Table 8.

Alternative perfusion reactors for ACT

		Culture			Results					Characteristics
System	Cells	Medium	Stimulation strategy	Perfused medium	Inoculated cells/ml	Days	Yield	Purity	Functionality	Features	Disadvantages	Other ACT
Aastrom	TIL [132]	AIMV, RPMI 1640, HEPES, BME, 10% AB serum, 6000 IU/mL IL-2	Irradiated PBMC APCs; 6000 IU/mL IL2, OKT3	AIM V, 1% human serum, Glutamine 6000 IU/mL rhIL-2	5 × 106	14	up to 5.8 × 109 cells (1127 fold)	Populations nearly identical to static; 90% CD8+	Activity against HLA-A2+ matched tumor lines; IFNγ secretion equal or higher than in static cultures	Slow medium exchange rates maintain a tissue-like microenvironment	Scaling is not available; limited opportunity for in-process monitoring; low surface area generates low yield	UCB [133]; DC [134]
ZRP	NK [91]	Alpha medium, glucose, 10% HS, glutamine, 1000 IU/mL IL2; proprietary activation cocktail.	Specific proprietary activating cocktail	NP	70 × 106	12–22	~ 14 fold	NK cell purity > 85%; T cells, B cells and NK T cells were below 2%	Cytotoxicity did not exceed 20% expression of activating receptors; strong IFNγ expression	Directed laminar flow of medium, which allows an undisturbed cell/cell- and cell/surface-contact and minimizes cell stress	Efficiency and killing capacity are questioned	Other NK [19]
	NK /γδT /CIK [135]	RPMI1640 complete medium (10% HS and 100 IU/mL IL2)	Irradiated K562- mb15–41BBL cells	NP	106	14	Static culturing resulted in higher cell counts than Z®-RP	Majority of expanded NK/γδT/CIK cells developed a CD56 bright phenotype	Static culturing resulted in higher cytotoxicity of NK/γδT/CIK than in dynamic culturing
Packed Bed	Tonsil tissue cells [136]	OPTI-MEM; 7.5% human AB serum	NP	OPTI-MEM	107	NP	Tissue formation	NP	NP	Architectural features typical of lymphoid organs	NP	DC [137]