FROM SCIENCE TO MEDICINE, AN UNCERTAIN ST EP - LESSONS FROM CD34(+) CELL SELECTION DEVICES

Recent years witnessed the introduction of innovative biotechnologies that changed and introduced more complexity in human hematopoietic pro genitor cell transplantation. Biomedical devices that select CD34 posi tive cells are one such example. These immunoadsorption devices are ba sed on simple technologies that have been in use for many years in res earch laboratories; they are all based on the use of a murine monoclon al antibody that recognizes the human membrane antigen CD34, and a met hod designed to retain antibody-coated CD34 positive cells while CD34 negative cells are eluted. While the technique is simple, the growing experience reported by several clinical research groups illustrates th e difficulties associated with the evaluation of innovative therapies, and the definition of potential clinical uses. How will the demonstra tion of clinical benefits associated with tumor purging of autologous grafts, or T-cell depletion of allogeneic graft be required, before th e use of these biomedical devices is eventually recommended? Which sid e effects - including the increase in cost of transplantation - are th en acceptable? These questions remained open as of today.