Cryopreservation in Closed Bag Systems as an Alternative to Clean Rooms for Preparations of Peripheral Blood Stem Cells.

Autologous and allogeneic stem cell transplantation (SCT) represents a therapeutic option widely used for hematopoietic malignancies. One important milestone in the development of this treatment strategy was the development of effective cryopreservation technologies resulting in a high quality with respect to cell viability as well as lack of contamination of the graft.Stem cell preparations have been initially performed within standard laboratories as it is routinely still the case in many countries. With the emergence of cleanrooms, manufacturing of stem cell preparations within these facilities has become a new standard mandatory in Europe. However, due to high costs and laborious procedures, novel developments recently emerged using closed bag systems as reliable alternatives to conventional cleanrooms. Several hurdles needed to be overcome including the addition of the cryoprotectant dimethylsulfoxide (DMSO) as a relevant manipulation. As a result of the development, closed bag systems proved to be comparable in terms of product quality and patient outcome to cleanroom products. They also comply with the strict regulations of good manufacturing practice.With closed systems being available, costs and efforts of a cleanroom facility may be substantially reduced in the future. The process can be easily extended for other cell preparations requiring minor modifications as donor lymphocyte preparations. Moreover, novel developments may provide solutions for the production of advanced-therapy medicinal products in closed systems.

[1]  M. Orman,et al.  Risk factors for microbial contamination of peripheral blood stem cell products , 2012, Transfusion.

[2]  P. Feugier,et al.  Hematologic recovery after autologous PBPC transplantation: importance of the number of postthaw CD34+ cells , 2003, Transfusion.

[3]  M. Vatish,et al.  Synthetic polymers enable non-vitreous cellular cryopreservation by reducing ice crystal growth during thawing , 2014, Nature Communications.

[4]  C. Chapman,et al.  Umbilical cord blood collection and separation for haematopoietic progenitor cell banking , 1997, Bone Marrow Transplantation.

[5]  C. Chapman,et al.  Cord blood banking: volume reduction of cord blood units using a semi-automated closed system , 1999, Bone Marrow Transplantation.

[6]  Scott E. Smith,et al.  Randomized phase III trial of pegfilgrastim versus filgrastim after autologus peripheral blood stem cell transplantation. , 2010, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[7]  C. Peschel,et al.  Long‐term experiences in cryopreservation of mobilized peripheral blood stem cells using a closed‐bag system: a technology with potential for broader application , 2015, Transfusion.

[8]  M. Bhatia,et al.  Number of viable CD34+ cells reinfused predicts engraftment in autologous hematopoietic stem cell transplantation , 2002, Bone Marrow Transplantation.

[9]  T. Fliedner,et al.  Description of a closed plastic bag system for the collection and cryopreservation of leukapheresis‐derived blood mononuclear leukocytes and CFUc from human donors , 1980, Transfusion.

[10]  Ø. Bruserud,et al.  Autologous peripheral blood progenitor cells cryopreserved with 5 and 10 percent dimethyl sulfoxide alone give comparable hematopoietic reconstitution after transplantation , 2008, Transfusion.

[11]  M. Weinstein,et al.  Controlled evaluation of 5 versus 10 milliliters of blood cultured in aerobic BacT/Alert blood culture bottles , 1994, Journal of clinical microbiology.

[12]  M. Sadelain,et al.  Scalable Expansion of Potent Genetically Modified Human Langerhans Cells in a Closed System for Clinical Applications , 2007, Journal of immunotherapy.

[13]  V. Khandelwal,et al.  Haploidentical hematopoietic SCT for acquired severe aplastic anemia using post-transplant high-dose CY , 2015, Bone Marrow Transplantation.

[14]  Volker Huppert,et al.  Automation of cellular therapy product manufacturing: results of a split validation comparing CD34 selection of peripheral blood stem cell apheresis product with a semi-manual vs. an automatic procedure , 2016, Journal of Translational Medicine.

[15]  R. Strauss,et al.  Bacterial contamination rates following processing of bone marrow and peripheral blood progenitor cell preparations , 1996, Transfusion.

[16]  W. Sibrowski,et al.  Processing of peripheral blood progenitor cell components in improved clean areas does not reduce the rate of microbial contamination , 2002, Transfusion.

[17]  M. Dijkstra-Tiekstra,et al.  Optimization of the freezing process for hematopoietic progenitor cells: effect of precooling, initial dimethyl sulfoxide concentration, freezing program, and storage in vapor‐phase or liquid nitrogen on in vitro white blood cell quality , 2014, Transfusion.

[18]  A. Tukiendorf,et al.  A faster reconstitution of hematopoiesis after autologous transplantation of hematopoietic cells cryopreserved in 7.5% dimethyl sulfoxide if compared to 10% dimethyl sulfoxide containing medium. , 2013, Cryobiology.

[19]  J. Lovelock,et al.  Prevention of Freezing Damage to Living Cells by Dimethyl Sulphoxide , 1959, Nature.

