Escalation of Plerixafor for Mobilization of CD34+ Hematopoietic Progenitor Cells and Evaluation of Globin Gene Transfer in Patients With Sickle Cell Disease
Safety and Efficacy Trial of Escalation of Plerixafor for Mobilization of CD34+ Hematopoietic Progenitor Cells and Evaluation of Globin Gene Transfer in Patients With Sickle Cell Disease
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 1
Contacts and Locations
Study Contact
Study Contact
- Name: Roni Tamari, MD
- Phone Number: 646-608-3738
Study Contact Backup
- Name: Michel Sadelain, MD, PhD
- Phone Number: 212-639-6190
Study Locations
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New York
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New York, New York, United States, 10065
- Weill Cornell Medical College
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New York, New York, United States, 10065
- Memorial Sloan Kettering Cancer Center
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients must have confirmed and measurable Sickle Cell Disease, defined by SS or Sβ thalassemia confirmed by hemoglobin fractionation.
- ≥ 18 to 65 years of age
- Patient must have a ECOG performance status ≤2 or Karnofsky score > 70%
Patients must have acceptable organ and marrow function as defined below:
- WBC ≥ 3,000/μL
- ANC ≥ 1,500/μL
- platelets ≥150,000//μL
- Hemoglobin ≥ 6 gm/dL
- Calculated creatinine clearance ≥ 60ml/min * *Using the Cockcroft-gault equation [140 - Age(yrs)] [Weight(kg)] x 0.85 if Female 72 [Serum Creatinine (mg/dL]
- Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
- Each patient must be willing to participate as a research subject and must sign an informed consent form.
Exclusion Criteria:
Patients who are:
- Receiving or received treatment with an investigational agent within 4 weeks prior to entering the study OR
- have not recovered from adverse events due to agents administered more than 4 weeks earlier as determined by the treating physician.
- Patients with ALT(SGPT) > 2.5 X upper limit of normal
- Patients with a creatinine clearance of < 60 ml/min
Patients who have uncontrolled illness including, but not limited to:
- Ongoing or active infection
- Emergency room admission or hospitalization in the past 14 days
- Major surgery in the past 30 days
- Medical/psychiatric illness/social situations that would limit compliance with study requirements as determined by the treating physician.
- Female patients who are pregnant or breast-feeding
- Patients with active hepatitis B, hepatitis C, or HIV infection
- Patients with poor cardiac function as defined by an ejection fraction < 40% are excluded due to potential poor tolerance of the fluid shifts with leukapheresis (only for patients enrolled on second phase of protocol for Leukapheresis).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Plerixafor
Patients will receive a single dose of subcutaneous plerixafor with peripheral blood studies at approximately 0-2 hours before, approximately 6-12 hours after, and approximately 20-48 hours after plerixafor administration, with leukapheresis in the last 3 patients on the protocol.
Collected HPCs will be transferred to the MSKCC CTCEF to determine if the HPCs are amenable to transduction with a lentiviral vector encoding the normal ß- globin gene.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
safety
Time Frame: up to 30 days
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Safety is assessed using a dose limiting toxicity (DLT) endpoint.
Definition of a DLT is the occurrence of any of the below events that meets the following criteria: The occurrence of a vasoocclusive crisis requiring hospitalization, acute chest syndrome, CNS acute event, or any other disease related ischemic-based adverse event (AE) should be considered as a DLT, if occurring in the 48 hours DLT observation period.
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up to 30 days
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efficacy
Time Frame: ≥ 30/ul at either 6-12 hours or 24-48 hours post plerixafor.
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Efficacy is defined as 100% of evaluable patients reaching a PB CD34 concentration ≥ 30/uL.
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≥ 30/ul at either 6-12 hours or 24-48 hours post plerixafor.
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Roni Tamari, MD, Memorial Sloan Kettering Cancer Center
Publications and helpful links
General Publications
- Boulad F, Zhang J, Yazdanbakhsh K, Sadelain M, Shi PA. Evidence for continued dose escalation of plerixafor for hematopoietic progenitor cell collections in sickle cell disease. Blood Cells Mol Dis. 2021 Sep;90:102588. doi: 10.1016/j.bcmd.2021.102588. Epub 2021 Jun 15.
- Avecilla ST, Boulad F, Yazdanbakhsh K, Sadelain M, Shi PA. Process and procedural adjustments to improve CD34+ collection efficiency of hematopoietic progenitor cell collections in sickle cell disease. Transfusion. 2021 Sep;61(9):2775-2781. doi: 10.1111/trf.16551. Epub 2021 Jun 23.
- Boulad F, Shore T, van Besien K, Minniti C, Barbu-Stevanovic M, Fedus SW, Perna F, Greenberg J, Guarneri D, Nandi V, Mauguen A, Yazdanbakhsh K, Sadelain M, Shi PA. Safety and efficacy of plerixafor dose escalation for the mobilization of CD34+ hematopoietic progenitor cells in patients with sickle cell disease: interim results. Haematologica. 2018 May;103(5):770-777. doi: 10.3324/haematol.2017.187047. Epub 2018 Feb 1. Erratum In: Haematologica. 2018 Sep;103(9):1577. doi: 10.3324/haematol.2018.199414.
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 13-229
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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