NCT02991898终止2 期
Adoptive Transfer of T Regulatory Cell for Suppression of Acute Graft-vs-Host-Disease After an Umbilical Cord Blood Transplant for Hematologic Malignancies
适应症
试验速览
- 阶段
- 2 期
- 状态
- 终止
- 入组人数
- 3
- 试验地点
- 2
- 主要终点
- Number of Participants Survived
研究概览
简要总结
This is a single center pilot study of a non-myeloablative umbilical cord blood transplant for the treatment of a hematological malignancy with a single infusion of T regulatory (Treg) given shortly after UCB transplantation.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Must be ≥18, but < 70 years of age with no matched 7/8 or 8/8 sibling donor - patients ≥ 70 and ≤ 75 years of age may be eligible if they have a Co-Morbidity score ≤ 2 (http://www.qxmd.com/calculate-online/hematology/hct-ci)
- •UCB unit(s) composing the graft will be selected according to the current University of Minnesota umbilical cord blood graft selection algorithm and an additional cord blood unit to be used as the source to manufacture the Treg product. This UCB unit must be matched at 4-6/6 to the patient, considering HLA-A, B at the antigen level and DRB1 at the allele level
- •Acute Leukemias: Must be in remission by morphology. Also a small percentage of blasts that is equivocal between marrow regeneration versus early relapse are acceptable provided there are no associated cytogenetic markers consistent with relapse. Refer to Section 5.2 for complete definitions.
- •Burkitt's Lymphoma in CR2 or subsequent CR
- •Natural Killer Cell Malignancies
- •Chronic Myelogenous Leukemia: all types except refractory blast crisis. Chronic phase patients must have failed at least two different tyrosine-kinase inhibitors (TKIs), or been intolerant to all available TKIs or have T315I mutation.
- •Myelodysplastic Syndrome: IPSS INT-2 or High Risk; R-IPSS High or Very High; WHO classification: RAEB-1, RAEB-2; Severe Cytopenias: ANC < 0.8, Anemia or thrombocytopenia requiring transfusion; Poor or very poor risk cytogenetics based on IPSS or R-IPSS definitions; therapy-related MDS. Blasts must be be < 5%, preferably < 20% blasts by morphology by bone marrow aspirate morphology.. If ≥ 5% blasts, chemotherapy for cytoreduction to <5% blasts prior to transplantation may be considered.
- •Chronic myeloid neoplasms, including but not limited to CMML with blasts must around 5% blasts, preferably < 20% blasts by morphology by bone marrow aspirate morphology. If ≥5% blasts, chemotherapy for cytoreduction to <5% blasts prior to transplantation may be considered.
- •Large-Cell Lymphoma, Hodgkin Lymphoma and Multiple Myeloma with chemotherapy sensitive disease that has failed or patients who are ineligible for an autologous transplant.
- •Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL), Marginal Zone B-Cell Lymphoma, Follicular Lymphoma, which have progressed within 12 months of achieving a partial or complete remission. Patients who had remissions lasting > 12 months are eligible after at least two prior therapies. Patients with bulky disease should be considered for debulking chemotherapy before transplant. Patients with refractory disease are eligible, unless has bulky disease and an estimated tumor doubling time of less than one month.
- •Lymphoplasmacytic Lymphoma, Mantle-Cell Lymphoma, Prolymphocytic Leukemia are eligible after initial therapy if chemotherapy sensitive.
- •Patients must have undergone an autologous transplant ≤ 12 months prior to transplant on this study or have received multi-agent or immunosuppressive chemotherapy within 3 months of the preparative regimen.
- •Performance Status, Organ Function, Contraception Use
- •Karnofsky score ≥ 70% (Appendix II)
- •Adequate organ function within 14 days (30 days for cardiac and pulmonary) of registration on-study defined as:
- •Renal: creatinine ≤ 2.0 mg/dL, for patient with a creatinine > 1.2 mg/dL or a history of renal dysfunction an estimated glomerular filtration rate ≥ 40 mL/min/1.73 m2 is required
- •ALT, AST and alkaline phosphatase ≤ 5 x upper limit of normal and total bilirubin ≤ 2.5 mg/dL except for patients with Gilbert's syndrome or hemolysis
- •Pulmonary function: DLCO, FEV1, FVC ≥ 40% predicted, and absence of O2 requirements.
- •Cardiac: Absence of decompensated congestive heart failure, or uncontrolled arrhythmia and left ventricular ejection fraction ≥ 40%.
- •Sexually active females of childbearing potential and males with partners of child-bearing potential must agree to use adequate birth control during study treatment.
- •Voluntary written consent
排除标准
- •Untreated active infection
- •History of HIV infection
- •Pregnant or breast feeding. The agents used in this study may be teratogenic to a fetus and there is no information on the excretion of agents into breast milk. Females of childbearing potential must have a blood test or urine study within 14 days prior to registration to rule out pregnancy
- •Prior allogeneic transplantation
- •Less than 3 months from myeloablative conditioning for autologous transplantation (if applicable)
- •Evidence of progressive disease by imaging modalities or biopsy - persistent PET activity, though possibly related to lymphoma, is not an exclusion criterion in the absence of CT changes indicating progression.
- •CML in blast crisis
- •Large cell lymphoma, mantle cell lymphoma and Hodgkin disease that is progressing on salvage therapy.
- •Active central nervous system malignancy
结局指标
主要结局
Number of Participants Survived
时间窗: 2 years
Count of patients who survived 2 years post intervention
次要结局
- Percentage of Donor Cell Chimerism(Day +100)
- Number of Participants Experiencing Treatment Related Mortality (TRM)(6 months)
- Number of Participants With Incidence of Bacterial, Viral and Fungal Infections(1 year)
- Number of Participants Who Experienced Relapse(1 year)
- Number of Participant With Detectable Treg Cells at d14(14 days)
- Number of Participants Experiencing Treg Cell Infusion Toxicity(48 hours post infusion)
- Number of Participants With Grade II-IV aGVHD(Assessed weekly until day 100, then day 180, 360)
- Number of Participants With Immune Reconstitution(Assessed at Day 4, weekly for 8 weeks)
- Length of Treg Survival(24 hours post infusion)
- Number of Participants With Neutrophil Recovery(Day 42)
- Number of Participants Survived One Year Post-transplant(1 year)
- Number of Participants With Platelet Recovery(1 year)
- Number of Participants With Chronic GVHD(1 year)
研究者
研究点 (2)
Loading locations...
相似试验
已完成
1 期
Multiple Donor Treg DLI for Severe Refractory Chronic GVHDChronic Graft Versus Host DiseaseNCT02749084Mario Arpinati18
已完成
1 期
Trial of Adoptive Immunotherapy With TRACT to Prevent Rejection in Living Donor Kidney Transplant RecipientsEnd Stage Renal DiseaseNCT02145325Northwestern University10
Unknown
不适用
Clinical Study of CAR-CLD18 T Cells in Patients With Advanced Gastric Adenocarcinoma and Pancreatic AdenocarcinomaAdvanced Gastric AdenocarcinomaPancreatic AdenocarcinomaNCT03159819Changhai Hospital24
进行中（未招募）
1 期
Personalized TCR-T: Study of Adoptively Transferred T-cell Receptor Gene-engineered T Cells (TCR-T)Malignant Epithelial NeoplasmsNCT05349890Providence Health & Services1
Unknown
1 期
Safety Study of Using Regulatory T Cells Induce Liver Transplantation ToleranceChronic Rejection of Liver TransplantNCT01624077Nanjing Medical University1