CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Manufacturing chimeric antigen receptor T cells from cryopreserved peripheral blood cells: time for a collect-and-freeze model?
Manufacturing chimeric antigen receptor T cells from cryopreserved peripheral blood cells: time for a collect-and-freeze model?
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这些数据证明能够仅使用从 50 mL 血液中分离的冷冻保存的健康供者 PBMC,在短短 8 天内成功生成 CAR-T 细胞产品。值得注意的是,CAR-T 细胞的数量足以按照美国食品药品监督管理局目前批准产品所用的剂量水平,为一名 80 kg 患者进行输注。作者提供了原理验证,即冷冻保存有限体积且起始 T 细胞计数充足的静脉血,可使后续成功制造 CAR-T 细胞疗法成为可能。
嵌合抗原受体(CAR)修饰的T细胞疗法已经彻底改变了复发/难治性B细胞恶性肿瘤患者的结局。尽管结果令人振奋,但若干临床和后勤方面的挑战限制了其广泛应用。首先,单采要求限制了其可及性,只有具备收集和处理外周血单个核细胞(PBMC)资源的机构才能开展。其次,即使使用单采产品,在相当一部分患者中无法成功制造CAR-T 细胞也是一个已明确的问题。在接受过大量既往治疗的患者中,既往化疗可能影响T细胞质量和功能,限制了制造强效CAR-T 细胞产品的能力。在初次癌症诊断后不久或生命更早期、个体仍健康时分离并储存T细胞,是使用来自接受过大量既往治疗患者T细胞的一种替代方案。本研究的目标是确定是否可以从少量(50 mL)健康供者血液中制造出CAR-T 细胞产品。
Cell Vault的合作者从三名健康供体采集了50 mL外周静脉全血。PBMCs被分离、冷冻保存并运送至威斯康星医学院。每位供体的PBMCs被解冻,并使用CD19慢病毒载体在CliniMACS Prodigy设备上通过8天流程制造CAR-T 细胞。
富集T细胞数量的起始剂量范围为4.0 10 7细胞至4.8 10 7细胞,CD4/CD8纯度为74-79%,平均CD4:CD8比值为1.4。在收获日,培养物中总CD3细胞扩增至3.6-4.6 10 9细胞,导致74至115倍扩增,平均CD4:CD8比值为2.9,CD3频率大于99%。所得CD19 CAR表达从19.2%至48.1%不等,相应的最终CD19+ CAR-T 细胞计数范围为7.82 10 8细胞至2.21 10 9细胞。最终CAR-T 细胞产品在表型上被激活且未耗竭,并包含由干细胞样记忆T细胞组成的分化群体。
Collaborators at Cell Vault collected 50 mL of whole peripheral venous blood from three healthy donors. PBMCs were isolated, cryopreserved and shipped to the Medical College of Wisconsin. PBMCs for each individual donor were thawed, and CAR T cells were manufactured using an 8-day process on the CliniMACS Prodigy device with a CD19 lentiviral vector.
Starting doses of enriched T-cell numbers ranged from 4.0 10 7 cells to 4.8 10 7 cells, with a CD4/CD8 purity of 74-79% and an average CD4:CD8 ratio of 1.4. On the day of harvest, total CD3 cells in the culture expanded to 3.6-4.6 10 9 cells, resulting in a 74- to 115-fold expansion, an average CD4:CD8 ratio of 2.9 and a CD3 frequency of greater than 99%. Resulting CD19 CAR expression varied from 19.2% to 48.1%, with corresponding final CD19+ CAR T-cell counts ranging from 7.82 10 8 cells to 2.21 10 9 cells. The final CAR T-cell products were phenotypically activated and non-exhausted and contained a differentiated population consisting of stem cell-like memory T cells.
Overall, these data demonstrate the ability to successfully generate CAR T-cell products in just 8 days using cryopreserved healthy donor PBMCs isolated from only 50 mL of blood. Notably, numbers of CAR T cells were more than adequate for infusion of an 80-kg patient at dose levels used for products currently approved by the Food and Drug Administration. The authors offer proof of principle that cryopreservation of limited volumes of venous blood with an adequate starting T-cell count allows later successful manufacture of CAR T-cell therapy.
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