Donor lymphocyte apheresis for adoptive immunotherapy compared with blood stem cell apheresis

Donor lymphocyte transfusion has gained considerable interest as adoptive c ellular immunotherapy for treatment of relapse after allogeneic stem cell t ransplantation. This study was designed to compare the yield of CD3(+), CD3 (+)4(+), CD3(+)8(+), CD19(+), CD3(-)56(+)16(+), and CD34(+) cells contained in apheresis products from 61 consecutive non-cytokine treated, human leuk ocyte antigen (HLA)-matched donors for lymphocyte collection with the corre sponding apheresis-derived cell yield from 112 consecutive, HLA-matched don ors for blood stem cell collection who received recombinant human granulocy te colony stimulating factor (rhG-CSF, filgrastim) 6 mug/kg every 12 hours until cell collection was completed. Apheresis was started on day 4 or 5 of rhG-CSF treatment. The yield of lymphoid subsets was significantly differe nt in the two sample groups, rhG-CSF treated product yields exceeding untre ated product yields by a median of 2.1-fold (range: 1.3-2.6). However, the CD34(+) cell yield in rhG-CSF-treated apheresis products exceeded untreated products by 26-fold. A single untreated apheresis procedure was usually su fficient to collect a target dose of 1 x 10(8)/kg CD3(+) cells. Untreated a pheresis products contained a median of 0.2 x 10(6)/kg CD34(+) cells. A pot ential engraftment dose of greater than or equal to0.5 x 10(6) CD34(+) cell s per kg of recipient body weight was contained in 16% of 57 untreated aphe resis products. One single apheresis performed in a normal, untreated donor provides a sufficient amount of CD3(+) cells for adoptive immunotherapy. C ompared with that of an rhG-CSF stimulated apheresis product, the CD34(+) c ell count is usually, but not always, below the engraftment dose range, RhG -CSF treatment has tittle effect on the yield of lymphoid subsets collected by apheresis but is highly selective of the release of CD34(+) cells. This report provides baseline data for studies that will show whether other cyt okines such as granulocyte macrophage colony stimulating factor (GM-CSF) an d/or Flt-3 Ligand can immunomodulate allotransfusates in vivo to improve th e graft-vs.-leukemia (GVL) effect after allogeneic stem cell transplantatio n, while lowering the incidence and severity of graft-vs.-host disease (GVH D). J. Clin. Apheresis, 16:82-87, 2001. (C) 2001 Wiley-Liss, Inc.