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1.
Bull Cancer ; 107(12S): S185-S192, 2020 Dec.
Article Fr | MEDLINE | ID: mdl-33039133

CD34+ immunomagnetic positive selection allows for CD34+ hematopoietic progenitors separation from CD3+ lymphocytes subsets, usually from an apheresis product collected from a previously mobilized donor. This T-cell depleted stem cell graft is primarily intended for rare cases (around 2% of allotransplanted patients in France) of severe, persistent, symptomatic bi- or tri-cytopenia post-allotransplantation, in order to allow for hematologic reconstitution without increasing the risk of GvHD occurrence. Although semi-manual and complex, the process is of sufficient robustness to consistently generate a cellular product with distinctive features and specifications, based on iterative in-process quality controls, that are discussed within these guidelines.


Antigens, CD34 , Hematopoietic Stem Cells/cytology , Immunomagnetic Separation/methods , Immunomagnetic Separation/standards , Quality Control , Cytapheresis , Graft vs Host Disease/prevention & control , Hematopoietic Stem Cells/immunology , Humans , Pancytopenia/therapy , Societies, Medical
2.
Bull Cancer ; 107(1S): S85-S93, 2020 Jan.
Article Fr | MEDLINE | ID: mdl-31547937

The extraordinary and unexpected success of cellular immunotherapy using genetically engineered T-cells to express a chimeric antigen receptor (CAR) targeting CD19, in the treatment of refractory or relapsing B-hematological malignancies, has provided a real therapeutic hope. Indeed, remission rates reach more than 80 % in patients at a stage, without any other possibilities of treatment, notably in the child's acute lymphoblastic leukemia. These results, initially resulting from academic research, led to Food and Drug accreditation for market access of two innovative autologous therapy drugs, Kimryah® and Yescarta®. Based on the impressive clinical results, mainly so far in hematological malignancies (LAL, MM, LBDGC, etc.), the development of several types of cells expressing a CAR receptor suggests a wide range of future applications, particularly in the field of solid tumors. However, while the development of CAR-T cells now appears to be in the hands of private pharmaceuticals companies, the logistical constraints, the cryopreservation and the very high cost of these personalized medicines may ultimately limit their use. The development of academic productions by CAR-T cells could bypass some of these disadvantages. The strong innovation capacity of healthcare institutions associated with research units allows them to identify the ideal tumor target and efficient performing cells. Thus, authorized production platforms could allow for shorter administration times and reasonable production costs for national health systems. The aim of this workshop is to identify the requirements for the academic production of CAR-T cells, while respecting the research standards useful to establish proof of concept, but also at the preclinical development stage, leading in fine to the manufacture, through an authorized pharmaceutical establishment, of the innovative therapy drug, and in accordance with Good Manufacturing Practice (GMP). The ultimate goal is to make these innovative and high-performance medicines available to as many patients as possible.


Immunotherapy, Adoptive/standards , Academic Medical Centers , Antibodies, Monoclonal/genetics , Antibodies, Monoclonal/immunology , Antigens, Neoplasm/immunology , Cell Culture Techniques , Cell Line , Drug Industry , Europe , France , Genetic Vectors/genetics , Humans , Immunotherapy, Adoptive/economics , Immunotherapy, Adoptive/methods , Lentivirus/genetics , Recombinant Fusion Proteins/genetics , Recombinant Fusion Proteins/immunology , T-Cell Antigen Receptor Specificity , Transgenes
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