Haplo T-Cell Depleted Transplantation in High-Risk Sickle Cell Disease

Phase 2

Active, not recruiting

• Conditions: Sickle Cell Disease
• Interventions: Drug: CD34 selected T-cell depleted allogeneic SCT

• Registration Number: NCT01461837
• Lead Sponsor: New York Medical College

Brief Summary

This study is being done to determine the safety and outcome (long-term control) of a high-dose chemotherapy regimen followed by an infusion of CD34 selected (immune cells) stem cells from a partially matched adult family member donor, called haploidentical stem cell transplantation, in high-risk sickle cell disease patients.

Funding Source - FDA OOPD

Detailed Description

The purpose of this study is to investigate host myeloimmunosuppressive conditioning followed by familial haploidentical T cell depleted allogeneic stem cell transplantation in patients with high risk Sickle Cell Disease (SCD). It is hypothesized that it will be safe and well tolerated, and result in sustained donor chimerism, acceptable engraftment and immune reconstitution. Also, that it will limit SCD related organ damage resulting in improved and/or stable neurological, neurocognitive, pulmonary and pulmonary vascular function and health related quality of life (QOL).

Patients 2-20.99 years of age with a diagnosis of high-risk SCD and with an unaffected HLA partially matched family donor and meeting eligibility criteria (inclusion and exclusion criteria) are eligible.

Study Timeline

• Study First Submitted: 2011-10-19
• Study First Submitted QC: 2011-10-26
• Study First Posted: 2011-10-28
• Study Start: 2012-01
• Status Verified: 2024-03
• Last Update Submitted: 2024-03-12
• Last Update Posted: 2024-03-13
• Primary Completion: 2024-12
• Study Completion: 2025-12

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 21

Inclusion Criteria

• Homozygous Hemoglobin S Disease, or Hemoglobin S Beta0/+ thalassemia

• Patients must demonstrate one or more of the following Sickle Cell Disease Complications

  1. Clinically significant neurologic event (stroke) or any neurologic deficit lasting >24 hours that is accompanied by an infarct on cerebral MRI
  2. Minimum of two episodes of acute chest syndrome.
  3. Recurrent painful events (at least 3 in the 2 years prior to enrollment).
  4. Abnormal TCD study requiring starting on chronic transfusion therapy.
  5. At least one silent infarct lesion on a MRI scan of the head.

• A familial haploidentical donor without homozygous sickle cell disease

• Adequate organ function (renal, liver, cardiac and pulmonary function)

• Karnofsky or Lansky (age appropriate) Performance Score ≥50%

• Liver biopsy is optional to assess for iron overload in chronically transfused patients.

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Exclusion Criteria

• Females who are pregnant or breast-feeding
• SCD Patients with documented uncontrolled infection
• SCD patients who have an unaffected HLA matched family donor willing to proceed to donation
• Karnofsky/Lansky (age appropriate) Performance Score <50% (hemiplegia alone secondary to a previous stroke is not an exclusion)
• Demonstrated lack of compliance with medical care.
• Clinically significant fibrosis or cirrhosis of the liver
• Previously received a HSCT

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Haplo Stem Cell Transplantation	CD34 selected T-cell depleted allogeneic SCT	CD34 selected T-cell depleted allogeneic SCT

Primary Outcome Measures

Name	Time	Method
Treatment related events	1 year	Death, primary or late graft rejection, or recurrence of disease and acceptable rate of hematopoietic engraftment, acute and chronic graft-versus-host disease

Secondary Outcome Measures

Name	Time	Method
neurological/neurocognitive status	2 years	Change from baseline in neurological/neurocognitive status
Pulmonary/pulmonary vascular status	2 years	Change from baseline of Pulmonary/pulmonary vascular status
Health-related quality of life	4 years	Change from baseline of Health-related quality of life (CHRIs-HSCT/CHRIs-General)

Trial Locations

Locations (6)

New York Medical College; 🇺🇸 Valhalla, New York, United States

University of California Los Angeles (UCLA); 🇺🇸 Los Angeles, California, United States

Lurie Children's Hospital; 🇺🇸 Chicago, Illinois, United States

Medical College of Wisconsin/Children's Hospital of Wisconsin; 🇺🇸 Milwaukee, Wisconsin, United States

Washington University/St. Louis Children's Hospital; 🇺🇸 Saint Louis, Missouri, United States

Children's Hospital and Research Center Oakland; 🇺🇸 Oakland, California, United States