Lymphocyte apheresis for chimeric antigen receptor T-cell manufacturing in children and young adults with leukemia and neuroblastoma
| Autor: | Catherine Lindgren, Navin Pinto, Francesco Ceppi, Julie Rivers, Naomi Linn, Meghan Delaney, Colleen Annesley, Stephanie Mgebroff, Rebecca Gardner, Julie R. Park |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Adult Adolescent CD3 Complex Lymphocyte T cell medicine.medical_treatment Immunology Receptors Antigen T-Cell Peripheral blood mononuclear cell Immunotherapy Adoptive 03 medical and health sciences Neuroblastoma Young Adult 0302 clinical medicine Antigen Immunology and Allergy Medicine Humans Leukapheresis Lymphocyte Count Autografts Child Leukemia Receptors Chimeric Antigen business.industry Infant Hematology Immunotherapy Chimeric antigen receptor 030104 developmental biology medicine.anatomical_structure Apheresis 030220 oncology & carcinogenesis Child Preschool business |
| Zdroj: | Transfusion. 58(6) |
| ISSN: | 1537-2995 |
| Popis: | Background The first step in the production of chimeric antigen receptor T cells is the collection of autologous T cells using apheresis technology. The procedure is technically challenging, because patients often have low leukocyte counts and are heavily pretreated with multiple lines of chemotherapy, marrow transplantation, and/or radiotherapy. Here, we report our experience of collecting T lymphocytes for chimeric antigen receptor T-cell manufacturing in pediatric and young adult patients with leukemia, non-Hodgkin lymphoma, or neuroblastoma. Study design and methods Apheresis procedures were performed on a COBE Spectra machine using the mononuclear cell program, with a collection target of 1 × 109 total mononuclear cells per kilogram. Data were collected regarding preapheresis and postapheresis blood counts, apheresis parameters, products, and adverse events. Results Ninety-nine patients (ages 1.3-25.7 years) and 102 apheresis events were available for analysis. Patients underwent apheresis at a variety of absolute lymphocyte cell counts, with a median absolute lymphocyte count of 944 cells/μL (range, 142-6944 cells/μL). Twenty-two patients (21.6%) had absolute lymphocyte counts less than 500 cells/μL. The mononuclear cell target was obtained in 100% of all apheresis harvests, and chimeric antigen receptor T-cell production was possible from the majority of collections (94%). Mononuclear cell collection efficiency was 65.4%, and T-lymphocyte collection efficiency was 83.4%. Ten patients (9.8%) presented with minor adverse events during the 102 apheresis procedures, with one exception of a severe allergy. Conclusions Mononuclear cell apheresis for chimeric antigen receptor T-cell therapy is well tolerated and safe, and it is possible to obtain an adequate quantity of CD3+ lymphocytes for chimeric antigen receptor T-cell manufacturing in heavily pretreated patients who have low lymphocyte counts. |
| Databáze: | OpenAIRE |
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