCs, apheresis-collected since 2014 at the Children's Hospital of Philadelphia, were retrospectively reviewed. Flow cytometry was used to assess vCD34% on fresh products and thawed quality control vials. The ratio of vCD34% thawed to fresh, which we call "post-thaw index," was used as an outcome measure, with a "poor" post-thaw index defined as <70%. HPC CD45 normalized mean fluorescence intensity (MFI) was calculated by dividing CD45 MFI of HPCs to the CD45 MFI of lymphocytes in the same sample. We trained XGBoost, k-nearest neighbor and random forest models for the prediction and calibrated the best model to minimize falsely-reassuring predictions. RESULTS In total, 63 of 370 (17%) products had a poor post-thaw index. The best model was XGBoost, with an area under the receiver operator curve of 0.83 evaluated on an independent test data set. The most important predictor for a poor post-thaw index was the HPC CD45 normalized MFI. Transplants after 2015, based on the lower of the two vCD34% values, showed faster engraftment than older transplants, which were based on fresh vCD34% only (average 10.6 vs 11.7 days, P = 0.0006). CONCLUSIONS Transplants taking into account post-thaw vCD34% improved engraftment time in our patients; however, it came at the cost of unnecessary multi-day collections. The results from applying our predictive algorithm retrospectively to our data suggest that more than one-third of additional-day collections could have been avoided. Our investigation also identified CD45 nMFI as a novel marker for assessing HPC health post-thaw.
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Affiliation(s)
- Arwa Z Al-Riyami
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Clinical Pathology & Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Hematology, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Elena Maryamchik
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Clinical Pathology & Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Richard S Hanna
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | - Xingwu Zheng
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Shilpa Choudhari
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Colleen Finn
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Nicholas Giacobbe
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Rene Machietto
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Robert Rieser
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Farzaneh Ghasemi Tahrir
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Xiaoyong Zhang
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Stephan Kadauke
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Clinical Pathology & Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yongping Wang
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Department of Clinical Pathology & Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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Rimac V, Bojanić I, Dabelić S, Ćepulić BG. Variable recovery of cryopreserved hematopoietic stem cells and leukocyte subpopulations in leukapheresis products. Transfus Apher Sci 2023; 62:103763. [PMID: 37460360 DOI: 10.1016/j.transci.2023.103763] [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: 05/02/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 11/27/2023]
Abstract
INTRODUCTION Due to the expansion of cell therapy using not only haematopoietic stem cells (HSC) but also other leukocyte subpopulations, the loss of these cells in cryopreserved apheresis products needs to be evaluated. Various factors that could negatively affect post-thaw recovery, such as leukapheresis product characteristics, storage time and cryopreservation protocols have been identified. METHODS The post-thaw recovery of HSCs, lymphocytes, NK cells and monocytes, as well as the factors that could adversely affect it were analysed in autologous and allogeneic leukapheresis products. RESULTS The lowest post-thaw recovery was observed in autologous and allogeneic CD34+ cells, with the median of 73.7% and 68.1%, respectively. In leukocyte subpopulation, the lowest post-thaw recovery was observed for CD14+ cells, both autologous and allogeneic. The highest post-thaw recovery was observed for CD3+/CD8+ cells in autologous, and for CD19+ cells in allogeneic samples. The statistically significant difference was observed between autologous and allogeneic PBSC products for CD3+ cell recovery (P = 0.031) and CD3+/CD8+ cell recovery (P = 0.009). The evaluation of factors that could adversely affect the post-thaw recovery in autologous samples showed weak negative correlations between platelet concentration and CD3+ recovery, as well as between storage time and CD3+CD8+ recovery. In allogeneic samples, a strong negative correlation was observed only between the percentage of granulocytes and CD3+, CD3+/CD8+ and CD3+/CD4+ cell recoveries. CONCLUSION Since various post-thaw recoveries of leukocyte subpopulations were observed, the cell therapy manufacturing centers should evaluate how their cryopreservation method and other factors affect the recovery of cell population of interest in their settings.
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Affiliation(s)
- Vladimira Rimac
- Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
| | - Ines Bojanić
- Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia; University of Zagreb, School of Medicine, Šalata 3, 10000 Zagreb, Croatia; University of Applied Health Sciences Zagreb, Mlinarska cesta 38, 10000 Zagreb, Croatia.
| | - Sanja Dabelić
- University of Zagreb, Faculty of Pharmacy and Biochemistry, A. Kovačića 1, 10 000 Zagreb, Croatia
| | - Branka Golubić Ćepulić
- Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia; University of Zagreb, School of Medicine, Šalata 3, 10000 Zagreb, Croatia; University of Applied Health Sciences Zagreb, Mlinarska cesta 38, 10000 Zagreb, Croatia
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Cheng J, Wang S, Lv SQ, Song Y, Guo NH. Resveratrol inhibits AhR/Notch axis and reverses Th17/Treg imbalance in purpura by activating Foxp3. Toxicol Res (Camb) 2023; 12:381-391. [PMID: 37397914 PMCID: PMC10311159 DOI: 10.1093/toxres/tfad021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 02/19/2023] [Accepted: 03/06/2023] [Indexed: 07/04/2023] Open
Abstract
Background Resveratrol has been reported to reverse the imbalance of T helper 17/regulatory T (Th17/Treg) by inhibiting the aryl hydrocarbon receptor pathway to treat immune thrombocytopenia. However, the regulation mechanism of the Notch signaling pathway by resveratrol has not been reported in purpura. This study is aimed to explore the mechanism of resveratrol ultrafine nanoemulsion (Res-mNE) in immune thrombocytopenia. Methods The immune thrombocytopenia mouse model was constructed to explore the effect of RES-mNE on immune thrombocytopenia. Cluster of differentiation 4 (CD4+) T cells were isolated and treated with different medications. CD4+ T cells were induced to differentiate into Th17 cells and Treg cells. Flow cytometry was used to detect the proportion of Th17 cells and Treg cells. The secretion was measured by the enzyme-linked immunosorbent assay (ELISA). Quantitative reverse-transcription polymerase chain reaction (qRT-PCR) and western blot were used to detect the mRNA and protein levels. Results Th17 cells, IL-17A and IL-22 increased in the immune thrombocytopenia mouse model, and the Treg cells and IL-10 decreased. Res-mNE promoted Treg cell differentiation and IL-10 secretion in CD4+ T cells while inhibiting Th17 cell differentiation and IL-17A and IL-22 levels. The AhR activator 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) reversed the effect of Res-mNE. Notch inhibitors reduced the ratio of Th17/Treg differentiation. Res-mNE activated the expression of Foxp3 by mediating AhR/Notch signaling to reverse the imbalance of Th17/Treg differentiation in immune thrombocytopenia. Conclusion Taken together, our findings demonstrated that RES-mNE inhibited the AhR/Notch axis and reversed Th17/Treg imbalance by activating Foxp3.
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Affiliation(s)
- Jing Cheng
- Department of Hematology, The Second Affiliated Hospital of Nanchang University, No.1, Minde Road, Nanchang 330006, Jiangxi Province, P.R. China
| | - Sheng Wang
- Department of Psychiatry, Jiangxi Mental Hospital, Shangfang Road, Nanchang 330008, Jiangxi Province, P.R. China
| | - Shi-Qin Lv
- Department of Hematology, The Second Affiliated Hospital of Nanchang University, No.1, Minde Road, Nanchang 330006, Jiangxi Province, P.R. China
| | - Yuan Song
- Department of Hematology, The Second Affiliated Hospital of Nanchang University, No.1, Minde Road, Nanchang 330006, Jiangxi Province, P.R. China
| | - Ning-Hong Guo
- Department of Hematology, The Second Affiliated Hospital of Nanchang University, No.1, Minde Road, Nanchang 330006, Jiangxi Province, P.R. China
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Partanen A, Turunen A, Silvennoinen R, Valtola J, Pyörälä M, Siitonen T, Sikiö A, Putkonen M, Sankelo M, Penttilä K, Kuittinen T, Mäntymaa P, Pelkonen J, Jantunen E, Varmavuo V. Impact of the number of cryopreserved CD34 + cells in the infused blood grafts on hematologic recovery and survival in myeloma patients after autologous stem cell transplantation: Experience from the GOA study. J Clin Apher 2023; 38:33-44. [PMID: 36239392 DOI: 10.1002/jca.22022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/09/2022] [Accepted: 09/21/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Prospective data on the impact of CD34+ cell loss during cryopreservation and the amount of cryopreserved CD34+ cells infused after high-dose therapy on hematologic recovery and post-transplant outcome in multiple myeloma (MM) are scarce. PATIENTS AND METHODS This post-hoc study aimed to investigate factors associating with CD34+ cell loss during cryopreservation and the effects of the infusion of a very low number (<1.0 × 106 /kg, group A), low number (1-1.9 × 106 /kg, group B), and optimal number (≥2 × 106 /kg, group C) of thawed viable CD34+ cells on hematologic recovery, progression free survival, and overall survival after autologous stem cell transplantation among 127 patients with MM. RESULTS In group C, pegfilgrastim use (P = 0.001), plerixafor use (P = 0.039), and older age ≥ 60 years (P = 0.026) were associated with less loss of CD34+ cells during cryopreservation. Better mobilization efficacy correlated with greater CD34+ cell loss in group B (P = 0.013 and P = 0.001) and in group C (P < 0.001 and P < 0.001). Early platelet engraftment was slowest in group A (20 d vs 12 d in group B vs 11 d in group C, P = 0.003). The infused viable CD34+ cell count <1.0 × 106 /kg seemed not to have influence on PFS (P = 0.322) or OS (P = 0.378) in MM patients. CONCLUSIONS Cryopreservation impacts significantly on the CD34+ cell loss. A very low number of graft viable CD34+ cells did not affect PFS or OS.
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Affiliation(s)
- Anu Partanen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Antti Turunen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Raija Silvennoinen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland.,Department of Hematology, Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jaakko Valtola
- Department of Medicine, Central Hospital of Savonlinna, Savonlinna, Finland
| | - Marja Pyörälä
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Timo Siitonen
- Department of Medicine, Oulu University Hospital, Oulu, Finland
| | - Anu Sikiö
- Department of Medicine, Central Hospital of Central Finland, Jyväskylä, Finland
| | - Mervi Putkonen
- Department of Medicine, Turku University Hospital, Turku, Finland
| | - Marja Sankelo
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Karri Penttilä
- Department of Medicine, Central Hospital of Savonlinna, Savonlinna, Finland.,Finnish Medicines Agency, Kuopio, Finland
| | - Taru Kuittinen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | | | - Jukka Pelkonen
- Eastern Finland Laboratory Centre, Kuopio, Finland.,Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
| | - Esa Jantunen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland.,Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, North Karelia Hospital District, Joensuu, Finland
| | - Ville Varmavuo
- Department of Medicine, Kymenlaakso Central Hospital, Kotka, Finland
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10
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Mfarrej B, Vicari O, Ouffai S, Malenfant C, Granata A, Thevenet S, Chabannon C, Lemarié C, Calmels B. Sepax-2 cell processing device: a study assessing reproducibility of concentrating thawed hematopoietic progenitor cells. J Transl Med 2022; 20:503. [PMID: 36329460 PMCID: PMC9632571 DOI: 10.1186/s12967-022-03703-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
Background Autologous hematopoietic progenitor cell (HPC) transplantation is currently the standard of care for a fraction of patients with newly diagnosed myelomas and relapsed or refractory lymphomas. After high-dose chemotherapy, cryopreserved HPC are either infused directly after bedside thawing or washed and concentrated before infusion. We previously reported on the comparability of washing/concentrating HPC post-thaw vs. infusion without manipulation in terms of hematopoietic engraftment, yet settled for the prior favoring cell debris and DMSO removal. For almost two decades, automation of this critical step of washing/concentrating cells has been feasible. As part of continuous process verification, we aim to evaluate reproducibility of this procedure by assessing intra-batch and inter-batch variability upon concentration of thawed HPC products using the Sepax 2 S-100 cell separation system. Methods Autologous HPC collected from the same patient were thawed and washed either in two batches processed within a 3-4 h interval and immediately infused on the same day (intra-batch, n = 45), or in two batches on different days (inter-batch, n = 49) for those patients requiring 2 or more high-dose chemotherapy cycles. Quality attributes assessed were CD34+ cell recovery, viability and CD45+ viability; CFU assay was only performed for allogeneic grafts. Results Intra-batch and inter-batch median CD34+ cell recovery was comparable (75% vs. 73% and 77% vs. 77%, respectively). Similarly, intra-batch and inter-batch median CD45+ cell viability was comparable (79% vs. 80% and 79% vs. 78%, respectively). Bland-Altman analysis describing agreement between batches per patient revealed a bias close to 0%. Additionally, lower HPC recoveries noted in batch 1 were noted as well in batch 2, regardless of the CD34+ cell dose before cryopreservation, both intra- and inter-batch, suggesting that the quality of the collected product plays an important role in downstream recovery. Intrinsic (high mature and immature granulocyte content) and extrinsic (delay between apheresis and cryopreservation) variables of the collected product resulted in a significantly lower CD45+ viability and CD34+ cell recovery upon thawing/washing. Conclusions Automated post-thaw HPC concentration provides reproducible cell recoveries and viabilities between different batches. Implications of this work go beyond HPC to concentrate cell suspension/products during manufacturing of cell and gene therapy products. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-022-03703-1.