[20]  Volker Huppert,et al.  Automated CD34+ cell isolation of peripheral blood stem cell apheresis product. , 2015, Cytotherapy.

[21]  R. Albertini,et al.  Bone-marrow transplantation in a patient with the Wiskott-Aldrich syndrome. , 1968, Lancet.

[22]  C. Parmentier,et al.  Successful infusion of 40 cryopreserved autologous bone-marrows. In vitro studies of the freezing procedure. , 1984, Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie.

[23]  M. Sabatino,et al.  Preliminary evaluation of a highly automated instrument for the selection of CD34+ cells from mobilized peripheral blood stem cell concentrates , 2016, Transfusion.

[24]  E. Thomas,et al.  Intravenous infusion of bone marrow in patients receiving radiation and chemotherapy. , 1957, The New England journal of medicine.

[25]  N. Kröger,et al.  Autologous stem cell transplantation following high-dose chemotherapy for non-rhabdomyosarcoma soft tissue sarcomas , 2010 .

[26]  G. Tricot,et al.  Impact of a change in antibacterial prophylaxis on bacteremia and hospitalization rates following outpatient autologous peripheral blood stem cell transplantation for multiple myeloma , 2014, Transplant infectious disease : an official journal of the Transplantation Society.

[27]  R. Kamble,et al.  Microbial contamination of hematopoietic progenitor cell grafts—incidence, clinical outcome, and cost‐effectiveness: an analysis of 735 grafts , 2005, Transfusion.

[28]  P. Chiusolo,et al.  Should the standard dimethyl sulfoxide concentration be reduced? Results of a European Group for Blood and Marrow Transplantation prospective noninterventional study on usage and side effects of dimethyl sulfoxide , 2014, Transfusion.

[29]  D. Gao,et al.  Mechanisms of cryoinjury in living cells. , 2000, ILAR journal.

[30]  R. Epstein,et al.  Long-term results of autologous marrow transplantation for relapsed or refractory male or female germ cell tumors , 1998, Bone Marrow Transplantation.

[31]  J. Hołowiecki,et al.  Comparison of the cryoprotective solutions based on human albumin vs. autologous plasma: its effect on cell recovery, clonogenic potential of peripheral blood hematopoietic progenitor cells and engraftment after autologous transplantation , 2015, Vox sanguinis.

[32]  C. Lee,et al.  Impact of donor arm skin disinfection on the bacterial contamination rate of platelet concentrates , 2002, Vox sanguinis.

[33]  B. Bouroncle Preservation of Living Cells at −79°C with Dimethyl Sulfoxide.∗ , 1965 .

[34]  I. Hajjar,et al.  Routine cultures of bone marrow and peripheral stem cell harvests: clinical impact, cost analysis, and review. , 1998, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[35]  M. Lowdell,et al.  Quality issues in stem cell and immunotherapy laboratories , 2003, Transfusion medicine.

[36]  A. S. Parkes,et al.  Revival of Spermatozoa after Vitrification and Dehydration at Low Temperatures , 1949, Nature.

[37]  H. Shiba,et al.  Human autologous serum obtained using a completely closed bag system as a substitute for foetal calf serum in human mesenchymal stem cell cultures , 2006, Cell biology international.

[38]  J. Dipersio,et al.  Factors that influence the collection and engraftment of allogeneic peripheral-blood stem cells in patients with hematologic malignancies. , 1997, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[39]  W. Ross,et al.  Collection, storage and transfusion of blood stem cells for the treatment of hemopoietic failure. , 1979, Blood cells.

[40]  U. Nydegger,et al.  Influence of the Cryoprotective Agents Glycerol and Hydroxyethyl Starch on Red Blood Cell ATP and 2,3‐Diphosphoglyceric Acid Levels , 1992, Vox sanguinis.

[41]  J. Beyer,et al.  Bacterial contamination of ex vivo processed PBPC products under clean room conditions , 2003, Transfusion.

[42]  P. de Micco,et al.  Multivariate analysis of determinants of bacterial contamination of whole‐blood donations , 2002, Vox sanguinis.

[43]  V. Gattei,et al.  A new freezing and storage procedure improves safety and viability of haematopoietic stem cells and neutrophil engraftment: a single institution experience , 2010, Vox sanguinis.

[44]  H. Goldschmidt,et al.  Poor mobilization of hematopoietic stem cells-definitions, incidence, risk factors, and impact on outcome of autologous transplantation. , 2010, Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.

[45]  M. Cairo,et al.  Determining post‐thaw CD34+ cell dose of cryopreserved haematopoietic progenitor cells demonstrates high recovery and confirms their integrity , 2008, Vox sanguinis.

[46]  C. von Kalle,et al.  Identity, potency, in vivo viability, and scaling up production of lentiviral vector-induced dendritic cells for melanoma immunotherapy. , 2012, Human gene therapy methods.