Unstimulated leukapheresis in patients and donors: comparison of two apheresis systems

Schulz, Miriam; Bialleck, Heike; Thorausch, Kristin; Bug, Gesine; Dünzinger, Ulrich; Seifried, Erhard; Bönig, Halvard

doi:10.1111/trf.12506

Cited by 39 publications

(67 citation statements)

References 22 publications

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“…In healthy, unstimulated mononuclear cell donors, platelets can decrease by as much as 44%. 20 This reinforces the importance of obtaining a postprocedure CBC to determine the need for blood product transfusions after leukocytapheresis.…”

Section: Technical Mattersmentioning

confidence: 98%

Leukocytapheresis for the treatment of hyperleukocytosis secondary to acute leukemia

Aqui

O’Doherty

2014

Hematology

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Patients presenting with new or recurrent acute leukemia, particularly of the myeloid lineage, with WBC counts exceeding 100 ϫ 10 9 /L are often considered for leukocytapheresis, especially if they are experiencing symptoms of leukostasis. These symptoms are thought to occur because of blast aggregates and WBC thrombi in the circulation, which reduce blood flow. Leukostasis may cause various complications, including hyperviscosity syndrome, vascular occlusion resulting in intracranial hemorrhages and respiratory failure, and perivascular leukemic infiltrates. Leukostasis occurs more commonly with a high WBC count and with leukemias of monocytoid lineage such as acute myelomonocytic leukemia, which is a reflection of the nature of the leukemic blasts. Leukocytapheresis is used in an effort to quickly decrease a patient's circulating blast count, which can both prevent the development of leukostasis and provide symptomatic relief of leukostasis. However, the impact of leukocytapheresis on early-and long-term mortality is controversial, with several studies producing conflicting results. In this chapter, the pathophysiology of leukostasis, performance of leukocytapheresis, and efficacy of this treatment are reviewed. Learning Objective• To gain an understanding of the pathophysiology of leukostasis and the role of leukocytapheresis as a therapeutic invention

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Section: Technical Mattersmentioning

confidence: 98%

Leukocytapheresis for the treatment of hyperleukocytosis secondary to acute leukemia

Aqui

O’Doherty

2014

Hematology

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“…[70][71][72] If it were possible to further enrich lymphocytes over monocytes at the time of collection this would be a welcome advance, as it would minimise the need for further ex vivo manipulation.…”

Section: Future For Car T Cell Therapymentioning

confidence: 99%

“…Variation in lymphocyte content, according to chamber flush, has been reported, 71,73 and this variability persists even after the introduction of highly automated apheresis systems. 72 Alternative methods of T cell collection for the purposes of CAR T cell manufacturing are under investigation. Nonetheless, to date, leukapheresis remains the standard in the field, primarily due to the procedure's ability to reproducibly obtain large numbers of viable T cells for initiating culture.…”

Section: Future For Car T Cell Therapymentioning

confidence: 99%

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Clinical Development and Manufacture of Chimeric Antigen Receptor T cells and the Role of Leukapheresis

Fesnak¹,

O’Doherty²

2017

European Oncology &Amp; Haematology

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Adoptive transfer of chimeric antigen receptor (CAR) T cells is a powerful targeted immunotherapeutic technique. CAR T cells are manufactured by harvesting mononuclear cells, typically via leukapheresis from a patient’s blood, then activating, modifying the T cells to express a transgene encoding a tumour-specific CAR, and infusing the CAR T cells into the patient. Gene transfer is achieved through the use of retroviral or lentiviral vectors, although non-viral delivery systems are being investigated. This article discusses the challenges associated with each stage of this process. Despite the need for a consistent end product, there is inherent variability in cellular material obtained from critically ill patients who have been exposed to cytotoxic therapy. It is important to carefully select target antigens to maximise effect and minimise toxicity. Various types of CAR T cell toxicity have been documented: this includes “on target, on tumour”, “on target, off tumour” and “off target” toxicity. A growing body of clinical evidence supports the efficacy and safety of CAR T cell therapy; CAR T cells targeting CD19 in B cell leukemias are the best-studied therapy to date. However, providing personalised therapy on a large scale remains challenging; a future aim is to produce a universal “off the shelf” CAR T cell.

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“…Thus, the collection efficiency which separate up to 55% of the handled cells is compatible with standardization and quality control on nuclear cells treated, as on the buffy coat hematocrit. Since the oldest apheresis system COBE Spectra ® , new cell separators are approved to collect large amount of mononuclear cell in either adult or pediatric patients [29] with major inconvenience of double vascular puncture.…”

Section: Technical Aspects Of Ecp: Two-step System (Apheresis and Celmentioning

confidence: 99%

Extracorporeal Photopheresis: Scientific and Technical Considerations for Improving Clinical Management of Patients

Garban¹,

Makowski

Carras

et al. 2014

J Stem Cell Res Ther

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Unstimulated leukapheresis in patients and donors: comparison of two apheresis systems

Abstract: Based on more than 200 unstimulated apheresis procedures, we conclude that both apheresis systems are safe, robust, and equally suitable for unstimulated MNC collections. Both can be successfully run with manufacturer-recommended settings and algorithms.

Cited by 39 publications

References 22 publications

Leukocytapheresis for the treatment of hyperleukocytosis secondary to acute leukemia

Leukocytapheresis for the treatment of hyperleukocytosis secondary to acute leukemia

Clinical Development and Manufacture of Chimeric Antigen Receptor T cells and the Role of Leukapheresis

Extracorporeal Photopheresis: Scientific and Technical Considerations for Improving Clinical Management of Patients

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