EBV-specific Cytotoxic T-lymphocytes (CTLs) for Refractory EBV Infection
A Pilot Study in the Treatment of Refractory Epstein-Barr Virus (EBV) Infection With Related Donor EBV Cytotoxic T-Lymphocytes in Children, Adolescents and Young Adult Recipients
Related donor Epstein-Barr Virus (EBV) specific cytotoxic T cells (CTLs) manufactured with the Miltenyi CliniMACS Prodigy Cytokine Capture System will be administered in children, adolescents and young adults with refractory EBV infection post Allogeneic Hematopoietic Stem Cell Transplantation (AlloHSCT), with primary immunodeficiencies (PID) or post solid organ transplant.
Funding Source: FDA OOPD
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Lauren Harrison
- Phone Number: 6172857844
- Email: lauren_harrison@nymc.edu
Study Contact Backup
- Name: Mitchell Cairo, MD
- Phone Number: 914-594-2150
- Email: mitchell_cairo@nymc.edu
Study Locations
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California
-
Los Angeles, California, United States, 90027
- Recruiting
- Children's Hosptial Los Angeles
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Contact:
- Neena Kapoor, MD
- Email: nkapoor@chla.usc.edu
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San Francisco, California, United States, 94158
- Recruiting
- University of California San Francisco
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Contact:
- Julia Chu, MD
- Email: Julia.Chu2@ucsf.edu
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-
Maryland
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Baltimore, Maryland, United States, 21287
- Recruiting
- Johns Hopkins
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Contact:
- Kenneth Cooke, MD
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-
Missouri
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Saint Louis, Missouri, United States, 63130
- Recruiting
- Washington University
-
Contact:
- Shalini Shenoy, MD
- Email: shalinishenoy@wustl.edu
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New York
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Valhalla, New York, United States, 10595
- Recruiting
- New York Medical College
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Contact:
- Mitchell S Cairo, MD
- Phone Number: 914-594-2150
- Email: mitchell_cairo@nymc.edu
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Principal Investigator:
- Mitchell S. Cairo, MD
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Ohio
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Columbus, Ohio, United States, 43205
- Recruiting
- Nationwide Children's Hosptial
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Contact:
- Dean Lee, MD, PhD
- Phone Number: 614-722-3550
- Email: Dean.Lee@nationwidechildrens.org
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104
- Recruiting
- Children's Hospital of Pennsylvania
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Contact:
- Nancy Bunin, MD
- Phone Number: 215-590-2255
- Email: buninn@email.chop.edu
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Wisconsin
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Milwaukee, Wisconsin, United States, 53226
- Recruiting
- Medical College of Wisconsin/Children's Hospital of Wisconsin
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Contact:
- Julie A Talano, MD
- Phone Number: 414-955-4185
- Email: jtalano@mcw.edu
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Contact:
- Meredith Beversdorf, RN
- Phone Number: (414) 266-5891
- Email: mbeversdorf@mcw.edu
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
1. Patients with Epstein-Barr virus infections post allogeneic HSCT, primary immunodeficiencies or post solid organ transplant with:
- Increasing or persistent quantitative EBV RT-PCR DNA copies despite two weeks of appropriate anti-viral therapy and/or
- progressive clinical symptoms attributable to EBV, including biopsy proven colitis, lymphadenopathy, hepatomegaly, splenomegaly AND/OR
- Medical intolerance to anti-viral therapies including:
- intolerance to rituximab Consent: Written informed consent given (by patient or legal representative) prior to any study-related procedures.
Performance Status > 30% (Lansky < 16 yrs and Karnofsky > 16 yrs) Age: 0.1 to 79.99 years Females of childbearing potential with a negative urine pregnancy test
2 Donor Eligibility 5.2.1 Related donor available with a T-cell response to the EBV MACS® GMP PepTivator antigen(s) causing the therapy-refractory EBV infection.
a. Third Party Related Allogeneic Donor: If original donor is not available or does not have a T-cell response: third party related allogeneic donor (family donor > 1 HLA A, B, DR match to recipient) with IgG positive to EBV and/or a T-cell response at least to the viral MACS® GMP PepTivator EBV Select (containing among other antigens, NA-1, LMP2A and BZLF-1).
AND Allogeneic donor disease screening is complete similar to hematopoietic stem cell donors (Appendix 1).
AND Obtained informed consents by donor or donor legally authorized representative prior to donor collection.
3 Patient exclusion criteria:
A patient meeting any of the following criteria is not eligible for the present study:
Patient with acute GVHD > grade 2 or extensive chronic GVHD at the time of CTL infusion Patient receiving steroids (>0.5 mg/kg prednisone equivalent) at the time of CTL infusion Patient treated with donor lymphocyte infusion (DLI) within 4 weeks prior to CTL infusion Patient with poor performance status determined by Karnofsky (patients >16 years) or Lansky (patients ≤16 years) score ≤30% Concomitant enrollment in another experimental clinical trial investigating the treatment of refractory EBV infection Any medical condition which could compromise participation in the study according to the investigator's assessment Known HIV infection Female patient of childbearing age who is pregnant or breast-feeding or not willing to use an effective method of birth control during study treatment.
Known hypersensitivity to iron dextran Patients unwilling or unable to comply with the protocol or unable to give informed consent.
Known human anti-mouse antibodies
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: Refractory EBV
Patients with refractory EBV will get one dose of EBV specific CTLs.
If they don't show a response based on EBV PCRs, patients may get up to another 4 doses of EBV-CTLs (5 doses maximum)
|
EBV specific CTLs will be generated from HLA related matched and mismatched donors in a GMP facility and administered to the patient with refractory CTLs.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
Time Frame: Patients will be followed for 12 weeks after each infusion
|
Patients will be monitored for adverse events related to the infusion of EBV CTLs
|
Patients will be followed for 12 weeks after each infusion
|
|
Incidence of Response to Treatment [Efficacy]
Time Frame: Patients will be followed for 12 weeks after each infusion
|
Patients will be followed for improvement in viral infection by monitoring EBV PCR weekly for response to treatment with CTLs
|
Patients will be followed for 12 weeks after each infusion
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Mitchell Cairo, MD, New York Medical College
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
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
- Disease Attributes
- Genetic Diseases, Inborn
- Immune System Diseases
- Virus Diseases
- DNA Virus Infections
- Herpesviridae Infections
- Tumor Virus Infections
- Primary Immunodeficiency Diseases
- Infections
- Communicable Diseases
- Immunologic Deficiency Syndromes
- Epstein-Barr Virus Infections
Other Study ID Numbers
Other Study ID Numbers
- NYMC 581
- FD006363 (Other Grant/Funding Number: FDA OOPD)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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