Transfusion · 2019 · 40 citations · 19 references
Life SciencesCell BiologyImmunologyCell TherapyCellular ImmunologyImmunotherapyCell-mediated ImmunityChimeric Antigen Receptor T-cell TherapyHuman Leukocyte Antigen SystemLymphocyte ActivationT Cell ActivationT Cell BiologyAutologous Car T-cell TherapyCd4 Positive T CellsCd8 Positive T CellsChimeric Antigen Receptor T Cell ManufacturingDensity SeparationImmune Cell ManufacturingT Cell ExpansionT-cell Manufacturing
BACKGROUND: When manufacturing chimeric antigen receptor (CAR) T cells using anti-CD3/anti-CD28 beads, ex vivo T-cell expansion is dependent on the composition of leukocytes used in the manufacturing process. We investigated the effects of leukocyte composition on CAR T-cell expansion and characteristics using an alternative manufacturing method. METHODS: Anti-B-cell maturation antigen and CD19-CAR T cells were manufactured using autologous peripheral blood mononuclear cell (PBMNC) concentrates. The PBMNCs were enriched for lymphocytes using density gradient separation, which were used for CAR T-cell culture initiation. T-cell expansion was stimulated with soluble anti-CD3 and interleukin-2. RESULTS: Fifty-one CAR T-cell products were evaluated; 28 anti-B-cell maturation antigen (BCMA) CAR T cells produced for 24 patients and 27 CD19 CAR T cells produced for 24 patients. CAR T-cell expansion was reduced when greater quantities of monocytes were present in the post-density gradient separation PBMNCs. In addition, the ratio of CD4 to CD8 cells in the CAR T-cell products after 7 days of culture was dependent on the quantity of monocytes, RBCs, and neutrophils in the post-density gradient separation PBMNCs. Greater quantities of monocytes and RBCs were associated with a greater proportion of CD4+ cells and greater quantities of neutrophils were associated with a greater proportion of CD8+ cells. CONCLUSIONS: The composition of leukocytes used to manufacture CAR T cells can affect cell expansion and the composition of CAR T-cell products. More uniform or complete lymphocyte enrichment of PBMNCs improves the consistency of final CAR T-cell products.
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Long-Term Follow-up of CD19 CAR Therapy in Acute Lymphoblastic Leukemia
Jae H. Park, Isabelle Rivière, Mithat Gönen et al. · New England Journal of Medicine · 2018 · 2.7K citations · Full text
Life Sciences, Hematology, Oncology +17