CFSE flow cytometric quantification of lymphocytic proliferation in extracorporeal photopheresis: Use for quality control

Abstract 

Quality control is essential to validate extracorporeal photopheresis (ECP) processes. There is just one protocol based on PHA-induced proliferation. Since it involves the use of radioactive thymidine, we developed another technique using CFSE labeling. We compared the two tests in a paired series including 18 procedures. The thymidine test was valid. Once proliferation was obtained (10 patients out of 13), the CFSE test was in close agreement with it. In particular, two cases of residual proliferation after ECP were simultaneously detected by both techniques. Only the CFSE test allows targeted analysis of lymphocytes, thus identifying a surviving lymphocytic sub-population.

Keywords: Extracorporeal photopheresis, Quality control, Tritiated thymidine, CFSE, Flow cytometry, Lymphocytic proliferation