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Affiliation(s)
- Bechara Mfarrej
- grid.418443.e0000 0004 0598 4440Centre de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France ,Module Biothérapies du Centre d’Investigation Clinique de Marseille, AP-HM, Aix- Marseille Université, Institut Paoli-Calmettes, CBT-1409 Inserm, Marseille, France
| | - Olivier Vicari
- grid.418443.e0000 0004 0598 4440Centre de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France ,Module Biothérapies du Centre d’Investigation Clinique de Marseille, AP-HM, Aix- Marseille Université, Institut Paoli-Calmettes, CBT-1409 Inserm, Marseille, France
| | - Sarah Ouffai
- grid.418443.e0000 0004 0598 4440Centre de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France ,Module Biothérapies du Centre d’Investigation Clinique de Marseille, AP-HM, Aix- Marseille Université, Institut Paoli-Calmettes, CBT-1409 Inserm, Marseille, France
| | - Carine Malenfant
- grid.418443.e0000 0004 0598 4440Centre de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France ,Module Biothérapies du Centre d’Investigation Clinique de Marseille, AP-HM, Aix- Marseille Université, Institut Paoli-Calmettes, CBT-1409 Inserm, Marseille, France
| | - Angela Granata
- grid.418443.e0000 0004 0598 4440Centre de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France ,Module Biothérapies du Centre d’Investigation Clinique de Marseille, AP-HM, Aix- Marseille Université, Institut Paoli-Calmettes, CBT-1409 Inserm, Marseille, France
| | - Sophie Thevenet
- grid.418443.e0000 0004 0598 4440Centre de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France ,Module Biothérapies du Centre d’Investigation Clinique de Marseille, AP-HM, Aix- Marseille Université, Institut Paoli-Calmettes, CBT-1409 Inserm, Marseille, France
| | - Christian Chabannon
- grid.418443.e0000 0004 0598 4440Centre de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France ,Module Biothérapies du Centre d’Investigation Clinique de Marseille, AP-HM, Aix- Marseille Université, Institut Paoli-Calmettes, CBT-1409 Inserm, Marseille, France ,grid.5399.60000 0001 2176 4817Aix-Marseille Université Faculté des Sciences Médicales et Paramédicales, Marseille, France
| | - Claude Lemarié
- grid.418443.e0000 0004 0598 4440Centre de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France ,Module Biothérapies du Centre d’Investigation Clinique de Marseille, AP-HM, Aix- Marseille Université, Institut Paoli-Calmettes, CBT-1409 Inserm, Marseille, France
| | - Boris Calmels
- grid.418443.e0000 0004 0598 4440Centre de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France ,Module Biothérapies du Centre d’Investigation Clinique de Marseille, AP-HM, Aix- Marseille Université, Institut Paoli-Calmettes, CBT-1409 Inserm, Marseille, France
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11
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Dalva K, Haskologlu S, Dalva-Aydemir S, Oz MD, Ozturk A, Ipek S, Demir HA, Ertem M, Ilhan O, Gurman G. Effect of CD34+ Total/Myeloid CD34+ Cell Progenitors and B-Lymphoid Progenitors Within the Bone Marrow Grafts on the Hematopoietic Recovery After Hematopoietic Stem Cell Transplantation. EXP CLIN TRANSPLANT 2022; 20:937-944. [DOI: 10.6002/ect.2022.0210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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12
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Hénon P, Kowalczyk M, Aries A, Vignon C, Trébuchet G, Lahlil R. Industrialized GMP Production of CD34 + Cells (ProtheraCytes®) at Clinical Scale for Treatment of Ischemic Cardiac Diseases Is Feasible and Safe. Stem Cell Rev Rep 2022; 18:1614-1626. [PMID: 35420389 PMCID: PMC9209364 DOI: 10.1007/s12015-022-10373-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2022] [Indexed: 02/08/2023]
Abstract
Regenerative medicine now needs to pass a crucial turning point, from academic research to the market. Several sources/types of cells have been experimented with, more or less successfully. CD34+ cells have demonstrated multipotent or even pluripotent capacities, making them good candidates for regenerative medicine, particularly for treating heart diseases. Strongly encouraged by the results we achieved in a pilot study using CD34+ stem cells in patients with poor-prognosis acute myocardial infarcts (AMIs), we soon began the development of an industrialized platform making use of a closed automated device (StemXpand®) and a disposable kit (StemPack®) for the large-scale expansion of CD34+ cells with reproducible good manufacturing practice (GMP). This scalable platform can produce expanded CD34+ cells (ProtheraCytes®) of sufficient quality that, interestingly, express early markers of the cardiac and endothelial pathways and early cardiac-mesoderm markers. They also contain CD34+ pluripotent cells characterized as very small embryonic-like stem cells (VSELs), capable of differentiating under appropriate stimuli into different tissue lineages, including endothelial and cardiomyocytic ones.
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Affiliation(s)
| | | | - Anne Aries
- Institut de Recherche en Hématologie et Transplantation, Hôpital du Hasenrain, 87 Avenue d'Altkirch, Mulhouse, France
| | | | | | - Rachid Lahlil
- Institut de Recherche en Hématologie et Transplantation, Hôpital du Hasenrain, 87 Avenue d'Altkirch, Mulhouse, France
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13
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Comparison between standard and high dose of G-CSF for mobilization of hematopoietic progenitors cells in patients and healthy donors. Transfus Med Rev 2022; 36:159-163. [DOI: 10.1016/j.tmrv.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/22/2022] [Accepted: 06/07/2022] [Indexed: 11/23/2022]
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14
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Vladimira R, Ines B. Role of flow cytometry in evaluation of the cellular therapy products used in haematopoietic stem cell transplantation. Int J Lab Hematol 2022; 44:446-453. [PMID: 35419954 DOI: 10.1111/ijlh.13849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 03/22/2022] [Accepted: 03/27/2022] [Indexed: 11/26/2022]
Abstract
Cellular therapy nowadays includes various products from haematopoietic stem cells (HSC) collected from bone marrow, peripheral blood, and umbilical cord blood to more complex adoptive immune therapy for the treatment of malignant diseases, and gene therapy for inherited immune deficiencies. Broader utilization of cellular therapy requires extensive quality testing of these products that should fulfil the same requirements regarding composition, purity, and potency nevertheless they are manufactured in various centres. Technical improvements of the flow cytometers accompanied by the increased number of available reagents and fluorochromes used to conjugate monoclonal antibodies, enable detailed and precise insight into the function of the immune system and other areas of cell biology, and allows cell evaluation based on size, shape, and morphology or assessment of cell surface markers, as well as cell purity and viability, which greatly contributes to the development and progress of the cell therapy. The aim of this paper is to give an overview of the current use and challenges of flow cytometry analysis in quality assessment of cellular therapy products, with regard to basic principles of determining HSC and leukocyte subpopulation, assessment of cells viability and quality of thawed cryopreserved HSC as well as the importance of validation and quality control of flow cytometry methods according to good laboratory practice.
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Affiliation(s)
- Rimac Vladimira
- Clinical Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Bojanić Ines
- Clinical Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
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15
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Partanen A, Kuittinen O, Turunen A, Valtola J, Pyorala M, Kuitunen H, Vasala K, Kuittinen T, Mantymaa P, Pelkonen J, Jantunen E, Varmavuo V. Blood Graft and Outcome After Autologous Stem Cell Transplantation in Patients With Primary Central Nervous System Lymphoma. J Hematol 2022; 10:246-254. [PMID: 35059086 PMCID: PMC8734492 DOI: 10.14740/jh939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 11/30/2021] [Indexed: 11/22/2022] Open
Abstract
Background Autologous stem cell transplantation (auto-SCT) is a treatment option for patients with primary central nervous system lymphoma (PCNSL). Methods In this prospective multicenter study, the effects of blood graft cellular content on hematologic recovery and outcome were analyzed in 17 PCNSL patients receiving auto-SCT upfront. Results The infused viable CD34+ cell count > 1.7 × 106/kg correlated with more rapid platelet engraftment (10 vs. 31 days, P = 0.027) and with early neutrophil recovery (day + 15) (5.4 vs. 1.6 × 109/L, P = 0.047). A higher number of total collected CD34+ cells > 3.3 × 106/kg infused predicted worse 5-year progression-free survival (PFS) (33% vs. 100%, P = 0.028). In addition, CD3+CD8+ T cells > 78 × 106/kg in the infused graft impacted negatively on the 5-year PFS (0% vs. 88%, P = 0.016). Conclusion The cellular composition of infused graft seems to impact on the hematologic recovery and PFS post-transplant. Further studies are needed to verify the optimal autograft cellular content in PCNSL.
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Affiliation(s)
- Anu Partanen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Outi Kuittinen
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Oncology, Kuopio University Hospital, Kuopio, Finland.,Department of Oncology, Oulu University Hospital, Oulu, Finland
| | - Antti Turunen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Jaakko Valtola
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Marja Pyorala
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Hanne Kuitunen
- Department of Oncology, Oulu University Hospital, Oulu, Finland
| | - Kaija Vasala
- Department of Oncology, Central Hospital of Central Finland, Jyvaskyla, Finland
| | - Taru Kuittinen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | | | - Jukka Pelkonen
- Eastern Finland Laboratory Centre, Kuopio, Finland.,Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
| | - Esa Jantunen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland.,Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, North Karelia Hospital District, Joensuu, Finland
| | - Ville Varmavuo
- Department of Medicine, Kymenlaakso Central Hospital, Kotka, Finland
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16
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Chang A, Ragg SJ, Ma DD. Meeting the COVID challenge: Optimizing vCD34+ in cryopreserved HPC samples for implementation of an external QA Program. Cytotherapy 2022; 24:437-443. [PMID: 35086777 PMCID: PMC8786609 DOI: 10.1016/j.jcyt.2021.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/20/2021] [Accepted: 10/25/2021] [Indexed: 11/28/2022]
Abstract
Background The COVID-19 pandemic has forced a fundamental change in the global procurement of allogeneic hematopoietic progenitor cells (HPCs) for transplantation. To better meet the emergent challenges of transporting cryopreserved allogeneic HPC during pandemics, there is an urgent need for External Quality Assurance (EQA) programs to evaluate reproducibility and harmonization of viable CD34+ cell (vCD34+) HPC enumeration, as the current EQA programs are unsuitable for analysis of vCD34+. The cost-effective distribution of HPC cryopreserved reference samples (CRSs) with acceptable reproducibility and specificity is key to the success of a vCD34+ EQA program. Methods Cryopreserved HPC samples (n = 11) were either stored on dry ice for 1 to 4 days or for 1 day followed by liquid nitrogen (LN) storage for 1 to 3 days to assess optimal conditions for vCD34+ EQA. Flow cytometric enumeration of vCD34+ HPCs was performed using a single platform assay combined with 7-AAD viability dye exclusion. The optimum transportation condition was validated in pilot and multicenter national studies (n = 12). Results A combination of 1 day on dry ice followed by LN storage stabilized viability compared with continuous storage on dry ice. This study demonstrates that dispatch of CRSs on dry ice to recipient centers across a distance of ≤4000 km within 26 h, followed by LN storage, resulted in reproducible intercenter vCD34+ enumeration. The estimated cost of safer and more convenient dry ice delivery is >20-fold lower than that of LN. Conclusion This approach can form the basis for economically and scientifically acceptable distribution of CRSs for external vCD34+ EQA.
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Affiliation(s)
- Annabella Chang
- Blood, Stem Cell and Cancer Research Program, St Vincent's Applied Medical Research Centre, and Department of Haematology and BM Transplant, St Vincent's Hospital Sydney, NSW, Australia
| | - Scott J Ragg
- Statewide BMT Program and Pathology Services, Royal Hobart Hospital, Hobart, TAS, Australia
| | - David D Ma
- Blood, Stem Cell and Cancer Research Program, St Vincent's Applied Medical Research Centre, and Department of Haematology and BM Transplant, St Vincent's Hospital Sydney, NSW, Australia; St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
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17
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Anu P, Antti T, Raija S, Marja P, Jaakko V, Timo S, Mervi P, Marja S, Anu S, Karri P, Taru K, Jukka P, Pentti M, Esa J, Ville V. Comparison of CD34 + cell mobilization, blood graft cellular composition, and post-transplant outcome in myeloma patients mobilized with filgrastim or pegfilgrastim added to low-dose cyclophosphamide: A prospective multicenter study. Transfusion 2021; 61:3202-3212. [PMID: 34498764 DOI: 10.1111/trf.16645] [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: 05/18/2021] [Revised: 08/01/2021] [Accepted: 08/06/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Scarce data exist on the impact of granulocyte-colony stimulating factor (G-CSF) type on the mobilizing capacity of CD34+ cells, graft cellular composition, and outcome in myeloma (MM) patients. PATIENTS AND METHODS In this prospective multicenter study, 70 patients with MM received filgrastim (FIL) and 20 patients received pegfilgrastim (PEG) as a G-CSF after low-dose cyclophosphamide. Flow cytometry was used to analyze the mobilization of CD34+ cells and cellular composition of blood grafts, hematologic recovery, and survival after auto-SCT according to the G-CSF choice. RESULTS The CD34+ cell yield of the first apheresis was higher in the FIL group (5.3 vs. 4.2 × 106 /kg, p = .025). The better mobilizing capacity was observed in the FIL group especially after bortezomib-based induction based on the higher first apheresis yield of CD34+ cells (7.5 vs. 4.4 × 106 /kg, p = .001). The median CD19+ cell count (1.0 vs. 0.4 × 106 /kg, p = .010) and the number of CD3+ T lymphocytes (43.1 vs. 31.8 × 106 /kg, p = .122) in the infused graft were higher in the patients mobilized with FIL. Both early (day +15) (56 vs. 108 × 109 /L, p = .002) and later platelet recovery at 6 months (191 vs. 226 × 109 /L, p = .026) were faster in the PEG group. CONCLUSION G-CSF type seems to impact on the mobilization capacity and cellular composition of infused graft and also platelet recovery post-transplant. A randomized study might be warranted to verify the effects of G-CSF choice in the mobilization field.
