Myeloid cells in peripheral blood mononuclear cell concentrates inhibit the expansion of chimeric antigen receptor T cells

详细信息    查看全文

• 作者：David F. Stroncek¹ ; ^{dstroncek@cc.nih.gov" class="auth_mail" title="E-mail the corresponding author} ; Jiaqiang Ren¹ ; Daniel W. Lee² ; Minh Tran¹ ; Sue Ellen Frodigh¹ ; Marianna Sabatino¹ ; Hanh Khuu¹ ; Melinda S. Merchant² ; Crystal L. Mackall²
• 关键词：acute lymphocytic leukemia ; adoptive cellular therapy ; chimeric antigen receptor T cells ; CD19 ; GD2 ; osteosarcoma
• 刊名：Cytotherapy
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：18
• 期：7
• 页码：893-901
• 全文大小：290 K

文摘

Autologous chimeric antigen receptor (CAR) T-cell therapies have shown promising clinical outcomes, but T-cell yields have been variable. CD19- and GD2-CAR T-cell manufacturing records were reviewed to identify sources of variability.

Methods

CD19-CAR T cells were used to treat 43 patients with acute lymphocytic leukemia or lymphoma and GD2-CAR T cells to treat eight patients with osteosarcoma and three with neuroblastoma. Both types of CAR T cells were manufactured using autologous peripheral blood mononuclear cells (PBMC) concentrates and anti-CD3/CD28 beads for T-cell enrichment and simulation.

Results

A comparison of the first 6 GD2- and the first 22 CD19-CAR T-cell products manufactured revealed that GD2-CAR T-cell products contained fewer transduced cells than CD19-CAR T-cell products (147 ± 102 × 10⁶ vs 1502 ± 1066 × 10⁶; P = 0.0059), and their PBMC concentrates contained more monocytes (31.4 ± 12.4% vs 18.5 ± 13.7%; P = 0.019). Among the first 28 CD19-CAR T-cell products manufactured, four had poor expansion yielding less than 1 × 10⁶ transduced T cells per kilogram. When PBMC concentrates from these four patients were compared with the 24 others, PBMC concentrates of poorly expanding products contained greater quantities of monocytes (39.8 ± 12.9% vs. 15.3 ± 10.8%, P = 0.0014). Among the patients whose CD19-CAR T cells expanded poorly, manufacturing for two patients was repeated using cryopreserved PBMC concentrates but incorporating a monocyte depleting plastic adherence step, and an adequate dose of CAR T cells was produced for both patients.

Conclusions

Variability in CAR T-cell expansion is due, at least in part, to the contamination of the starting PBMC concentrates with monocytes.