Phase 1 Study of Chemotherapy Plus HLA-mismatched GPBMC Infusion Bridging to Allo-HSCT for R/R Leukemia
Phase 1 Study of Chemotherapy Combining With HLA-mismatched G-CSF Mobilized Peripheral Blood Mononuclear Cell Infusion as a Bridge to Allogeneic Hematopoietic Stem Cell Transplantation for Relapsed and Refractory Leukemia
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 1
Contacts and Locations
Study Contact
Study Contact
- Name: Bo Cai, MD
- Phone Number: +861066947168
- Email: caibo2008@163.com
Study Contact Backup
- Name: Yangyang Lei, MD
- Phone Number: +861066947180
- Email: 942056176@qq.com
Study Locations
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Beijing, China, 100071
- Recruiting
- Department of Hematology, the Fifth Medical Center of Chinese PLA General Hospital
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Contact:
- Bo Cai, MD
- Phone Number: +861066947168
- Email: caibo2008@163.com
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Contact:
- Yangyang Lei, MD
- Phone Number: +861066947180
- Email: 942056176@qq.com
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Principal Investigator:
- Bo Cai, MD
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Sub-Investigator:
- Yangyang Lei, MD
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Sub-Investigator:
- Changlin Yu, MD
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Sub-Investigator:
- Xiao Lou, MD
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age >=15 years, male or female, non-limited by race or ethnicity.
- Confirmed diagnosis of R/R leukemia and risk stratification according to the World Health Organization (WHO) 5th edition classification, based on histopathology and cytogenetics.
- Adequate hepatic function including alanine transaminase (ALT) and aspartate aminotransferase (AST )<= 3 × upper limit of normal(ULN), and total bilirubin <= 1.5 × ULN.
- Adequate renal function including serum creatinine <= 2 × ULN or CrCl>= 40mL/min.
- LVEF measured by echocardiogram is within the normal range (LVEF > 50%).
- The subject must have one HLA mismatched donor who is >= 18 years old to provide GPBMCs for the first-step infusion. If this donor is not qualified as an allo-HSCT donor, the subject must also have another donor who is >= 18 years old and qualified as allo-HSCT donor (i.e., matched sibling, 9-10/10 loci matched unrelated, or haploidentical). In addition, the donor voluntarily donates hematopoietic stem cells and signs the consent form. Each subject (or his/her legal representatives) must sign the Informed Consent Form (ICF), indicating that he/she understands the purpose and procedures of research, and is willing to participate in research.
- Donor inclusion criteria: The donor meets the institution's criteria for related peripheral blood hematopoietic stem cell donors. The donor must be able to tolerate the cell separation and collection process, and sign the Informed Consent Form.
Exclusion Criteria:
- Uncontrolled infection or hemorrhage.
- Cardiovascular disease with clinical significance, such as uncontrolled or highly symptomatic cardiac arrhythmias, congestive heart failure, or myocardial infarction within 6 months prior to screening, or New York Heart Association (NYHA) function class 3 (moderate) or class 4 (severe) heart disease.
- Uncontrolled autoimmune disease or requiring immunosuppression treatment.
- History of severe blood infusion reaction.
- Nursing women, women of childbearing potential with positive urine pregnancy test, or women of childbearing potential who are not willing to maintain adequate contraception.
- Psychiatric disorder or cognitive impairment that in the researcher's judgment would make the subject not likely to adhere to the protocol requirements.
- Major surgery within 4 weeks prior to enrollment.
- Life-threatening illness other than leukemia or uncontrolled intercurrent illness.
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 |
|---|---|
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Experimental: Cohort 1
This cohort includes patients with relapsed and refractory leukemia.
Patients firstly receive chemotherapy per center standard, followed by HLA-mismatched GPBMC infusion.
Secondly, patients receive HLA-matched sibling/haploidentical/unrelated HSCT.
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Available chemotherapy regimens include but not limited to FLAG (fludarabine, cytarabine, G-CSF), DAV (daunorubicin, cytarabine, venetoclax), IAV (idarubicin, cytarabine, venetoclax), VDCP (vincristine, daunorubicin, cyclophosphamide, prednisone), hyper-CVAD A (cyclophosphamide, vincristine, doxorubicin, dexamethasone), FC (fludarabine and cyclophosphamide), et al.
HLA-mismatched GPBMCs are infused following chemotherapy.
Patients receive conditioning including but not limited to fludarabine, cyclophosphamide, antithymocyte globulin (ATG), and total body irradiation (TBI).
HLA-matched sibling/haploidentical/unrelated GPBMCs are infused at day 0. Post-transplant cyclophosphamide, tacrolimus/cyclosporin, and mycophenolate mofetil are administered as graft-versus-host disease prophylaxis.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Graft-Versus-Host Disease (GVHD)
Time Frame: Measured up to 2 years after the last participant is enrolled
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Including acute GVHD (aGVHD) and chronic GVHD (cGVHD), assessed per international universal criteria (e.g., Glucksberg classification).
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Measured up to 2 years after the last participant is enrolled
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Infections
Time Frame: Measured up to 2 years after the last participant is enrolled
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Covering bacterial, viral, fungal infections (e.g., pneumonia, sepsis, cytomegalovirus infection), confirmed based on clinical symptoms, laboratory tests, and etiological evidence.
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Measured up to 2 years after the last participant is enrolled
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Hematological Toxicity
Time Frame: Measured up to 2 years after the last participant is enrolled
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Including neutropenia, thrombocytopenia, anemia, etc., graded according to the Common Terminology Criteria for Adverse Events (CTCAE) standards.
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Measured up to 2 years after the last participant is enrolled
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Progression-Free Survival (PFS)
Time Frame: Measured up to 4 years after the last participant is enrolled
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Time from the completion of allo-HSCT to disease progression, relapse, or death from any cause.
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Measured up to 4 years after the last participant is enrolled
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Graft-Versus-Host Disease-Free, Relapse-Free Survival (GRFS)
Time Frame: Measured up to 4 years after the last participant is enrolled
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Time from the completion of allo-HSCT to the first occurrence of any of the following events: grade 3-4 acute GVHD, chronic GVHD requiring systemic treatment, disease relapse, or death.
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Measured up to 4 years after the last participant is enrolled
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Overall Survival (OS)
Time Frame: Measured up to 4 years after the last participant is enrolled
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Time from the completion of allo-HSCT to death from any cause.
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Measured up to 4 years after the last participant is enrolled
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Treatment-Related Mortality (TRM)
Time Frame: Measured up to 2 years after the last participant is enrolled
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TRM is defined as the death related to treatment instead of disease progression.
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Measured up to 2 years after the last participant is enrolled
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Bo Cai, MD, Department of Hematology, the Fifth Medical Center of Chinese PLA General Hospital
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
Other Study ID Numbers
Other Study ID Numbers
- Allo-GPBMC to Allo-HSCT
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
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