RECOVERY OF T-LYMPHOCYTES FOR ADOPTIVE IMMUNOTHERAPY BY LYMPHAPHERESIS OF HIV-INFECTED PATIENTS WITHOUT ALTERATIONS OF VIROLOGICAL, IMMUNOLOGICAL OR CLINICAL-PARAMETERS

We performed repeated continuous now cytaphereses (CFC) on 13 asymptom atic HTV-1-infected patients to study the feasibility of cell separati on procedures to recover high yields of peripheral blood T-lymphocytes for adoptive immunotherapy in HIV-infected patients and to determine immunological and virological alterations following such procedures. A mean yield of 6.23 x 10(9) lymphocytes could be obtained by each cyta pheresis, containing 1.82 x 10(9) CD4(+), 3.23 x 10(9) CD8(+) T-lympho cytes and 8.39 x 10(6) CD34(+) peripheral progenitor cells. The CD4/CD 8 ratio (mean 0.53, SD +/- 0.15) in the cell samples reflected the dis tribution of the lymphocyte subsets in vivo. Absolute lymphocyte count s decreased at a mean of 404/mm(3) (25%) immediately after CFC but wer e replaced from the extravascular pool within 1 h. The CD4/CD8 ratios, p24-antigenaemia, HLA-DR expression and neopterin levels did not chan ge significantly after cell separation. No alteration of the number of T-cells with integrated proviral DNA copies (1/10(3) to 1/10(6)) coul d be detected in peripheral T-helper cells by PCR after lymphapheresis . We conclude that high yields of peripheral T-lymphocytes can be obta ined by continuous flow lymphapheresis for cell-mediated immunotherapy , without deterioration of virological or immunological parameters in HIV-infected patients. The separated T-cells are fully replaced from e xtravascular pools after 1 h.