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The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2019 Feb 21

DOI: 10.23736/S1824-4785.19.03073-5

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Granulocyte radiolabelling using Leukokit® with introduction of a density gradient medium as ancillary material

Caroline GRANGEON-CHAPON 1, 2 , Caroline MAUREL 1, 2, Raphaël de LEMPS 1, 2, Philippe VIAU 1, Guillaume NIVAGGIONI 1, Julie MARTI 1, 2, Micheline RAZZOUK-CADET 1

1 Department of Nuclear Medicine, Archet Hospital, University Hospital of Nice, University Côte d’Azur, Nice, France; 2 Department of Pharmacy, Archet Hospital, University Hospital of Nice, University Côte d’Azur, Nice, France


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BACKGROUND: Radiolabelled white blood cells (WBCs) prepared in radiopharmacies are used to detect infectious or inflammatory sites with scintigraphy. Radiolabelling can be performed by using a disposable closed device, Leukokit®. Nevertheless, owing to the high radiosensitivity of lymphocytes, the question of eliminating lymphocytes before granulocyte radiolabelling is still a controversial step. The aim of this study was to assess a new modified Leukokit® with a protocol that allows granulocyte radiolabelling only.
METHODS: Seventy patients (male/female: 40/30, mean age: 61 years) with suspected infectious diseases underwent labelled leukocyte scintigraphy by radiolabelling with a density gradient medium in addition to Leukokit®. Compliance and quality of radiolabelling were checked according to the following criteria: visual inspection, labelling efficiency, cell viability (Trypan blue exclusion test), cell subset recovery test, lymphocyte elimination rate (granulocyte/WBC rate) and sterility test using media fills.
RESULTS: Visual inspection showed that all cell preparations were free of residual cell clumps or fibrin clots. Mean labelling efficiency was 70.4% ± 9.4% compliant with EANM Guidelines for leukocyte labelling. The mean cell viability was 97.7% ±1.4% (>96%). The mean number of leucocytes injected was 116x106 ±62x106 (>50x106). The mean erythrocyte/WBC ratio was 2.1 ±0.9 (<3) and the removed lymphocyte rate was 97.4% ±1.6% (>90%). Finally, the three sterility tests were negative and therefore successful.
CONCLUSIONS: Purification of granulocytes with Leukokit® can safely, easily and effectively be performed using a density gradient medium. Moreover, clarification regarding the status of density gradient medium could provide support for its clinical use even if further studies are needed. Since all technical obstacles have been removed, the precautionary principle should apply and lead users to eliminate lymphocytes that are highly radiosensitive cells and whose in vivo fate is uncertain.


KEY WORDS: Granulocytes - Lymphocytes - Tc99m-HMPAO - Centrifugation - Density gradient - Cell engineering

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