A Trial of Plerixafor/G-CSF as Additional Agents for Conditioning Before TCR Alpha/Beta Depleted HSCT in WAS Patients
A Trial of Plerixafor With G-CSF as Additional Agents in Conditioning Regimen for Prevention of Graft Failure After Transplantation With TCR Alpha/Beta Grafts Depletion in Patients With Wiskott-Aldrich Syndrome.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Severe graft dysfunction, such as the degree of donor chimerism predominantly in the myeloid compartment is one of major problem in patients with Wiskott-Aldrich syndrome (WAS), especially after hematopoietic stem cell transplantation (HSCT) from alternative donor. It often leads to the development of severe thrombocytopenia or even transplants rejection. In this study the hypothesis is that the use of plerixafor and G-CSF as additional agents in conditioning regimen would offers advantages due to lowing risk of mixed chimerism after HSCT. This effect is based on the fact that simultaneous use of plerixafor with G-CSF is efficient in inducing stem cell release and opening of bone marrow (BM) niches. Moreover, stem cell release probably leads to liberation of host stem cells from the anti-apoptotic effects of the BM stroma for the more powerful effect of chemotherapy.
In this study, the investigators use TCR alpha/beta grafts depletion of the grafts as basic technology for HSCT from haploidentical and unrelated donors approved in Institution.
Thus, the purpose of this study is to evaluate the safety and efficiency of myeloablative conditioning with Plerixafor and G-CSF as additional agents for prevention of graft failure after transplantation with TCR alpha/beta grafts depletion in patients with Wiskott-Aldrich syndrome.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Dmitry Balashov, MD, PhD
- Phone Number: 6534 +7(495)287-6570
- Email: bala8@yandex.ru
Study Contact Backup
- Name: Michael Maschan, Professor
- Phone Number: +7(926)651-2145
- Email: mmaschan@yandex.ru
Study Locations
-
-
-
Moscow, Russian Federation, 117997
- Recruiting
- Dmitry Rogachev Federal Research and Clinical Centre of Paediatric Haematology, Oncology and Immunology
-
Contact:
- Dmitry Balashov, MD, PhD
- Phone Number: 6534 +7(495)287-6570
- Email: bala8@yandex.ru
-
Contact:
- Michael Maschan, Professor
- Phone Number: +7(926)287-6570
- Email: mmaschan@yandex.ru
-
Sub-Investigator:
- Michael Maschan, Professor
-
Sub-Investigator:
- Alexandra Laberko, MD
-
Sub-Investigator:
- Svetlana Kozlovskaya, MD
-
Sub-Investigator:
- Elena Gutovskaya, MD
-
Sub-Investigator:
- Anna Shcherbina, Professor
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients aged ≥ 1 months and < 19 years
- Patients diagnosed with Wiskott-Aldrich syndrome eligible for an allogeneic transplantation and lacking a related HLA-matched donor
- Lansky/Karnofsky score > 40, WHO > 4
- Signed written informed consent
Exclusion Criteria:
- Dysfunction of liver (ALT/AST > 5 times normal value, or bilirubin > 3 times normal value), or of renal function (creatinine clearance < 30 ml / min)
- Severe cardiovascular disease (arrhythmias requiring chronic treatment, congestive heart failure or left ventricular ejection fraction <40%)
- Serious concurrent uncontrolled medical disorder
- Lack of parents' informed consent.
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/G-CSF for HSCT conditioning
Myeloablative conditioning regimen with Plerixafor and G-CSF as addition agents before stem cell transplantation in WAS patients.
|
Mobilization of hematopoietic stem (HSC) into circulation
Directed inhibition of CXC chemokine receptor type 4 (CXCR4) for opening enough BM niches for adequate donor HSC engraftment.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Event free survival (EFS)
Time Frame: 24 months
|
The EFS probability compared with historical control.
We mean event as patient's death, second transplantation or persistence of severe thrombocytopenia
|
24 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Overall survival (OS)
Time Frame: 24 months
|
The OS probability compared with historical control.
|
24 months
|
|
Percentage of patients with full/mixed donor chimerism
Time Frame: 12 months
|
Evaluation of the percentage of patients with the full/mixed donor chimerism (whole blood and CD3+ lineage).
In addition, patients will be divided in accordance with % of donors cells: >95%; 50%-95%; 10%-49%; <10%.
All data will be compared with historical control
|
12 months
|
|
Transplant related mortality (TRM)
Time Frame: 24 months
|
The TRM probability compared with historical control.
|
24 months
|
|
Severe thrombocytopenia (ST)
Time Frame: 24 months
|
The ST probability after HSCT compared with historical control
|
24 months
|
|
Autoimmune complications (AC)
Time Frame: 24 months
|
The AC probability after HSCT compared with historical control
|
24 months
|
|
Acute Graft Versus Host Diseases (aGVHD)
Time Frame: 12 months
|
Cumulative Incidence and severity of aGVHD
|
12 months
|
|
Chronic Graft Versus Host Diseases (cGVHD)
Time Frame: 24 months
|
Cumulative Incidence and severity of cGVHD
|
24 months
|
|
Plerixafor related complications (PRC)
Time Frame: 2 week
|
PRC: severity, features, incidence
|
2 week
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Chair: Alexei Maschan, Professor, Dmitry Rogachev Federal Research and Clinical Centre of Paediatric Haematology, Oncology and Immunology
- Principal Investigator: Dmitry Balashov, Dmitry Rogachev Federal Research and Clinical Centre of Paediatric Haematology, Oncology and Immunology
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
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
Additional Relevant MeSH Terms
- Pathologic Processes
- Immunologic Deficiency Syndromes
- Immune System Diseases
- Disease
- Hematologic Diseases
- Blood Coagulation Disorders, Inherited
- Hemorrhagic Disorders
- Genetic Diseases, Inborn
- Genetic Diseases, X-Linked
- Blood Coagulation Disorders
- Leukopenia
- Leukocyte Disorders
- Primary Immunodeficiency Diseases
- Lymphopenia
- Syndrome
- Wiskott-Aldrich Syndrome
- Anti-Infective Agents
- Antiviral Agents
- Anti-HIV Agents
- Anti-Retroviral Agents
- Plerixafor
Other Study ID Numbers
Other Study ID Numbers
- WAS_PG 2016
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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