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Affiliation(s)
- Partanen Anu
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Turunen Antti
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland.,Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Silvennoinen Raija
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland.,Department of Hematology, Helsinki University Hospital Comprehensive Cancer Center and University of Helsinki, Helsinki, Finland
| | - Pyörälä Marja
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Valtola Jaakko
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Siitonen Timo
- Department of Medicine, Oulu University Hospital, Oulu, Finland
| | - Putkonen Mervi
- Department of Medicine, Turku University Hospital, Turku, Finland
| | - Sankelo Marja
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Sikiö Anu
- Department of Medicine, Central Hospital of Central Finland, Jyväskylä, Finland
| | - Penttilä Karri
- The Finnish Medicines Agency Fimea, Kuopio, Finland.,Department of Medicine, Savonlinna Central Hospital, Savonlinna, Finland
| | - Kuittinen Taru
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Pelkonen Jukka
- Laboratory Center of Eastern Finland, Kuopio, Finland.,Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
| | | | - Jantunen Esa
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland.,Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, North Karelia Hospital District, Joensuu, Finland
| | - Varmavuo Ville
- Department of Medicine, Kymenlaakso Central Hospital, Kotka, Finland
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18
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Kim SM, Kim HY, Kim SJ, Jang JH, Kim K, Kim WS, Jung CW, Cho D, Kang ES. Correlation between peripheral blood automated hematopoietic progenitor cell counts and flow cytometric CD34 + cell counts differs according to diagnosis in patients undergoing autologous peripheral blood stem cell transplantation. J Clin Apher 2021; 36:737-749. [PMID: 34283414 DOI: 10.1002/jca.21924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 05/21/2021] [Accepted: 06/26/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND An automated hematopoietic progenitor cell count measurement in Sysmex XN analyzer (XN-HPC) has been developed to assist flow cytometry CD34+ cell count measurement, which requires technical expertise and a long turnaround time. Here, we evaluated the correlation between XN-HPC count and flow cytometric CD34+ cell count in pre-harvest peripheral blood (PB) samples from patients undergoing autologous peripheral blood stem cell (PBSC) transplantation according to diagnosis and investigated the possible cause of the decreased correlation in plasma cell neoplasm patients. MATERIALS AND METHODS We retrospectively included 399 patient data that had matched PB XN-HPC count and CD34+ cell count of PB and apheresis product from Samsung Medical Center (SMC) and the Hematopoietic Stem Cell (HSC) registry. We assessed the diagnostic accuracy and the potential cutoff values of XN-HPC count for predicting adequate PBSC collection. RESULTS The PB XN-HPC count was 1.6 and 1.3-fold higher than the CD34+ cell count in SMC (25.0 vs 15.9/μl) and the HSC registry (20.0 vs 15.2/μl), respectively. Overall the correlation between the PB XN-HPC and CD34+ cell count was moderate (SMC, r = 0.71; HSC registry, r = 0.66). A significant proportional and systemic bias with overestimation of XN-HPC count were noted in the plasma cell neoplasm patients in both SMC and the HSC registry. However, no significant difference in correlation was observed according to myeloma-related laboratory parameters in plasma cell neoplasm patients. CONCLUSION Our results suggest that XN-HPC count should be interpreted cautiously in cancer patients undergoing autologous PBSC transplantation, especially in those with plasma cell neoplasm.
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Affiliation(s)
- Sang-Mi Kim
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyun-Young Kim
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seok Jin Kim
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea
| | - Jun Ho Jang
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kihyun Kim
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Won Seog Kim
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea
| | - Chul Won Jung
- Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Duck Cho
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Stem Cell and Regenerative Medicine Institute, Samsung Medical Center, Seoul, South Korea
| | - Eun-Suk Kang
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Stem Cell and Regenerative Medicine Institute, Samsung Medical Center, Seoul, South Korea
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19
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Turunen A, Silvennoinen R, Partanen A, Valtola J, Siitonen T, Putkonen M, Sankelo M, Pyörälä M, Kuittinen T, Penttilä K, Sikiö A, Savolainen ER, Mäntymaa P, Pelkonen J, Varmavuo V, Jantunen E. Autograft cellular composition and outcome in myeloma patients: Results of the prospective multicenter GOA study. Transfusion 2021; 61:1830-1844. [PMID: 33955591 DOI: 10.1111/trf.16424] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/24/2021] [Accepted: 03/06/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Autologous stem cell transplantation (auto-SCT) is a widely used treatment option in multiple myeloma (MM) patients. The optimal graft cellular composition is not known. STUDY DESIGN AND METHODS Autograft cellular composition was analyzed after freezing by flow cytometry in 127 MM patients participating in a prospective multicenter study. The impact of graft cellular composition on hematologic recovery and outcome after auto-SCT was evaluated. RESULTS A higher graft CD34+ cell content predicted faster platelet recovery after auto-SCT in both the short and long term. In patients with standard-risk cytogenetics, a higher graft CD34+ count (>2.5 × 106 /kg) was linked with shorter progression-free survival (PFS; 28 vs. 46 months, p = 0.04), but there was no difference in overall survival (OS) (p = 0.53). In a multivariate model, a higher graft CD34+ CD133+ CD38- (>0.065 × 106 /kg, p = 0.009) and NK cell count (>2.5 × 106 /kg, p = 0.026), lenalidomide maintenance and standard-risk cytogenetics predicted better PFS. In contrast, a higher CD34+ count (>2.5 × 106 /kg, p = 0.015) predicted worse PFS. A very low CD3+ cell count (≤20 × 106 /kg, p = 0.001) in the infused graft and high-risk cytogenetics remained predictive of worse OS. CONCLUSIONS Autograft cellular composition may impact outcome in MM patients after auto-SCT. More studies are needed to define optimal graft composition.
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Affiliation(s)
- Antti Turunen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland.,Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Raija Silvennoinen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland.,Department of Hematology, Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Anu Partanen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Jaakko Valtola
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Timo Siitonen
- Department of Medicine, Oulu University Hospital, Oulu, Finland
| | - Mervi Putkonen
- Department of Medicine, Turku University Hospital, Turku, Finland
| | - Marja Sankelo
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Marja Pyörälä
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Taru Kuittinen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Karri Penttilä
- Finnish Medicines Agency, Kuopio, Finland.,Department of Medicine, Savonlinna Central Hospital, Savonlinna, Finland
| | - Anu Sikiö
- Department of Medicine, Central Hospital of Central Finland, Jyväskylä, Finland
| | | | | | - Jukka Pelkonen
- Laboratory Centre of Eastern Finland, Kuopio, Finland.,Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
| | - Ville Varmavuo
- Department of Medicine, Kymenlaakso Central Hospital, Kotka, Finland
| | - Esa Jantunen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland.,Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, North Carelia Hospital District, Joensuu, Finland
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20
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Kasane M, Kurosawa S, Kojima M, Iwashita N, Kase Y, Tsubokura M, Nakabayashi S, Ikeda C, Kawamura K, Matsushita H, Narita R, Fukumoto H, Fujino T, Makita S, Fukuhara S, Munakata W, Suzuki T, Maruyama D, Ito A, Tanaka T, Inamoto Y, Kim SW, Tajima K, Tanosaki R, Izutsu K, Fukuda T. Usefulness of hematopoietic progenitor cell monitoring to predict autologous peripheral blood stem cell harvest timing: A single-center retrospective study. Transfus Apher Sci 2021; 60:103150. [PMID: 33941489 DOI: 10.1016/j.transci.2021.103150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 04/14/2021] [Accepted: 04/21/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION In autologous peripheral blood stem cell harvest (APBSCH), CD34-positive cells have been measured to assess the numbers of hematopoietic stem cells, but measurement requires specialized equipment. Recently, there was a report that peripheral blood hematopoietic progenitor cells (HPCs) are useful indicators of the presence of hematopoietic stem cells. We examined the usefulness of HPC monitoring to predict APBSCH timing. METHODS We retrospectively analyzed the relationship between HPC and collected CD34-positive cells in 84 consecutive patients who underwent APBSCH. RESULTS According to the receiver operating characteristics curve for the collection of ≥2 × 106 CD34-positive cells/kg, the HPC cut-off value on the day before collection was 21/μL, while that on the day of collection was 41/μL. No significant factors were found in the univariate analysis except for the HPC count on the day before collection (p < 0.001) and the day of collection (p < 0.001). According to the multivariate analysis, the HPC count on the day before collection (p < 0.001) and the day of collection (p < 0.001) were also factors that strongly influenced the quantity of CD34-positive cells collected. CONCLUSION Our results suggest that the HPC count on not only the day of collection but also the day before collection is a good indicator for appropriate APBSCH timing.
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Affiliation(s)
- Moemi Kasane
- Department of Clinical Laboratories, National Cancer Center Hospital, Japan
| | - Saiko Kurosawa
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Japan
| | - Minoru Kojima
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Japan.
| | - Nao Iwashita
- Department of Clinical Laboratories, National Cancer Center Hospital, Japan
| | - Yuki Kase
- Department of Clinical Laboratories, National Cancer Center Hospital, Japan
| | - Misato Tsubokura
- Department of Clinical Laboratories, National Cancer Center Hospital, Japan
| | - Saori Nakabayashi
- Department of Clinical Laboratories, National Cancer Center Hospital, Japan
| | - Chiaki Ikeda
- Department of Clinical Laboratories, National Cancer Center Hospital, Japan
| | - Kimihiko Kawamura
- Department of Clinical Laboratories, National Cancer Center Hospital, Japan
| | | | - Ryuichi Narita
- Clinical Engineering Section, National Cancer Center Hospital, Japan
| | - Hidetomo Fukumoto
- Clinical Engineering Section, National Cancer Center Hospital, Japan
| | - Takahiro Fujino
- Department of Hematology, National Cancer Center Hospital, Japan
| | - Shinichi Makita
- Department of Hematology, National Cancer Center Hospital, Japan
| | - Suguru Fukuhara
- Department of Hematology, National Cancer Center Hospital, Japan
| | - Wataru Munakata
- Department of Hematology, National Cancer Center Hospital, Japan
| | - Tatsuya Suzuki
- Department of Hematology, National Cancer Center Hospital, Japan
| | - Dai Maruyama
- Department of Hematology, National Cancer Center Hospital, Japan
| | - Ayumu Ito
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Japan
| | - Takashi Tanaka
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Japan
| | - Yoshihiro Inamoto
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Japan
| | - Sung-Won Kim
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Japan
| | - Kinuko Tajima
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Japan
| | - Ryuji Tanosaki
- Department of Blood Transfusion and Cellular Therapy, National Cancer Center Hospital, Japan
| | - Koji Izutsu
- Department of Hematology, National Cancer Center Hospital, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Japan
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21
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Santosa D, Pangarsa EA, Setiawan B, Naibaho RM, Rizky D, Dharmana E, Suharti C. Establishing the hematopoietic stem cell transplant (HSCT) in a developing country; the journey of HSCT in Semarang, Indonesia. Bone Marrow Transplant 2021; 56:270-273. [PMID: 32555316 PMCID: PMC7796855 DOI: 10.1038/s41409-020-0973-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 05/26/2020] [Accepted: 06/04/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Damai Santosa
- Division of Hematology/Medical Oncology, Department of Internal Medicine, Medical Faculty of Diponegoro University and Dr. Kariadi Hospital, Semarang, Indonesia.
| | - Eko Adhi Pangarsa
- Division of Hematology/Medical Oncology, Department of Internal Medicine, Medical Faculty of Diponegoro University and Dr. Kariadi Hospital, Semarang, Indonesia
| | - Budi Setiawan
- Division of Hematology/Medical Oncology, Department of Internal Medicine, Medical Faculty of Diponegoro University and Dr. Kariadi Hospital, Semarang, Indonesia
| | - Ridho M Naibaho
- Division of Hematology/Medical Oncology, Department of Internal Medicine, Medical Faculty of Mulawarman University, Parikesit General Hospital, Tenggarong, Indonesia
| | - Daniel Rizky
- Division of Hematology/Medical Oncology, Department of Internal Medicine, Medical Faculty of Diponegoro University and Dr. Kariadi Hospital, Semarang, Indonesia
| | - Edi Dharmana
- Department of Parasitology, Medical Faculty of Diponegoro University, Semarang, Indonesia
| | - Catharina Suharti
- Division of Hematology/Medical Oncology, Department of Internal Medicine, Medical Faculty of Diponegoro University and Dr. Kariadi Hospital, Semarang, Indonesia
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22
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Sarikonda G, Mathieu M, Natalia M, Pahuja A, Xue Q, Pierog PL, Trampont PC, Decman V, Reynolds S, Hanafi LA, Sun YS, Eck S, Hedrick MN, Stewart JJ, Tangri S, Litwin V, Dakappagari N. Best practices for the development, analytical validation and clinical implementation of flow cytometric methods for chimeric antigen receptor T cell analyses. CYTOMETRY PART B-CLINICAL CYTOMETRY 2020; 100:79-91. [PMID: 33373096 DOI: 10.1002/cyto.b.21985] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/10/2020] [Accepted: 12/15/2020] [Indexed: 12/12/2022]
Abstract
Chimeric Antigen Receptor (CAR) T cells are recognized as efficacious therapies with demonstrated ability to produce durable responses in blood cancer patients. Regulatory approvals and acceptance of these unique therapies by patients and reimbursement agencies have led to a significant increase in the number of next generation CAR T clinical trials. Flow cytometry is a powerful tool for comprehensive profiling of individual CAR T cells at multiple stages of clinical development, from product characterization during manufacturing to longitudinal evaluation of the infused product in patients. There are unique challenges with regard to the development and validation of flow cytometric methods for CAR T cells; moreover, the assay requirements for manufacturing and clinical monitoring differ. Based on the collective experience of the authors, this recommendation paper aims to review these challenges and present approaches to address them. The discussion focuses on describing key considerations for the design, optimization, validation and implementation of flow cytometric methods during the clinical development of CAR T cell therapies.
