Cell Manipulation

CELLF-HELP Training and Inservice

The Dana-Farber Cancer Institute’s Cell Manipulation Core Facility (CMCF) is approved to provide clinical stem cell transplant services to all Harvard affiliated hospitals. As one of the largest stem cell processing centers in the world, the CMCF manufactures over 1000 products per year.

In the continuum of care for patients treated for cancer and nonmalignant disease, hematopoietic stem cell transplantation has been both the standard for clinical treatment and the basis for novel therapeutic advancements. Although effectual, stem cell transplantation poses many risks and potential complications to the recipient. It is extremely important to have a dedicated and well-trained team throughout the treatment course. In this circle of patient care, the stem cell transplant lab’s mission is to provide cell therapy products that are both safe and effective prior to infusion. Technical procedure times range from 30 minutes to 12 hours; below are examples of best practices used in Cell Manipulation Core Facility procedures.

Approximate Processing Times

HPC Freeze	HPC Thaw	HPC-Cord Thaw	DLI Thaw	HPC Fresh	HPC Plasma Deplete	HPC-A RBC Deplete	HPC-M RBC Deplete
3 hours	30 minutes	2 hours	3 hours	3 hours	4 hours	4 hours	8 hours

Processing times may vary

Processing Fundamentals

Products are processed due to major and minor blood type incompatibility, presence of high titer antibody to donor red cells, and volume restrictions.

Clinical stem cell transplant processing typically involves the manipulation of plasma / supernatant and/or red blood cell layers, while maximizing the recovery of the buffy coat layer (containing stem cells) for infusion.

Manipulations for Blood Types

Recipient ABO Type	Donor ABO Type	Restrictions for Processing Peripheral Blood Stem Cells
A	A	Unmanipulated
A	B	Red Blood Cell Depleted* / Plasma Depleted**
A	O	Plasma Depleted**
A	AB	Red Blood Cell Depleted
B	A	Red Blood Cell Depleted* / Plasma Depleted**
B	B	Unmanipulated
B	O	Plasma Depleted**
B	AB	Red Blood Cell Depleted*
O	A	Red Blood Cell Depleted*
A	B	Red Blood Cell Depleted*
O	O	Unmanipulated
O	AB	Red Blood Cell Depleted*
AB	A	Plasma Depleted**
AB	B	Plasma Depleted**
AB	O	Plasma Depleted**
AB	AB	Unmanipulated
If volume of RBCs is <30mL total, Product is unmanipulated *If product is <150mL, Product is unmanipulated

View this table as a PDF

Clean Room

Quality Control Testing

Product Types

Hematopoietic Progenitor Cells (HPCs): Stem cells that give rise to both the red and white cell lineages.

HPC, Apheresis: Donors are given growth factors or chemotherapy, releasing stem cells from the bone marrow into the peripheral blood for collection by apheresis. Benefits include higher cell yields and a less invasive procedure in comparison to harvested bone marrow.

HPC, Marrow: Stem cells, as well as other desirable cellular lineages are collected from the iliac crest or sternum via multiple needle aspirations. Marrow products are utilized for patients with conditions that do not benefit from the increased risk of Graft Versus Host Disease (GVHD) following HPC, Apheresis transplantation. Donors may also prefer this collection method if they are averse to taking growth factors.

HPC, Cord: Blood containing stem cells is collected from the umbilical cord and placenta. Although HPC-Cord products contain less cells then other sources, they are a more widely available option for people who cannot find well matched donors.

Therapeutic Cells, Apheresis: Leukocytes are collected from the peripheral blood by apheresis. These cells are used in donor lymphocyte infusions for the treatment or prevention of tumor relapse and infection.

Processing Slideshows

Cryopreservation
HPC Wash & Thaw
Unmanipulated
- HPC, Marrow Unmanipulated
- HPC, Apheresis Unmanipulated
Plasma Deplete
Cord Blood Thaw
RBC Deplete
- HPC, Apheresis: Red Cell Deplete
- HPC, Marrow: Red Blood Cell Reduction
Therapeutic Cells

Cryopreservation of Hematopoietic Stem Cells

HPC Wash & Thaw

HPCA/M Thaw

HPC, Marrow Unmanipulated

HPC, Apheresis Unmanipulated

HPC: Plasma Deplete

HPC, Apheresis: Red Cell Deplete

HPC, Marrow: Red Blood Cell Reduction

Therapeutic Cell Apheresis: Donor Lymphocyte Infusion

Cell Manipulation

CELLF-HELP Training and Inservice

Approximate Processing Times

Processing Fundamentals

Manipulations for Blood Types

Clean Room

Quality Control Testing

Product Types

Processing Slideshows

Cryopreservation of Hematopoietic Stem Cells

HPC Wash & Thaw

HPCA/M Thaw

HPC, Marrow Unmanipulated

HPC, Apheresis Unmanipulated

HPC: Plasma Deplete

HPC, Apheresis: Red Cell Deplete

HPC, Marrow: Red Blood Cell Reduction

Therapeutic Cell Apheresis: Donor Lymphocyte Infusion

Core Leadership

Jerome Ritz, MD

Medical Director

Sarah Nikiforow, MD, PhD

Location

CERTIFICATES AND CIRCULAR OF INFORMATION

CMCF PUBLICATIONS

Links to Organizations