Definition of the Variables Affecting Efficacy of Immunodepletion Ex Vivo of Peripheral Blood Progenitor Cell Grafts by Alemtuzumab (Campath in the Bag)

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Definition of the Variables Affecting Efficacy of Immunodepletion Ex Vivo of Peripheral Blood Progenitor Cell Grafts by Alemtuzumab (Campath in the Bag) Nicolas Novitzky, Glenda Davison, Rygana Abdulla, Shaheen Mowla Biology of Blood and Marrow Transplantation Volume 19, Issue 12, Pages 1753-1759 (December 2013) DOI: 10.1016/j.bbmt.2013.10.001 Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 1 Dose ranging study with alemtuzumab on the lymphoid cell populations. The antibody was incubated with 5 × 106 cells in 1 mL. The x axis depicts the alemtuzumab concentrations, whereas the y axis shows the resulting cell numbers after the incubation. The bar graphs show significant reduction in cell numbers and particularly of T cells at .001 mg/mL. Further increases in the antibody concentration did not lead to greater immunodepletion. Biology of Blood and Marrow Transplantation 2013 19, 1753-1759DOI: (10.1016/j.bbmt.2013.10.001) Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 2 Dose ranging study with alemtuzumab on the myeloid–monocytic and CD34+ cell populations. The antibody was incubated with 5 × 106 cells in 1 mL. The x axis depicts the alemtuzumab concentrations, whereas the y axis shows the resulting cell after incubation. Incubation of mononuclear cells with alemtuzumab led to reduction in the number of myeloid and monocytic cells at all the concentrations tested. Biology of Blood and Marrow Transplantation 2013 19, 1753-1759DOI: (10.1016/j.bbmt.2013.10.001) Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 3 Mononuclear cells were incubated with alemtuzumab and fresh AB serum at 1, 5, and 10 × 106 cells/mL. Control and alemtuzumab tests contained IMDM only. The presence of AB serum at the highest cell concentration led to the greatest lymphocyte reduction, particularly of CD 4 cells. ***P < .01, **P < .05. Biology of Blood and Marrow Transplantation 2013 19, 1753-1759DOI: (10.1016/j.bbmt.2013.10.001) Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 4 Effect of alemtuzumab on clonogenic progenitor cells. CD34+ cells were selected with immunomagnetic beads and cultured in methyl cellulose containing IL-3 and granulocyte colony-stimulating factor for 14 days with incremental concentrations of alemtuzumab. No difference in the colony number was seen at any antibody dose. Biology of Blood and Marrow Transplantation 2013 19, 1753-1759DOI: (10.1016/j.bbmt.2013.10.001) Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 5 Representative standard curve of alemtuzumab concentrations between .1 and 10-7 mg/mL, with standard errors shown on the x axis. The y axis represents mean corrected absorbance (optical density) measured at 450 nm for the stated alemtuzumab concentrations on the x axis. The values were used to calculate alemtuzumab supernatant levels in donor samples. Biology of Blood and Marrow Transplantation 2013 19, 1753-1759DOI: (10.1016/j.bbmt.2013.10.001) Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 6 Cell numbers and residual concentration of alemtuzumab in supernatant. Alemtuzumab at .001 mg/mL was added to 1, 5, and 10 × 106 mononuclear cells as shown on the x axis. The y axis shows the remaining alemtuzumab concentration in mg/mL. At the 2 highest cell numbers, the concentrations of alemtuzumab is significantly lower (P < .01 and <.05). Biology of Blood and Marrow Transplantation 2013 19, 1753-1759DOI: (10.1016/j.bbmt.2013.10.001) Copyright © 2013 American Society for Blood and Marrow Transplantation Terms and Conditions