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Affiliation(s)
- Ghanashyam Sarikonda
- Navigate BioPharma Services, Inc., a Novartis subsidiary, Carlsbad, California, USA
| | | | - Mahwish Natalia
- Takeda Pharmaceutical International, Cambridge, Massachusetts, USA
| | - Anil Pahuja
- Navigate BioPharma Services, Inc., a Novartis subsidiary, Carlsbad, California, USA
| | - Qiong Xue
- Takeda Pharmaceutical International, Cambridge, Massachusetts, USA
| | - Piotr L Pierog
- Takeda Pharmaceutical International, Cambridge, Massachusetts, USA
| | | | - Vilma Decman
- GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | | | | | | | - Steven Eck
- Integrated Bioanalysis, Clinical Pharmacology & Safety Sciences, R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | | | | | - Shabnam Tangri
- Navigate BioPharma Services, Inc., a Novartis subsidiary, Carlsbad, California, USA
| | | | - Naveen Dakappagari
- Navigate BioPharma Services, Inc., a Novartis subsidiary, Carlsbad, California, USA
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23
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Partanen A, Turunen A, Valtola J, Pyörälä M, Vasala K, Kuittinen O, Kuitunen H, Penttilä K, Keskinen L, Kuittinen T, Mäntymaa P, Pelkonen J, Varmavuo V, Jantunen E. Mobilization characteristics, blood graft composition, and outcome in diffuse large B-cell lymphoma after autologous stem cell transplantation: Results from the prospective multicenter GOA study. Transfusion 2020; 61:516-525. [PMID: 33245582 DOI: 10.1111/trf.16198] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Diffuse large B-cell lymphoma (DLBCL) is a common indication for autologous stem cell transplantation (auto-SCT). STUDY DESIGN AND METHODS This prospective noninterventional study aimed to evaluate the impact of mobilization characteristics and graft cellular content on hematologic recovery and outcome after auto-SCT among 68 patients with DLBCL. RESULTS Better mobilization capacity as manifested by blood CD34+ cell count >32 × 106 /L and CD34+ cell yield of the first apheresis >2.75 × 106 /kg correlated with faster neutrophil (P = .005 and P = .017) and platelet (P = .002 and P < .001) recovery. A higher number of infused CD34+ cells (> 2.65 × 106 /kg) was associated with better 5-year overall survival (OS; 95% vs 67%, P = .012). The graft CD34+ CD133+ CD38- cell count >0.07 × 106 /kg was predictive of better 5-year OS (87% vs 63%; P = .008) and higher graft CD3+ cell count (>23.1 × 106 /kg) correlated also with better 5-year OS (80% vs 40%, P = .008). In multivariate analysis only disease status of CR I at auto-SCT was associated with better progression-free survival (P = .014) and OS (P = .039). CONCLUSION The mobilization capacity of CD34+ cells impacted on early hematologic recovery in patients with DLBCL after auto-SCT. Higher graft CD34+ cell count and both CD34+ CD133+ CD38- and CD3+ cells were also associated with better OS. The effect of optimal graft cellular composition on outcome in DLBCL should be evaluated in a randomized study.
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Affiliation(s)
- Anu Partanen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Antti Turunen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland.,Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jaakko Valtola
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Marja Pyörälä
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Kaija Vasala
- Department of Oncology, Central Hospital of Central Finland, Jyväskylä, Finland
| | - Outi Kuittinen
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Oncology, Kuopio University Hospital, Kuopio, Finland.,Department of Oncology, Oulu University Hospital, Oulu, Finland
| | - Hanne Kuitunen
- Department of Oncology, Oulu University Hospital, Oulu, Finland
| | - Karri Penttilä
- Department of Medicine, Central Hospital of Savonlinna, Savonlinna, Finland.,Finnish Medicines Agency, Kuopio, Finland
| | - Leena Keskinen
- Department of Oncology, Tampere University Hospital, Tampere, Finland
| | - Taru Kuittinen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | | | - Jukka Pelkonen
- Eastern Finland Laboratory Centre, Kuopio, Finland.,Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
| | - Ville Varmavuo
- Department of Medicine, Kymenlaakso Central Hospital, Kotka, Finland
| | - Esa Jantunen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland.,Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Hospital District of North Karelia, Joensuu, Finland
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24
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Hölig K, Schmidt H, Hütter G, Kramer M, Teipel R, Heidrich K, Zimmer K, Heidenreich F, Blechschmidt M, Torosian T, Ordemann R, Kroschinsky F, Rücker-Braun E, Gopsca L, Wagner-Drouet EM, Oelschlaegel U, Schmidt AH, Bornhäuser M, Ehninger G, Schetelig J. Salvage treatment with plerixafor in poor mobilizing allogeneic stem cell donors: results of a prospective phase II-trial. Bone Marrow Transplant 2020; 56:635-645. [PMID: 33028987 PMCID: PMC8589660 DOI: 10.1038/s41409-020-01053-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 08/14/2020] [Accepted: 09/02/2020] [Indexed: 11/09/2022]
Abstract
We conducted a prospective clinical trial to investigate the safety and efficacy of plerixafor (P) in allogeneic peripheral blood stem cells (PBSC) donors with poor mobilization response to standard-dose granulocyte colony-stimulating factor (G-CSF), defined by <2 × 106 CD34 + cells/kg recipient body-weight (CD34+/kg RBW) after 1st apheresis. A single dose of 240 µg/kg P was injected subcutaneously at 10 p.m. on the day of the 1st apheresis. Thirty-seven allogeneic PBSC donors underwent study treatment. The median CD34+ count in peripheral blood was 15/µl on Day 1 after G-CSF alone, versus 44/µl on Day 2 after G-CSF plus P (p < 0.001). The median yield of CD34+ cells was 1.1 × 108 on Day 1 and 2.8 × 108 on Day 2. In contrast to a median yield of only 1.31 × 106 CD CD34+/kg RBW on Day 1, triggering study inclusion, a median of 3.74 × 106 CD CD34+/kg RBW were collected with G-CSF plus P on Day 2. Of 37 donors, 21 reached the target cell count of >4.5 × 106 CD34+/kg RBW (57%, 95%CI 40-73%). No donor experienced a severe adverse event requiring treatment. In conclusion, P might be considered on a case-by-case basis for healthy allogeneic donors with very poor stem cell mobilization success after G-CSF.
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Affiliation(s)
- Kristina Hölig
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, TU, Dresden, Germany
| | | | - Gero Hütter
- Cellex Collection Center GmbH, Dresden, Germany
| | - Michael Kramer
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, TU, Dresden, Germany
| | - Raphael Teipel
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, TU, Dresden, Germany
| | - Katharina Heidrich
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, TU, Dresden, Germany
| | - Kristin Zimmer
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, TU, Dresden, Germany
| | - Falk Heidenreich
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, TU, Dresden, Germany.,DKMS gemeinnützige GmbH, Clinical Trials Unit, Dresden, Germany
| | - Matthias Blechschmidt
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, TU, Dresden, Germany
| | | | | | - Frank Kroschinsky
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, TU, Dresden, Germany
| | - Elke Rücker-Braun
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, TU, Dresden, Germany
| | - Laszlo Gopsca
- National Institute of Hematology and Infectious Diseases, Department of Hematology and Stem Cell Transplantation, Budapest, Hungary
| | - Eva Maria Wagner-Drouet
- Medizinische Klinik und Poliklinik III, Hämatologie, Internistische Onkologie, Pneumologie, Universitätsmedizin Mainz, Mainz, Germany
| | - Uta Oelschlaegel
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, TU, Dresden, Germany
| | | | - Martin Bornhäuser
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, TU, Dresden, Germany.,Center for Regenerative Therapies, Dresden, Germany
| | - Gerhard Ehninger
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, TU, Dresden, Germany
| | - Johannes Schetelig
- Department of Internal Medicine I, University Hospital Carl Gustav Carus, TU, Dresden, Germany. .,DKMS gemeinnützige GmbH, Clinical Trials Unit, Dresden, Germany.
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25
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Turunen A, Valtola J, Partanen A, Ropponen A, Kuittinen O, Kuitunen H, Vasala K, Ågren L, Penttilä K, Keskinen L, Savolainen ER, Pyörälä M, Kuittinen T, Selander T, Mäntymaa P, Pelkonen J, Jantunen E, Varmavuo V. Autograft cellular composition and outcome in NHL patients: results of the prospective multicenter GOA study. Leuk Lymphoma 2020; 61:2082-2092. [DOI: 10.1080/10428194.2020.1762879] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Antti Turunen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jaakko Valtola
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
- Department of Medicine, Savonlinna Central Hospital, Savonlinna, Finland
| | - Anu Partanen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Antti Ropponen
- Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
| | - Outi Kuittinen
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Oncology, Kuopio University Hospital, Kuopio, Finland
- Department of Oncology, Oulu University Hospital, Oulu, Finland
| | - Hanne Kuitunen
- Department of Oncology, Oulu University Hospital, Oulu, Finland
| | - Kaija Vasala
- Department of Oncology, Central Hospital of Central Finland, Jyväskylä, Finland
| | - Lasse Ågren
- Department of Medicine, North Carelia Hospital District, Joensuu, Finland
| | - Karri Penttilä
- Department of Medicine, Savonlinna Central Hospital, Savonlinna, Finland
- Finnish Medicines Agency, Kuopio, Finland
| | - Leena Keskinen
- Department of Oncology, Tampere University Hospital, Tampere, Finland
| | | | - Marja Pyörälä
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Taru Kuittinen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Tuomas Selander
- Science Service Center, Kuopio University Hospital, Kuopio, Finland
| | | | - Jukka Pelkonen
- Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
- Laboratory Centre of Eastern Finland, Kuopio, Finland
| | - Esa Jantunen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, North Carelia Hospital District, Joensuu, Finland
| | - Ville Varmavuo
- Department of Medicine, Kymenlaakso Central Hospital, Kotka, Finland
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26
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Turunen A, Partanen A, Valtola J, Ropponen A, Siitonen T, Kuittinen O, Kuitunen H, Putkonen M, Sankelo M, Keskinen L, Savolainen ER, Pyörälä M, Kuittinen T, Silvennoinen R, Penttilä K, Sikiö A, Vasala K, Mäntymaa P, Pelkonen J, Varmavuo V, Jantunen E. CD34+ cell mobilization, blood graft composition, and posttransplant recovery in myeloma patients compared to non-Hodgkin's lymphoma patients: results of the prospective multicenter GOA study. Transfusion 2020; 60:1519-1528. [PMID: 32333404 DOI: 10.1111/trf.15820] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Autologous stem cell transplantation is an established treatment option for patients with multiple myeloma (MM) or non-Hodgkin's lymphoma (NHL). STUDY DESIGN AND METHODS In this prospective multicenter study, 147 patients with MM were compared with 136 patients with NHL regarding the mobilization and apheresis of blood CD34+ cells, cellular composition of infused blood grafts, posttransplant recovery, and outcome. RESULTS Multiple myeloma patients mobilized CD34+ cells more effectively (6.3 × 106 /kg vs. 3.9 × 106 /kg, p = 0.001). The proportion of poor mobilizers (peak blood CD34+ cell count <20 × 106 /L) was higher in NHL patients (15% vs. 3%, p < 0.001). Plerixafor was added to rescue the mobilization failure in 17 MM patients (12%) and in 35 NHL patients (26%; p = 0.002). The infused grafts contained more natural killer (NK) and CD19+ cells in MM patients. Blood platelet and NK-cell counts were higher in MM patients posttransplant. Early treatment-related mortality was low in both groups, but NHL patients had a higher late (>100 days) nonrelapse mortality (NRM; 6% vs. 0%, p = 0.003). CONCLUSIONS Non-Hodgkin's lymphoma and MM patients differ in terms of mobilization of CD34+ cells, graft cellular composition, and posttransplant recovery. Thus, the optimal graft characteristics may also be different.
