The Use of Apheresis in Personalized Cell-Mediated Treatment of Prostate Cancer

Beside a supportive therapy of deficient blood component(s) by transfusions, hemotherapy involves the use of apheresis procedures due to plasma or blood cell collection (apheretic donation) and abnormal or excessive blood constituent removal or replacement, as well as to achieve an immunomodulatory or hemomodulatory effect (therapeutic apheresis—TAph). The basic goal of TAph is to reduce the “patients’ load” of pathogenic agents responsible for the development of disease to the levels that will allow clinical improvement. Hemotherapy also includes stem cell (SC) harvesting (for SC transplants and use in regenerative medicine), as well as collection, ex vivo manipulation and (re)infusion of immune cells with a goal to obtain positive curative effect (by cell-mediated hemobiotherapy). Despite the development of chimeric antigen receptor T cell (CAR-T) expertise in hematooncology, solid tumors still represent a large therapeutic challenge. However, it is evident that cell-based therapy must remain an integral part of the treatment of cancers, including metastatic castrate-resistant prostate cancer (mCRPCa). For definite confirmation of initial clinical results, future randomized trials, with larger number of patients, are required. The objective of this chapter is to provide a systematic overview of current knowledge regarding TAph and to summarize evidence-based practical approaches related to cell-mediated hemobiotherapy of malignant disorders.