Development of a flow cytometry–based pulse-width assay for detection of aggregates in cellular therapeutics to be infused by catheter

Background aimsDelivery of cell-based therapies through the carotid artery with the use of an intra-arterial catheter could introduce aggregates and cause focal ischemia in the brain. We developed a pulse-width flow cytometry method for aggregate detection and quantification. The assay was designed to be used as a cell product release assay in a clinical trial seeking to treat ischemic stroke with sorted cells brightly expressing aldehyde dehydrogenase (ALDHbr cells) delivered through intra-arterial catheters.MethodsThe forward light scatter pulse-width axis of a flow cytometer was calibrated for particle diameter measurements through the use of traceable standard microspheres and linear regression. As a positive control, Concanavalin A–aggregated cells were counted manually and sorted onto slides to compare with pulse width–determined values. Known numbers of aggregates were spiked into purified singlet cells for quantification. A clinical standard for aggregate count and diameter was determined. The assay was used to qualify catheters with the use of ALDHbr cells.ResultsThe pulse-width axis was highly linear for microsphere diameter (r2 > 0.99), which allowed for size calibration. Microscopically determined counts and diameters corresponded to pulse width-determined values. Known aggregate counts were linear with pulse width–determined aggregate counts (r2 = 0.98). The limit of detection was determined to be 0.004%. Flow of ALDHbr cells through catheters did not generate aggregates. The final method to be used as a release assay for the stroke clinical trial was tested successfully on samples from volunteer donors.ConclusionsThe pulse-width aggregate detection assay provides a reliable, reproducible, accurate and rapid means of detection, classification and quantification of aggregates in cell therapy products.