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Affiliation(s)
- Antti Turunen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland.,Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Anu Partanen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Jaakko Valtola
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Antti Ropponen
- Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
| | - Timo Siitonen
- Department of Medicine, Oulu University Hospital, Oulu, Finland
| | - Outi Kuittinen
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Oncology, Kuopio University Hospital, Kuopio, Finland
| | - Hanne Kuitunen
- Department of Oncology, Oulu University Hospital, Oulu, Finland
| | - Mervi Putkonen
- Department of Medicine, Turku University Hospital, Turku, Finland
| | - Marja Sankelo
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Leena Keskinen
- Department of Oncology, Tampere University Hospital, Tampere, Finland
| | | | - Marja Pyörälä
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Taru Kuittinen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Raija Silvennoinen
- Hematology, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
| | - Karri Penttilä
- Finnish Medicines Agency, Kuopio, Finland.,Department of Medicine, Savonlinna Central Hospital, Savonlinna, Finland
| | - Anu Sikiö
- Department of Medicine, Central Hospital of Central Finland, Jyväskylä, Finland
| | - Kaija Vasala
- Department of Oncology, Central Hospital of Central Finland, Jyväskylä, Finland
| | | | - Jukka Pelkonen
- Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland.,Laboratory Centre of Eastern Finland, Kuopio, Finland
| | - Ville Varmavuo
- Department of Medicine, Kymenlaakso Central Hospital, Kotka, Finland
| | - Esa Jantunen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland.,Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, North Carelia Hospital District, Joensuu, Finland
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27
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Partanen A, Turunen A, Valtola J, Vasala K, Ågren L, Penttilä K, Pyörälä M, Kuittinen T, Mäntymaa P, Pelkonen J, Jantunen E, Varmavuo V. A prospective comparison of pegfilgrastim and lipegfilgrastim combined with chemotherapy in the mobilization of
CD34
+
cells in
NHL
patients. J Clin Apher 2020; 35:255-263. [DOI: 10.1002/jca.21785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 03/15/2020] [Accepted: 03/17/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Anu Partanen
- Department of Medicine Kuopio University Hospital Kuopio Finland
| | - Antti Turunen
- Department of Medicine Kuopio University Hospital Kuopio Finland
- Institute of Clinical Medicine University of Eastern Finland Kuopio Finland
| | - Jaakko Valtola
- Department of Medicine Kuopio University Hospital Kuopio Finland
| | - Kaija Vasala
- Department of Oncology Central Hospital of Central Finland Jyväskylä Finland
| | - Lasse Ågren
- Siunsote‐Department of Medicine Hospital District of North Karelia Joensuu Finland
| | - Karri Penttilä
- Department of Medicine Central Hospital of Savonlinna Savonlinna Finland
- The Finnish Medicines Agency Kuopio Finland
| | - Marja Pyörälä
- Department of Medicine Kuopio University Hospital Kuopio Finland
| | - Taru Kuittinen
- Department of Medicine Kuopio University Hospital Kuopio Finland
| | | | - Jukka Pelkonen
- Eastern Finland Laboratory Centre Kuopio Finland
- Department of Clinical Microbiology University of Eastern Finland Kuopio Finland
| | - Esa Jantunen
- Department of Medicine Kuopio University Hospital Kuopio Finland
- Institute of Clinical Medicine University of Eastern Finland Kuopio Finland
- Siunsote‐Department of Medicine Hospital District of North Karelia Joensuu Finland
| | - Ville Varmavuo
- Department of Medicine Kymenlaakso Central Hospital Kotka Finland
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28
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Cid J, Castillo C, Marín P, Carbassé G, Herrera D, Monfort N, Fernández-Avilés F, Gutiérrez-García G, Martínez C, Rosiñol L, Suárez-Lledó M, Rovira M, Urbano-Ispizua Á, Lozano M. Increased collection efficiency of CD34+ cells after mobilization with preemptive use of plerixafor followed by leukocytapheresis on the same day. Transfusion 2020; 60:779-785. [PMID: 32064638 DOI: 10.1111/trf.15711] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 01/18/2020] [Accepted: 01/19/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Plerixafor should be administered 6 to 11 hours before starting leukocytapheresis. However, we have been using plerixafor followed by leukocytapheresis according to different time schedules since 2007. Our objective was to compare the CD34+ cell collection efficiency (CE1) of the first leukocytapheresis performed after using plerixafor at different time intervals. STUDY DESIGN AND METHODS Same-day schedule refers to the administration of plerixafor at 10:00 AM and starting the leukocytapheresis on the same day at 4:00 PM (6 hours interval). Next-day schedule refers to the administration of plerixafor at 8:00 PM and starting the leukocytapheresis on the next day (10:00 AM or 4:00 PM; either a 14- or 20-hr interval). Variables that might influence the CE1 of CD34+ cells were analyzed by longitudinal linear regression with a random effects model derived by generalized estimating equations. RESULTS The median CE1 of CD34+ cells was higher in the group of 30 patients who underwent leukocytapheresis on the same day when compared with the group of 62 patients who underwent leukocytapheresis on the next day (65.8% vs. 56.7%; p < 0.01). In the longitudinal linear regression analysis, only the time from plerixafor administration to leukocytapheresis start was associated with a statistically significant decrease in the CE1 of CD34+ cells (CE1 change -0.034%; p < 0.01). CONCLUSION Higher CE1 of CD34+ cells was observed when patients underwent leukocytapheresis on the same day after receiving plerixafor in comparison with administering plerixafor and underwent leukocytapheresis on the next day. Larger studies are necessary to confirm present results.
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Affiliation(s)
- Joan Cid
- Apheresis & Cellular Therapy Unit, Department of Hemotherapy and Hemostasis, ICMHO, Hospital Clínic, University of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Carlos Castillo
- Apheresis & Cellular Therapy Unit, Department of Hemotherapy and Hemostasis, ICMHO, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Pedro Marín
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Hematopoietic Stem Cell transplantation Unit, Department of Hematology, ICMHO, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Gloria Carbassé
- Apheresis & Cellular Therapy Unit, Department of Hemotherapy and Hemostasis, ICMHO, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Dolores Herrera
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Hematopoietic Stem Cell transplantation Unit, Department of Hematology, ICMHO, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Nuria Monfort
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Hematopoietic Stem Cell transplantation Unit, Department of Hematology, ICMHO, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Francesc Fernández-Avilés
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Hematopoietic Stem Cell transplantation Unit, Department of Hematology, ICMHO, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Gonzalo Gutiérrez-García
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Hematopoietic Stem Cell transplantation Unit, Department of Hematology, ICMHO, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Carmen Martínez
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Hematopoietic Stem Cell transplantation Unit, Department of Hematology, ICMHO, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Laura Rosiñol
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Hematopoietic Stem Cell transplantation Unit, Department of Hematology, ICMHO, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - María Suárez-Lledó
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Hematopoietic Stem Cell transplantation Unit, Department of Hematology, ICMHO, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Montserrat Rovira
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Hematopoietic Stem Cell transplantation Unit, Department of Hematology, ICMHO, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Álvaro Urbano-Ispizua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Hematopoietic Stem Cell transplantation Unit, Department of Hematology, ICMHO, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Miquel Lozano
- Apheresis & Cellular Therapy Unit, Department of Hemotherapy and Hemostasis, ICMHO, Hospital Clínic, University of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Furundarena JR, Uranga A, Alkorta A, González C, Javier Ferreiro J, Rey M, Aragón L, Urreta I, Emparanza JI, Redín H, Garrido A, Araiz M. Evaluation of the predictive value of the hematopoietic progenitor cell count using an automated hematology analyzer for CD34+ stem cell mobilization and apheresis product yield. Int J Lab Hematol 2019; 42:170-179. [DOI: 10.1111/ijlh.13142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 10/16/2019] [Accepted: 11/21/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | - Alasne Uranga
- Hematology Laboratory Donostia University Hospital (DUH) Donostia Spain
| | - Aitziber Alkorta
- Hematopoietic Stem Cell Transplantation Unit Hematology Department Donostia University Hospital (DUH) Donostia Spain
| | - Carmen González
- Hematology Laboratory Donostia University Hospital (DUH) Donostia Spain
| | - José Javier Ferreiro
- Hematopoietic Stem Cell Transplantation Unit Hematology Department Donostia University Hospital (DUH) Donostia Spain
| | - Mercedes Rey
- Immunology Laboratory Donostia University Hospital (DUH) Donostia Spain
| | - Larraitz Aragón
- Immunology Laboratory Donostia University Hospital (DUH) Donostia Spain
| | - Iratxe Urreta
- Clinical Epidemiology Unit Donostia University Hospital (DUH) Donostia Spain
| | | | - Helena Redín
- Core Laboratory Donostia University Hospital (DUH) Donostia Spain
| | - Adolfo Garrido
- Core Laboratory Donostia University Hospital (DUH) Donostia Spain
| | - María Araiz
- Hematopoietic Stem Cell Transplantation Unit Hematology Department Donostia University Hospital (DUH) Donostia Spain
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30
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Assessment of haematopoietic progenitor cell counting with the Sysmex ® XN-1000 to guide timing of apheresis of peripheral blood stem cells. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2019; 18:67-76. [PMID: 31403932 DOI: 10.2450/2019.0086-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 06/04/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Successful peripheral blood stem cell (PBSC) collection depends on optimal timing of apheresis, as usually determined by flow cytometry CD34-positive (+) cell count in peripheral blood (PB). Since this method is costly and labour-intensive, we evaluated the use of the Hematopoietic Progenitor Cell count programme on a Sysmex® XN haematologic analyser (XN-HPC) as a rapid and inexpensive alternative for predicting CD34+ cell count in PB samples. MATERIALS AND METHODS Haematopoietic progenitor cell and CD34+ cell counts were compared using 273 PB samples collected from 78 healthy donors and 72 patients who underwent PBSC transplantation. We assessed the effectiveness of the XN-HPC in safely predicting pre-harvest CD34+ counts. The most efficient cut-off values of XNHPC were identified. We also evaluated the imprecision (coefficient of variation, CV) and functional sensitivity. RESULTS Imprecision of the XN-HPC count was <6.3% on daily measurement of three levels of quality control material. Functional sensitivity was 8.9×106/L. A cut-off value of ≥62×106/L XN-HPC for multiple myeloma (MM) patients and ≥30×106/L for all other subjects had both 100% specificity and 100% positive predictive value for identifying samples with CD34+ cells ≥20×106/L. An XN-HPC threshold of <13×106/L identified preharvest CD34+ cell count <10×106/L with 100% sensitivity and 100% negative predictive value. DISCUSSION The XN-HPC is a fast, easy and inexpensive test that can safely improve apheresis workflow thus possibly replacing other more expensive CD34 counts currently performed and promoting optimal timing of PBSC collection.
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31
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Saucourt C, Vogt S, Merlin A, Valat C, Criquet A, Harmand L, Birebent B, Rouard H, Himmelspach C, Jeandidier É, Chartois-Leauté AG, Derenne S, Koehl L, Salem JE, Hulot JS, Tancredi C, Aries A, Judé S, Martel E, Richard S, Douay L, Hénon P. Design and Validation of an Automated Process for the Expansion of Peripheral Blood-Derived CD34 + Cells for Clinical Use After Myocardial Infarction. Stem Cells Transl Med 2019; 8:822-832. [PMID: 31037857 PMCID: PMC6646685 DOI: 10.1002/sctm.17-0277] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 03/04/2019] [Indexed: 12/11/2022] Open
Abstract
We previously demonstrated that intracardiac delivery of autologous peripheral blood‐derived CD34+ stem cells (SCs), mobilized by granulocyte‐colony stimulating factor (G‐CSF) and collected by leukapheresis after myocardial infarction, structurally and functionally repaired the damaged myocardial area. When used for cardiac indication, CD34+ cells are now considered as Advanced Therapy Medicinal Products (ATMPs). We have industrialized their production by developing an automated device for ex vivo CD34+‐SC expansion, starting from a whole blood (WB) sample. Blood samples were collected from healthy donors after G‐CSF mobilization. Manufacturing procedures included: (a) isolation of total nuclear cells, (b) CD34+ immunoselection, (c) expansion and cell culture recovery in the device, and (d) expanded CD34+ cell immunoselection and formulation. The assessment of CD34+ cell counts, viability, and immunophenotype and sterility tests were performed as quality tests. We established graft acceptance criteria and performed validation processes in three cell therapy centers. 59.4 × 106 ± 36.8 × 106 viable CD34+ cells were reproducibly generated as the final product from 220 ml WB containing 17.1 × 106 ± 8.1 × 106 viable CD34+ cells. CD34+ identity, genetic stability, and telomere length were consistent with those of basal CD34+ cells. Gram staining and mycoplasma and endotoxin analyses were negative in all cases. We confirmed the therapeutic efficacy of both CD34+‐cell categories in experimental acute myocardial infarct (AMI) in immunodeficient rats during preclinical studies. This reproducible, automated, and standardized expansion process produces high numbers of CD34+ cells corresponding to the approved ATMP and paves the way for a phase I/IIb study in AMI, which is currently recruiting patients. stem cells translational medicine2019;8:822&832
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Laurence Koehl
- INSERM, CIC-1421 and UMR ICAN 1166; AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Joe-Elie Salem
- INSERM, CIC-1421 and UMR ICAN 1166; AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Jean-Sébastien Hulot
- INSERM, CIC-1421 and UMR ICAN 1166; AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | | | | | | | | | | | - Luc Douay
- Université Pierre et Marie Curie, UMRS938, Paris, France
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32
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Allan D, Kiernan J, Gragert L, Dibdin N, Bartlett D, Campbell T, Mostert K, Halpenny M, Ganz K, Maiers M, Petraszko T, Elmoazzen H. Reducing ethnic disparity in access to high-quality HLA-matched cord blood units for transplantation: analysis of the Canadian Blood Services' Cord Blood Bank inventory. Transfusion 2019; 59:2382-2388. [PMID: 31002398 DOI: 10.1111/trf.15313] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 02/27/2019] [Accepted: 03/06/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Launched in 2013, Canadian Blood Services' Cord Blood Bank (CBS' CBB) has built a high-quality, ethnically diverse cord blood repository that aims to reduce ethnic disparity in accessing suitable units for transplantation. METHODS AND RESULTS As of December 2016, 2000 units have been banked. The self-reported maternal ethnicity was 58% non-Caucasian. Overall, 26% of units were classified as multi-ethnicity with Caucasian (84%) most frequently observed in combination with Asian, First Nations (predominant indigenous peoples in Canada south of the Arctic Circle), or African ethnicity. Utilization scores that incorporate total nucleated and CD34+ cell counts in the CBS' CBB were associated with greater likelihood of utilization compared with the international inventory of units (p < 0.05). The distribution of utilization scores was similar for Caucasians compared with non-Caucasians (p < 0.05). Using HLA genotypes of cord blood units and their mothers, we determined probable ethnic assignments for each haplotype using HaploStats (National Marrow Donor Program). Significant increases in HLA-match likelihoods are predicted for all ethnicities as the inventory grows to its target of 10,000 units and the gap in HLA-match likelihoods for Caucasian and non-Caucasian patients progressively declines. CONCLUSIONS The CBS' CBB inventory is predicted to have high HLA-matching likelihoods across a broad spectrum of ethnic groups, improving access to high-quality stem cell products for all patients.
