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1.
Bull Cancer ; 107(12S): S193-S201, 2020 Dec.
Article in French | MEDLINE | ID: mdl-33187683

ABSTRACT

CAR T-cells are anti-cancer immunocellular therapy drugs that involve reprogramming the patient's T-cells using a transgene encoding a chimeric antigen receptor (CAR). Although CAR T-cells are cellular therapies, the organization for manufacturing and delivering these medicinal products is in many ways different from the one for hematopoietic cell grafts or donor lymphocyte infusions. The implementation of this innovative therapy is recent and requires close coordination between clinical teams, the therapeutic apheresis unit, the cell therapy unit, the pharmaceutical laboratory, and pharmacy. Apart from the regulatory texts, which are regularly modified, and the specific requirements of each pharmaceutical laboratory, there is currently no guide to help the centers initiating their activity and there is no specific indicator to assess the quality of the CAR T-cell activity in each center. The purpose of the current harmonization workshop is to clarify the regulatory prerequisites warranted for a center to have a CAR T-cell activity and to propose recommendations for implementing quality tools, in particular indicators, and allowing their sharing.


Subject(s)
Immunotherapy, Adoptive/standards , Quality Assurance, Health Care , Receptors, Chimeric Antigen , Accreditation , Congresses as Topic/organization & administration , France , Health Personnel/education , Humans , Immunotherapy, Adoptive/legislation & jurisprudence , Societies, Medical
2.
Bull Cancer ; 107(1S): S44-S51, 2020 Jan.
Article in French | MEDLINE | ID: mdl-31570213

ABSTRACT

The modalities of mobilization of hematopoietic stem cells in autologous transplantation have evolved in recent years. The Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) organized the 9th hematopoietic stem cell transplantation clinical practices harmonization workshop series in September 2018 in Lille, France, to conduct a review of current practices of the society centers and of international recommendations. The cell dose objectives have been revised. The modalities of mobilization including the use of plerixafor have been specified allowing reaching the objectives of collection while limiting the number of apheresis. Collections failures have become exceptional.


Subject(s)
Hematopoietic Stem Cell Mobilization/methods , Hematopoietic Stem Cell Transplantation , Algorithms , Antigens, CD34/analysis , Antineoplastic Agents/adverse effects , Antineoplastic Agents/pharmacology , Benzylamines , Blood Component Removal/methods , Bone Marrow/drug effects , Cell Count , Cell Separation/methods , Cyclams , Granulocyte Colony-Stimulating Factor/adverse effects , Granulocyte Colony-Stimulating Factor/pharmacology , Hematopoietic Cell Growth Factors/pharmacology , Hematopoietic Stem Cell Mobilization/standards , Heterocyclic Compounds/pharmacology , Humans , Practice Patterns, Physicians' , Risk Factors , Transplantation, Autologous
3.
Bull Cancer ; 104(12S): S76-S83, 2017 Dec.
Article in French | MEDLINE | ID: mdl-29173975

ABSTRACT

The evolution of HLA typing and transplantation techniques makes it easier to identify a donor for hematopoietic stem cell (HSC) transplantation. This activity, strongly regulated by regulatory or normative texts, implies in addition biological, medical, para-medical and sometimes psychological evaluations. The benefit/risk discussion is complicated because it must take into account the benefit/risk ratio for the recipient, and the donor risk. No Evidence-Based Medicine data is available and serious events are very rare situations. Biovigilance declarations and their analysis are of fundamental importance. Certain obvious and definite contraindications could be detected very early in the process. It is important to assess whether a risk factor or pathology contributes to increasing the risk associated with collection. In case of recipient risk, the situation should be discussed with the patient team. These recommendations focus on adult peripheral blood HSC donors. They refer to donor information, confidentiality of exchanges, the impact of moral or material pressures, declarations of biovigilance, collegiality and traceability of difficult decisions, desirable experience and training for doctors in charge, use of expert advice informed by an explicit exchange on the possible risks, parsimony of therapeutic interventions and minimization of risks for the donor. We also recommend creation, availability and use by the community of tools and documents (registries, questionnaires, synthetic recommendations, feedback, and collegial qualification meetings) useful for practice.


Subject(s)
Hematopoietic Stem Cells , Histocompatibility Testing/standards , Living Donors , Adult , Confidentiality , Decision Making , France , Hematopoietic Stem Cell Transplantation/adverse effects , Histocompatibility Testing/adverse effects , Histocompatibility Testing/ethics , Humans , Morals , Risk Adjustment , Risk Assessment , Societies, Medical
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