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Affiliation(s)
- David Allan
- Ottawa Hospital Research Institute and Department of Medicine, University of Ottawa, Ottawa, Ontario.,Canadian Blood Services' Cord Blood Bank, Ottawa, Ontario
| | - Jeffrey Kiernan
- Ottawa Hospital Research Institute and Department of Medicine, University of Ottawa, Ottawa, Ontario.,Canadian Blood Services' Cord Blood Bank, Ottawa, Ontario
| | | | | | | | - Todd Campbell
- Canadian Blood Services' Cord Blood Bank, Ottawa, Ontario
| | - Karen Mostert
- Canadian Blood Services' Cord Blood Bank, Ottawa, Ontario
| | | | - Kathy Ganz
- Canadian Blood Services' Cord Blood Bank, Ottawa, Ontario
| | - Martin Maiers
- National Marrow Donor Program, Minneapolis, Minnesota
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33
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Ono Y, Yoshioka S, Inoue K, Yoshida M, Maruoka H, Ishikawa T. Stochastic model based on preharvest peripheral CD34‐positive cell count and collection efficiency predicting processed blood volume in peripheral hematopoietic stem cell apheresis. Transfusion 2018; 59:671-680. [DOI: 10.1111/trf.15096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 10/10/2018] [Accepted: 10/22/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Yuichiro Ono
- Department of HematologyKobe City Medical Center General Hospital Kobe Japan
| | - Satoshi Yoshioka
- Department of HematologyKobe City Medical Center General Hospital Kobe Japan
| | - Kazuhisa Inoue
- Department of Clinical EngineeringKobe City Medical Center General Hospital Kobe Japan
| | - Masahiro Yoshida
- Department of Clinical LaboratoryKobe City Medical Center General Hospital Kobe Japan
| | - Hayato Maruoka
- Department of Clinical LaboratoryKobe City Medical Center General Hospital Kobe Japan
| | - Takayuki Ishikawa
- Department of HematologyKobe City Medical Center General Hospital Kobe Japan
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34
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Partanen A, Valtola J, Ropponen A, Kuitunen H, Kuittinen O, Vasala K, Ågren L, Penttilä K, Keskinen L, Pyörälä M, Nousiainen T, Selander T, Mäntymaa P, Pelkonen J, Varmavuo V, Jantunen E. Comparison of filgrastim, pegfilgrastim, and lipegfilgrastim added to chemotherapy for mobilization of CD34 + cells in non-Hodgkin lymphoma patients. Transfusion 2018; 59:325-334. [PMID: 30450652 DOI: 10.1111/trf.14993] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/01/2018] [Accepted: 09/05/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Data are limited on the long-acting granulocyte-colony stimulating factors (G-CSFs) pegfilgrastim (PEG) and lipegfilgrastim (LIPEG) compared with filgrastim (FIL) regarding the mobilization efficiency of CD34+ cells, graft cellular composition, and engraftment. STUDY DESIGN AND METHODS In this prospective nonrandomized study, 36 patients with non-Hodgkin lymphoma received FIL, 67 received PEG, and 16 patients received LIPEG as a cytokine after chemotherapy. We analyzed the mobilization and collection of CD34+ cells, cellular composition of blood grafts, and hematologic recovery after auto-SCT according to the type of G-CSF used. RESULTS Patients in the LIPEG group had fewer apheresis sessions (1 vs. 2, p = 0.021 for FIL and p = 0.111 for PEG) as well as higher median blood CD34+ cell counts at the start of the first apheresis (LIPEG 74 × 106 /L vs. FIL 31 × 106 /L, p = 0.084 or PEG 27 × 106 /L, p = 0.021) and CD34+ yields of the first apheresis (FIL 5.1 × 106 /kg vs. FIL 2.3 × 106 /kg, p = 0.105 or PEG 1.8 × 106 /kg, p = 0.012). Also, the costs associated with G-CSF mobilization and apheresis were lower in the LIPEG group. The graft composition was comparable except for the higher infused CD34+ cell counts in the LIPEG group. The engraftment kinetics were significantly slower in the FIL group. CONCLUSION LIPEG appears to be more efficient compared with PEG after chemotherapy to mobilize CD34+ cells for auto-SCT demonstrated as fewer sessions of aphereses needed as well as 2.8-fold CD34+ cell yields on the first apheresis day. Early hematologic recovery was more rapid in the LIPEG group. Thus further studies on LIPEG in the mobilization setting are warranted.
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Affiliation(s)
- A Partanen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland.,Department of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - J Valtola
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - A Ropponen
- Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
| | - H Kuitunen
- Department of Oncology, Oulu University Hospital, Oulu, Finland
| | - O Kuittinen
- Department of Oncology, Oulu University Hospital, Oulu, Finland
| | - K Vasala
- Department of Oncology, Central Hospital of Central Finland, Jyväskylä, Finland
| | - L Ågren
- Siunsote- Hospital District of North Karelia, Joensuu, Finland
| | - K Penttilä
- Department of Medicine, Central Hospital of Savonlinna, Savonlinna, Finland.,The Finnish Medicines Agency, Kuopio, Finland
| | - L Keskinen
- Department of Oncology, Tampere University Hospital, Tampere, Finland
| | - M Pyörälä
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - T Nousiainen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - T Selander
- Science Service Center, Kuopio University Hospital, Kuopio, Finland
| | - P Mäntymaa
- Eastern Finland Laboratory Centre, Kuopio, Finland
| | - J Pelkonen
- Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland.,Eastern Finland Laboratory Centre, Kuopio, Finland
| | - V Varmavuo
- Department of Medicine, Kymenlaakso Central Hospital, Kotka, Finland
| | - E Jantunen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland.,Siunsote- Hospital District of North Karelia, Joensuu, Finland.,Department of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
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35
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Valtola J, Silvennoinen R, Ropponen A, Siitonen T, Säily M, Sankelo M, Putkonen M, Partanen A, Pyörälä M, Savolainen ER, Mäntymaa P, Pelkonen J, Jantunen E, Varmavuo V. Blood graft composition and post-transplant recovery in myeloma patients mobilized with plerixafor: a prospective multicenter study. Leuk Lymphoma 2018; 60:453-461. [PMID: 30160591 DOI: 10.1080/10428194.2018.1485911] [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] [Indexed: 01/26/2023]
Abstract
The composition of autologous blood grafts after cryopreservation, post-transplant hematological recovery up to 1 year and immune recovery up to 6 months as well as outcome was analyzed in 87 patients with multiple myeloma (MM). The patients receiving added plerixafor due to poor mobilization (11%) were compared to those mobilized with G-CSF or cyclophosphamide (CY) plus G-CSF. The use of plerixafor was found to significantly affect the graft composition as there was a significantly higher proportion of the more primitive CD34+ cells, higher number of T and B lymphocytes as well as NK cells in the grafts of patients who received also plerixafor. The hematological recovery after auto-SCT was comparable between the groups. The recovery of CD3+CD4+ T cells was faster in plerixafor mobilized patients at 1 and 3 months post-transplant. There were no significant differences in progression-free (PFS) or overall survival (OS) according to the plerixafor use.
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Affiliation(s)
- Jaakko Valtola
- a Department of Medicine , Kuopio University Hospital , Kuopio , Finland
| | - Raija Silvennoinen
- a Department of Medicine , Kuopio University Hospital , Kuopio , Finland.,b Division of Hematology , Comprehensive Cancer Center Helsinki University Hospital , Helsinki , Finland
| | - Antti Ropponen
- c Department of Clinical Microbiology , University of Eastern Finland , Kuopio , Finland
| | - Timo Siitonen
- d Department of Medicine , Oulu University Hospital , Oulu , Finland
| | - Marjaana Säily
- d Department of Medicine , Oulu University Hospital , Oulu , Finland
| | - Marja Sankelo
- e Department of Internal Medicine , Tampere University Hospital , Tampere , Finland
| | - Mervi Putkonen
- f Department of Medicine , Turku University Hospital , Turku , Finland
| | - Anu Partanen
- a Department of Medicine , Kuopio University Hospital , Kuopio , Finland
| | - Marja Pyörälä
- a Department of Medicine , Kuopio University Hospital , Kuopio , Finland
| | - Eeva-Riitta Savolainen
- g Nordlab Oulu, Medical Research Center Oulu , Oulu University Hospital University of Oulu , Oulu , Finland
| | | | - Jukka Pelkonen
- c Department of Clinical Microbiology , University of Eastern Finland , Kuopio , Finland.,h Laboratory Centre of Eastern Finland , Kuopio , Finland
| | - Esa Jantunen
- a Department of Medicine , Kuopio University Hospital , Kuopio , Finland.,i Institute of Clinical Medicine , University of Eastern Finland , Kuopio , Finland.,j Siunsote, Central Hospital of North Karelia , Joensuu , Finland
| | - Ville Varmavuo
- k Department of Medicine , Kymenlaakso Central Hospital , Kotka , Finland
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36
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Avecilla ST, Goss C, Marionneaux SM, Wright DR, Leiva TD, Tonon JA, Smith KM, Maslak P. Method comparison study of peripheral blood CD34+ count performed on an Abbott CELL-DYN Sapphire hematology analyzer versus flow cytometry reference procedure (modified ISHAGE). ACTA ACUST UNITED AC 2018; 1. [PMID: 30873513 DOI: 10.1002/acg2.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction CD34+ cell enumeration is a critical parameter used to determine the timing of apheresis collections of hematopoietic progenitor cell products (HPC(A)). Automated hematology analyzers equipped with flow cytometry capabilities may be a solution to the problem of limited access to standard flow cytometry testing. Methods We compared CD34+ cell enumeration using a reference flow cytometry procedure employing modified International Society of Hematotherapy and Graft Engineering (ISHAGE) analysis with a hematology analyzer /flow cytometer hybrid (CELL DYN (CD)Sapphire) using a sequential gating analysis designed to emulate the ISHAGE gating strategy. Results CD34+ cell values obtained from the ISHAGE and CD Sapphire analysis were plotted and compared in a linear regression analysis which showed a high degree of correlation (R2=0.96). No statistically significant (p=0.53) differences in CD34+ cell enumeration values were observed between the flow cytometer and automated hematology analyzer using manual analysis schema. Conclusions We have demonstrated that an automated hematology analyzer equipped with a flow module can provide CD34+ cell enumeration results in the peripheral blood for clinical decision algorithms without the need for a dedicated flow cytometry laboratory.
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Affiliation(s)
- Scott T Avecilla
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Cheryl Goss
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | - Tyler D Leiva
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jo-Ann Tonon
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Katherine M Smith
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Peter Maslak
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
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37
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Bai L, Best G, Xia W, Peters L, Wong K, Ward C, Greenwood M. Expression of Intracellular Reactive Oxygen Species in Hematopoietic Stem Cells Correlates with Time to Neutrophil and Platelet Engraftment in Patients Undergoing Autologous Bone Marrow Transplantation. Biol Blood Marrow Transplant 2018; 24:1997-2002. [PMID: 29933068 DOI: 10.1016/j.bbmt.2018.06.014] [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: 03/26/2018] [Accepted: 06/08/2018] [Indexed: 11/26/2022]
Abstract
Reactive oxygen species (ROS) play important roles in hematopoiesis and regulate the self-renewal, migration, and myeloid differentiation of hematopoietic stem cells (HSCs). This study was conducted to determine whether ROS levels in donor HSCs correlate with neutrophil and platelet engraftment in patients after bone marrow transplantation. Cryopreserved HSC samples from 51 patients who underwent autologous transplantation were studied. Levels of intracellular ROS were assessed by flow cytometry using 2',7'-dichlorodihydrofluorescein diacetate (H2DCFDA) in the CD45+/CD34+ HSC population. Colony forming unit assays were performed on HSCs isolated from the ROShigh and ROSlow populations to assess the differentiation potential of these 2 cell subsets. Distinct populations of ROShigh and ROSlow cells were evident in all patient samples. The median percentage of ROShigh expressing HSCs in the study cohort was 75.8% (range, 2% to 95.2%). A significant correlation was identified between the percentage of ROShigh stem cells present in the hematopoietic progenitor cells collected by apheresis product infused and the time to neutrophil engraftment (P < .001, r = -.54), as well as time to plt20, plt50, and plt100 (P < 0.001; r = -.55, -.59, and -.56 respectively). The dose of CD34+/ROShigh/kg infused also inversely correlated with a shorter time to neutrophil engraftment; time to engraftment for patients receiving > or ≤3 × 106 cells/kg was 11.5 days (range, 9 to 23) versus 14 days (range, 10 to 28), respectively (P = .02). The dose of ROShigh HSCs delivered did not correlate with platelet engraftment. Collectively, these data suggest that the dose of ROShigh stem cells delivered to patients may predict time to neutrophil engraftment after autologous transplantation.
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Affiliation(s)
- Lijun Bai
- Department of Haematology and Transfusion Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia; Cellular Therapeutic Laboratory, Northern Blood Research Centre, Kolling Research Institute, Sydney, New South Wales, Australia.
| | - Giles Best
- Department of Haematology and Transfusion Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia; Cellular Therapeutic Laboratory, Northern Blood Research Centre, Kolling Research Institute, Sydney, New South Wales, Australia
| | - Wei Xia
- Department of Haematology and Transfusion Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia; Cellular Therapeutic Laboratory, Northern Blood Research Centre, Kolling Research Institute, Sydney, New South Wales, Australia
| | - Lyndsay Peters
- Department of Haematology and Transfusion Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Kelly Wong
- Department of Haematology and Transfusion Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Christopher Ward
- Department of Haematology and Transfusion Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia; Cellular Therapeutic Laboratory, Northern Blood Research Centre, Kolling Research Institute, Sydney, New South Wales, Australia
| | - Matthew Greenwood
- Department of Haematology and Transfusion Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia; Cellular Therapeutic Laboratory, Northern Blood Research Centre, Kolling Research Institute, Sydney, New South Wales, Australia
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38
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Jansen RT, Cobbaert CM, Weykamp C, Thelen M. The quest for equivalence of test results: the pilgrimage of the Dutch Calibration 2.000 program for metrological traceability. ACTA ACUST UNITED AC 2018; 56:1673-1684. [DOI: 10.1515/cclm-2017-0796] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 11/17/2017] [Indexed: 01/02/2023]
Abstract
Abstract
Calibration 2.000 was initiated 20 years ago for standardization and harmonization of medical tests. The program also intended to evaluate adequate implementation of the In Vitro Diagnostics (IVD) 98/79/EC directive, in order to ensure that medical tests are fit-for-clinical purpose. The Calibration 2.000 initiative led to ongoing verification of test standardization and harmonization in the Netherlands using commutable external quality assessment (EQA)-tools and a type 1 EQA-design, where feasible. National support was guaranteed by involving all laboratory professionals as well as laboratory technicians responsible for EQA and quality officers. A category 1 EQA-system for general chemistry analytes, harmonizers for specific analytes like hGH and IGF-1, and commutable materials for other EQA-sections have been developed and structurally introduced in the EQA-schemes. The type 1 EQA-design facilitates the dialogue between individual specialists in laboratory medicine and the IVD-industry to reduce lot-to-lot variation and to improve standardization. In such a way, Calibration 2.000 sheds light on the metrological traceability challenges that we are facing and helps the laboratory community to get the issues on the table and resolved. The need for commutable trueness verifiers and/or harmonizers for other medical tests is now seen as paramount. Much knowledge is present in the Netherlands and for general chemistry, humoral immunology and protein chemistry, a few endocrinology tests, and various therapeutic drug monitoring (TDM) tests, commutable materials are available. Also the multi sample evaluation scoring system (MUSE) and the category 1 EQA-design offer many possibilities for permanent education of laboratory professionals to further improve the between and within laboratory variation and the test equivalence.
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Affiliation(s)
- Rob T.P. Jansen
- SKML , Mercator 1, Toernooiveld 214 , 6525EC Nijmegen , The Netherlands
| | | | - Cas Weykamp
- Queen Beatrix Hospital , MCA Laboratory , Winterswijk , The Netherlands
| | - Marc Thelen
- Amphia Hospital, Clinical Chemistry and Haematology , Breda , The Netherlands
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Partanen A, Valtola J, Ropponen A, Vasala K, Penttilä K, Ågren L, Pyörälä M, Nousiainen T, Selander T, Mäntymaa P, Pelkonen J, Varmavuo V, Jantunen E. Preemptive plerixafor injection added to pegfilgrastim after chemotherapy in non-Hodgkin lymphoma patients mobilizing poorly. Ann Hematol 2017; 96:1897-1906. [PMID: 28879595 DOI: 10.1007/s00277-017-3123-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 08/27/2017] [Indexed: 12/15/2022]
Abstract
Filgrastim is usually combined with chemotherapy to mobilize hematopoietic progenitor cells in non-Hodgkin lymphoma (NHL) patients. Limited information is available on the efficacy of a preemptive plerixafor (PLER) injection in poor mobilizers after chemotherapy and pegfilgrastim. In this prospective study, 72 patients with NHL received chemotherapy plus pegfilgrastim, and 25 hard-to-mobilize patients received also PLER. The usefulness and efficacy of our previously developed algorithm for PLER use in pegfilgrastim-containing mobilization regimen were evaluated as well as the graft cellular composition, hematological recovery, and outcome after autologous stem cell transplantation (auto-SCT) according to the PLER use. A median 3.4-fold increase in blood CD34+ cell counts was achieved after the first PLER dose. The minimum collection target was achieved in the first mobilization attempt in 66/72 patients (92%) and 68 patients (94%) proceeded to auto-SCT. An algorithm for PLER use was fulfilled in 76% of the poor mobilizers. Absolute numbers of T-lymphocytes and NK cells were significantly higher in the PLER group, whereas the number of CD34+ cells collected was significantly lower. Early neutrophil engraftment was slower in the PLER group, otherwise hematological recovery was comparable within 12 months from auto-SCT. No difference was observed in survival according to the PLER use. Chemotherapy plus pegfilgrastim combined with preemptive PLER injection is an effective and convenient approach to minimize collection failures in NHL patients intended for auto-SCT. A significant effect of PLER on the graft cellular composition was observed, but no difference in outcome after auto-SCT was detected.
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Affiliation(s)
- A Partanen
- Department of Medicine, Kuopio University Hospital, P.O.B. 100, 70029 KYS, Kuopio, Finland.
| | - J Valtola
- Department of Medicine, Kuopio University Hospital, P.O.B. 100, 70029 KYS, Kuopio, Finland
| | - A Ropponen
- Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
| | - K Vasala
- Department of Oncology, Central Hospital of Central Finland, Jyväskylä, Finland
| | - K Penttilä
- Department of Medicine, Central Hospital of Savonlinna, Savonlinna, Finland
- The Finnish Medicines Agency, Kuopio, Finland
| | - L Ågren
- Department of Medicine, North Karelia Central Hospital, Joensuu, Finland
| | - M Pyörälä
- Department of Medicine, Kuopio University Hospital, P.O.B. 100, 70029 KYS, Kuopio, Finland
| | - T Nousiainen
- Department of Medicine, Kuopio University Hospital, P.O.B. 100, 70029 KYS, Kuopio, Finland
| | - T Selander
- Science Service Center, Kuopio University Hospital, Kuopio, Finland
| | - P Mäntymaa
- Laboratory Center of Eastern Finland, Kuopio, Finland
| | - J Pelkonen
- Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
- Laboratory Center of Eastern Finland, Kuopio, Finland
| | - V Varmavuo
- Department of Medicine, Kymenlaakso Central Hospital, Kotka, Finland
| | - E Jantunen
- Department of Medicine, Kuopio University Hospital, P.O.B. 100, 70029 KYS, Kuopio, Finland
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40
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Partanen A, Valtola J, Silvennoinen R, Ropponen A, Siitonen T, Putkonen M, Sankelo M, Pelkonen J, Mäntymaa P, Varmavuo V, Jantunen E. Impact of lenalidomide-based induction therapy on the mobilization of CD34 + cells, blood graft cellular composition, and post-transplant recovery in myeloma patients: a prospective multicenter study. Transfusion 2017; 57:2366-2372. [PMID: 28681435 DOI: 10.1111/trf.14220] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 05/15/2017] [Accepted: 05/22/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Lenalidomide is an immunomodulatory drug that is also currently used in transplant-eligible patients with multiple myeloma. Previous studies have suggested a negative impact of lenalidomide on the mobilization of CD34+ cells. No data are available regarding the more detailed composition of blood grafts after lenalidomide. STUDY DESIGN AND METHODS In a multicenter, prospective study, we analyzed the mobilization of CD34+ cells, graft cellular composition, and post-transplant hematologic recovery in 26 patients with multiple myeloma after lenalidomide-based induction and in 34 lenalidomide-naive controls with multiple myeloma. All patients were mobilized with low-dose cyclophosphamide plus granulocyte-colony-stimulating factor. The cellular composition of the grafts was analyzed from thawed, cryopreserved samples with flow cytometry. Graft function was evaluated by engraftment data and by complete blood counts until 12 months after the graft infusion. RESULTS Patients in the lenalidomide arm had lower median peak CD34+ counts and approximately 40% lower CD34+ cell yields from the first apheresis session, but these differences were not significant. The median total number of CD34+ cells collected was comparable (6.4 vs. 7.5 × 106 /kg). The number of apheresis sessions was higher in the lenalidomide group (2 vs. 1; p = 0.039). The blood graft composition was comparable between the groups. Hematologic recovery within 12 months post-transplant did not differ between the groups. CONCLUSION Lenalidomide-based induction seems to have an impact on the number of aphereses performed, but not on the total yields of the CD34+ cells in the graft. Neither cellular composition of the grafts nor post-transplant recovery was affected by the limited pre-transplant exposure to lenalidomide.
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Affiliation(s)
- Anu Partanen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Jaakko Valtola
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Raija Silvennoinen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland.,Division of Hematology, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
| | - Antti Ropponen
- Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
| | - Timo Siitonen
- Department of Medicine, Oulu University Hospital, Oulu, Finland
| | - Mervi Putkonen
- Department of Medicine, Turku University Hospital, Turku, Finland
| | - Marja Sankelo
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Jukka Pelkonen
- Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland.,Laboratory Center of Eastern Finland, Kuopio, Finland
| | | | - Ville Varmavuo
- Department of Medicine, Kymenlaakso Central Hospital, Kotka, Finland
| | - Esa Jantunen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
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Grommé M, Russcher H, Braakman E, Klinkspoor JH, Dobber JA, de Greef I, de Wit NC. Multicenter study to evaluate a new enumeration method for hematopoietic stem cell collection management. Transfusion 2017; 57:1949-1955. [DOI: 10.1111/trf.14183] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 02/10/2017] [Accepted: 02/16/2017] [Indexed: 02/02/2023]
Affiliation(s)
- Monique Grommé
- Department of Internal Medicine; Division of Haematology, Erasmus Medical Centre; Rotterdam the Netherlands
| | - Henk Russcher
- Clinical Chemistry, Erasmus Medical Centre; Rotterdam the Netherlands
| | - Eric Braakman
- Department of Hematology; Erasmus Medical Centre; Rotterdam the Netherlands
| | - J. Henriëtte Klinkspoor
- Laboratory for General Clinical Chemistry, Academic Medical Center; Amsterdam the Netherlands
| | - Johan A. Dobber
- Laboratory for Specialized Haematology; Academic Medical Center; Amsterdam the Netherlands
| | - Inge de Greef
- Department of Hematology; Erasmus Medical Centre; Rotterdam the Netherlands
| | - Norbert C.J. de Wit
- Central Diagnostic Laboratory; Maastricht University Medical Center; Maastricht the Netherlands
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42
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Pugliese SC, Kumar S, Janssen WJ, Graham BB, Frid MG, Riddle SR, El Kasmi KC, Stenmark KR. A Time- and Compartment-Specific Activation of Lung Macrophages in Hypoxic Pulmonary Hypertension. THE JOURNAL OF IMMUNOLOGY 2017; 198:4802-4812. [PMID: 28500078 DOI: 10.4049/jimmunol.1601692] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 04/12/2017] [Indexed: 01/10/2023]
Abstract
Studies in various animal models suggest an important role for pulmonary macrophages in the pathogenesis of pulmonary hypertension (PH). Yet, the molecular mechanisms characterizing the functional macrophage phenotype relative to time and pulmonary localization and compartmentalization remain largely unknown. In this study, we used a hypoxic murine model of PH in combination with FACS to quantify and isolate lung macrophages from two compartments over time and characterize their programing via RNA sequencing approaches. In response to hypoxia, we found an early increase in macrophage number that was restricted to the interstitial/perivascular compartment, without recruitment of macrophages to the alveolar compartment or changes in the number of resident alveolar macrophages. Principal component analysis demonstrated significant differences in overall gene expression between alveolar and interstitial macrophages (IMs) at baseline and after 4 and 14 d hypoxic exposure. Alveolar macrophages at both day 4 and 14 and IMs at day 4 shared a conserved hypoxia program characterized by mitochondrial dysfunction, proinflammatory gene activation, and mTORC1 signaling, whereas IMs at day 14 demonstrated a unique anti-inflammatory/proreparative programming state. We conclude that the pathogenesis of vascular remodeling in hypoxic PH involves an early compartment-independent activation of lung macrophages toward a conserved hypoxia program, with the development of compartment-specific programs later in the course of the disease. Thus, harnessing time- and compartment-specific differences in lung macrophage polarization needs to be considered in the therapeutic targeting of macrophages in hypoxic PH and potentially other inflammatory lung diseases.
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Affiliation(s)
- Steven C Pugliese
- Cardiovascular Pulmonary Research Laboratories, Departments of Pediatrics and Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045.,Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado, Aurora, CO 80045
| | - Sushil Kumar
- Cardiovascular Pulmonary Research Laboratories, Departments of Pediatrics and Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045
| | - William J Janssen
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado, Aurora, CO 80045.,Department of Medicine, National Jewish Health, Denver, CO 80206
| | - Brian B Graham
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado, Aurora, CO 80045
| | - Maria G Frid
- Cardiovascular Pulmonary Research Laboratories, Departments of Pediatrics and Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045
| | - Suzette R Riddle
- Cardiovascular Pulmonary Research Laboratories, Departments of Pediatrics and Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045
| | - Karim C El Kasmi
- Division of Gastroenterology, Hepatology, and Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO 80045
| | - Kurt R Stenmark
- Cardiovascular Pulmonary Research Laboratories, Departments of Pediatrics and Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045;
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43
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Watts MJ, Linch DC. Optimisation and quality control of cell processing for autologous stem cell transplantation. Br J Haematol 2016; 175:771-783. [DOI: 10.1111/bjh.14378] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Michael J. Watts
- University College London Hospitals; London UK
- University College London; London UK
| | - David C. Linch
- University College London Hospitals; London UK
- University College London; London UK
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44
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Assessing pilot vial material as a surrogate for functional and phenotypic stem cell markers in cryopreserved haematopoietic stem cell product. Bone Marrow Transplant 2016; 51:1631-1632. [DOI: 10.1038/bmt.2016.236] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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45
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Morgenstern DA, Ahsan G, Brocklesby M, Ings S, Balsa C, Veys P, Brock P, Anderson J, Amrolia P, Goulden N, Cale CM, Watts MJ. Post-thaw viability of cryopreserved peripheral blood stem cells (PBSC) does not guarantee functional activity: important implications for quality assurance of stem cell transplant programmes. Br J Haematol 2016; 174:942-51. [DOI: 10.1111/bjh.14160] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 04/05/2016] [Indexed: 12/21/2022]
Affiliation(s)
- Daniel A. Morgenstern
- Department of Paediatric Oncology/Haematology; Great Ormond Street Hospital; London UK
| | - Gulrukh Ahsan
- Cell Therapy Laboratory; Great Ormond Street Hospital; London UK
| | | | - Stuart Ings
- Wolfson Cellular Therapy Unit; University College London Hospitals; London UK
| | - Carmen Balsa
- Wolfson Cellular Therapy Unit; University College London Hospitals; London UK
| | - Paul Veys
- Paediatric Bone Marrow Transplantation; Great Ormond Street Hospital; London UK
| | - Penelope Brock
- Formerly; Department of Paediatric Oncology/Haematology; Great Ormond Street Hospital; London UK
| | - John Anderson
- Department of Paediatric Oncology/Haematology; Great Ormond Street Hospital; London UK
| | - Persis Amrolia
- Paediatric Bone Marrow Transplantation; Great Ormond Street Hospital; London UK
| | - Nicholas Goulden
- Formerly; Department of Paediatric Oncology/Haematology; Great Ormond Street Hospital; London UK
| | | | - Michael J. Watts
- Wolfson Cellular Therapy Unit; University College London Hospitals; London UK
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46
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Valtola J, Silvennoinen R, Ropponen A, Siitonen T, Säily M, Sankelo M, Terävä V, Putkonen M, Kuittinen T, Pelkonen J, Mäntymaa P, Remes K, Varmavuo V, Jantunen E. Blood graft cellular composition and posttransplant outcomes in myeloma patients mobilized with or without low-dose cyclophosphamide: a randomized comparison. Transfusion 2016; 56:1394-401. [PMID: 27041692 DOI: 10.1111/trf.13574] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 01/28/2016] [Accepted: 02/02/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND Autologous stem cell transplantation is a standard treatment in multiple myeloma (MM). Blood grafts are usually collected after mobilization with granulocyte-colony-stimulating factor (G-CSF) alone or in a combination with cyclophosphamide (CY). There is limited knowledge of the possible effects of different mobilization regimens on blood graft characteristics and posttransplant outcomes. STUDY DESIGN AND METHODS Thirty-eight patients with MM were included in this study. The patients were randomly assigned at registration to mobilization with either low-dose CY plus G-CSF (Arm A) or G-CSF alone (Arm B) and received three cycles of lenalidomide, bortetzomib, and dexamethasone induction. Flow cytometry analysis of lymphocyte subsets in the blood grafts after cryopreservation was performed. Hematologic and immune recovery were evaluated up to 12 months posttransplant. RESULTS The blood grafts in Arm A contained significantly more CD34+ cells but in Arm B there was a greater proportion of CD34+CD38- cells and higher numbers of T and B lymphocytes as well as natural killer (NK) cells. The engraftment was comparable but lymphocyte count at 15 days posttransplant was higher in Arm B (0.8 × 10(9) /L vs. 0.5 × 10(9) /L, p = 0.033). At 3 and 6 months posttransplant the total number of NK cells was also higher in G-CSF-mobilized patients. There was no difference in progression-free survival between the study arms. CONCLUSION CY plus G-GSF yields more CD34+ cells but seems to diminish lymphocyte and NK cell counts in the grafts and hampers immune recovery after transplantation. Thus G-CSF alone might be a preferred mobilization method due to more rapid immune recovery posttransplant.
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Affiliation(s)
- Jaakko Valtola
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Raija Silvennoinen
- Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
| | - Antti Ropponen
- Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
| | - Timo Siitonen
- Department of Medicine, Oulu University Hospital, Oulu, Finland
| | - Marjaana Säily
- Department of Medicine, Oulu University Hospital, Oulu, Finland
| | - Marja Sankelo
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Venla Terävä
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Mervi Putkonen
- Department of Medicine, Turku University Hospital, Turku, Finland
| | | | - Jukka Pelkonen
- Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland.,Laboratory Center of Eastern Finland, Kuopio, Finland
| | | | - Kari Remes
- Department of Medicine, Turku University Hospital, Turku, Finland.,University of Turku, Turku, Finland
| | - Ville Varmavuo
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Esa Jantunen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
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47
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Fritsch G, Frank N, Dmytrus J, Frech C, Pichler H, Witt V, Geyeregger R, Scharner D, Trbojevic D, Zipperer E, Printz D, Worel N. Relevance of flow cytometric enumeration of post-thaw leucocytes: influence of temperature during cell staining on viable cell recovery. Vox Sang 2016; 111:187-96. [PMID: 27037580 DOI: 10.1111/vox.12398] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 02/11/2016] [Accepted: 02/11/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Our post-thaw cell recovery rates differed substantially in interlaboratory comparisons of identical samples, potentially due to different temperatures during cell staining. MATERIALS AND METHODS Viable CD34(+) cells and leucocyte (WBC) subtypes were quantified by multiparameter single-platform flow cytometry in leucapheresis products collected from 30 adult lymphoma and myeloma patients, and from 10 paediatric patients. After thawing, cells were prepared for analysis within 30 min between thawing and acquisition, at either 4°C or at room temperature. RESULTS For cell products cryopreserved in conventional freezing medium (10% final DMSO), viable cell recovery was clearly lower after staining at 4°C than at RT. Of all WBC subtypes analysed, CD4(+) T cells showed the lowest median recovery of 4% (4°C) vs. 25% (RT), followed by CD3, CD34 and CD8 cells. The recovery was highest for CD3γδ cells with 44% (4°C) vs. 71% (RT). In the 10 samples cryopreserved in synthetic freezing medium (5% final DMSO), median recovery rates were 89% for viable CD34 (both at 4°C and RT) and 79% (4°C) vs 68% (RT) for WBC. CONCLUSIONS The post-thaw environment and, potentially, the cryoprotectant impact the outcome of cell enumeration, and results from the analysis tube may not be representative of the cells infused into a patient.
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Affiliation(s)
- G Fritsch
- Children's Cancer Research Institute (CCRI), St. Anna Kinderkrebsforschung, Vienna, Austria
| | - N Frank
- Children's Cancer Research Institute (CCRI), St. Anna Kinderkrebsforschung, Vienna, Austria
| | - J Dmytrus
- Children's Cancer Research Institute (CCRI), St. Anna Kinderkrebsforschung, Vienna, Austria
| | - C Frech
- Children's Cancer Research Institute (CCRI), St. Anna Kinderkrebsforschung, Vienna, Austria
| | - H Pichler
- St. Anna Kinderspital, Universitätskinderklinik, Vienna, Austria
| | - V Witt
- St. Anna Kinderspital, Universitätskinderklinik, Vienna, Austria
| | - R Geyeregger
- Children's Cancer Research Institute (CCRI), St. Anna Kinderkrebsforschung, Vienna, Austria
| | - D Scharner
- Children's Cancer Research Institute (CCRI), St. Anna Kinderkrebsforschung, Vienna, Austria
| | - D Trbojevic
- Children's Cancer Research Institute (CCRI), St. Anna Kinderkrebsforschung, Vienna, Austria
| | - E Zipperer
- Children's Cancer Research Institute (CCRI), St. Anna Kinderkrebsforschung, Vienna, Austria
| | - D Printz
- Children's Cancer Research Institute (CCRI), St. Anna Kinderkrebsforschung, Vienna, Austria
| | - N Worel
- Dept. for Blood Group Serology and Transfusion Medicine, Medical University, Vienna, Austria
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48
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Valtola J, Varmavuo V, Ropponen A, Selander T, Kuittinen O, Kuitunen H, Keskinen L, Vasala K, Nousiainen T, Mäntymaa P, Pelkonen J, Jantunen E. Early immune recovery after autologous transplantation in non-Hodgkin lymphoma patients: predictive factors and clinical significance. Leuk Lymphoma 2016; 57:2025-32. [DOI: 10.3109/10428194.2015.1129537] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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49
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Zhu F, Heditke S, Kurtzberg J, Waters-Pick B, Hari P, Margolis DA, Keever-Taylor CA. Hydroxyethyl starch as a substitute for dextran 40 for thawing peripheral blood progenitor cell products. Cytotherapy 2015; 17:1813-9. [DOI: 10.1016/j.jcyt.2015.08.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 08/11/2015] [Accepted: 08/24/2015] [Indexed: 01/15/2023]
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50
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Hadarits O, Zóka A, Barna G, Al-Aissa Z, Rosta K, Rigó J, Kautzky-Willer A, Somogyi A, Firneisz G. Increased Proportion of Hematopoietic Stem and Progenitor Cell Population in Cord Blood of Neonates Born to Mothers with Gestational Diabetes Mellitus. Stem Cells Dev 2015; 25:13-7. [PMID: 26494027 PMCID: PMC4692114 DOI: 10.1089/scd.2015.0203] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
We assessed the hematopoietic stem and progenitor cell (HSPC) population in the cord blood of neonates born to mothers with gestational diabetes mellitus (GDM) in a hypothesis generating pilot study, due to that, neonatal polycythemia may be the consequence of GDM pregnancy. Forty-five pregnant women with GDM (last trimester mean HbA1C = 33.9 mmol/mol) and 42 (nondiabetic) control pregnant women were enrolled after their routine 75 g oral glucose tolerance test (OGTT) between the 24th and 28th gestational week (with expected differences in their mean routine clinical characteristics: plasma glucose at OGTT: 0′ = 5.07 vs. 4.62 mM, 120′ = 8.9 vs. 5.76 mM, age = 35.07 vs. 31.66 years, prepregnancy body mass index = 27.9 vs. 23.9 kg/m2, GDM vs. control, respectively) on a voluntary basis after signing the informed consent. EDTA-treated cord blood samples were analyzed by flow cytometry and the software Kaluza1.2 using CD45 and CD34-specific fluorescent antibodies to identify the HSPC population (CD34+ cells within the CD45dim blast gate). The proportion of CD34+CD45dim HSPCs among the nucleated cells was significantly (P < 0.05, statistical power = 60.8%) higher in the cord blood samples of neonates born to mothers with GDM (median 0.38%) compared to neonates born to nondiabetic mothers (median 0.32%) and according to treatment types (P < 0.05) median: control 0.32%, GDM-diet only 0.37%, GDM-on insulin 0.45%; control versus GDM on insulin (P < 0.05). The increased proportion of circulating CD34+CD45dim cells in the cord blood may possibly be related to altered fetal stem cell mobilization in GDM pregnancy, yet these results should be interpreted only as preliminary due to the small sample sizes.
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Affiliation(s)
- Orsolya Hadarits
- 1 1st Department of Obstetrics and Gynecology, Semmelweis University , Budapest, Hungary
| | - András Zóka
- 2 2nd Department of Internal Medicine, Semmelweis University , Budapest, Hungary
| | - Gábor Barna
- 3 1st Department of Pathology and Experimental Cancer Research, Semmelweis University , Budapest, Hungary
| | - Zahra Al-Aissa
- 2 2nd Department of Internal Medicine, Semmelweis University , Budapest, Hungary
| | - Klára Rosta
- 1 1st Department of Obstetrics and Gynecology, Semmelweis University , Budapest, Hungary .,4 Department of Obstetrics and Fetomaternal Medicine, University Hospital , Vienna, Austria
| | - János Rigó
- 1 1st Department of Obstetrics and Gynecology, Semmelweis University , Budapest, Hungary
| | - Alexandra Kautzky-Willer
- 5 Division of Endocrinology and Metabolism, Department of Medicine 3, Medical University of Vienna , Vienna, Austria
| | - Anikó Somogyi
- 2 2nd Department of Internal Medicine, Semmelweis University , Budapest, Hungary
| | - Gábor Firneisz
- 2 2nd Department of Internal Medicine, Semmelweis University , Budapest, Hungary .,6 Hungarian Academy of Sciences, Semmelweis University , Molecular Medicine Research Group, Budapest, Hungary
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