Co-infusion of Treg-enriched Donor Lymphocytes With CD3-depleted Hematopoietic Stem Cell Graft to Prevent Graft-versus Host Disease After Allogeneic Hematopoietic Stem Cell Transplantation Among Children With Hematologic Malignancies
Pilot Study of Co-Infusion of Donor Lymphocytes Enriched With Regulatory T Lymphocytes With Ex-vivo CD3-Depleted Hematopoietic Stem Cell Graft for the Prevention of Graft-versus-Host Disease in Children With Hematopoietic and Lymphoid Tissue Neoplasms
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
- Infusion of ex-vivo T-depleted peripheral blood hematopoietic stem cells (CD3 depletion product)
- Infusion of donor lymphocytes enriched with T regulatory lymphocytes (CD25 selective product)
Drug therapy (pharmacological prophylaxis of GVHD)
- Cyclosporine A
- Sirolimus o Ruxolitinib o Abatacept
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Michael Maschan, Prof
- Phone Number: +79166512145
- Email: mmaschan@yandex.ru
Study Locations
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Moscow, Russia
- Recruiting
- National medical research center of pediatric haematology, oncology and immulogy named after Dmytriy Rogachyov, Moscow, 117198
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Contact:
- Lena Smirnova
- Phone Number: +7(985)130-61-03
- Email: lena.smirnova@dgoi.ru
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Informed consent signed by the patient (age 14 to 25 years) and/or his/her legal representative (age 0 to 18 years).
- The patient has an indication for allogeneic hematopoietic stem cell transplantation (HSCT) established in accordance with the current regulatory framework
- Planned HSCT from a haploidentical donor
- The Karnofsky or Lansky score is more than 70%
- Life expectancy of at least 8 weeks
- Heart function: ejection fraction of at least 40%
- Consent to continue follow-up for 3 years
Exclusion Criteria:
- Acute viral hepatitis or acute HIV infection
- Hypoxemia with SaO2 <90%
- Bilirubin >3 normal
- Creatinine >3 norms
- Pregnancy and lactation
- Life-threatening infection
- Severe (>?) pathology of the central nervous system (epilepsy, dementia, organic damage to the central nervous system)
- Karnofsky score or Lansky score <70%
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Sequential Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Active Comparator: Cyclosporine A
Four groups corresponding to the pharmacological prophylaxis of GVHD: 1) Cyclosporine A
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The combination of partial T depletion and pharmacological immunosuppression minimized in volume and duration will combine the advantages of T depletion (early engraftment, low risk of GVHD, low risk of organ complications) and pharmacological prophylaxis (restoration of anti-infective immunity).
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Active Comparator: Sirolimus
Drug therapy (pharmacological prophylaxis of GVHD) 2) Sirolimus
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Pharmacological prophylaxis of GVHD is one of the key subjects of evaluation in the current study.
Since the optimal pharmacological approach is not known, the allocation of the patients to study groups will be by randomization procedure, although not for the purpose of direct comparison, but for unbiased descriptive analysis.
There will be four main groups and an additional group to be open for allocation based on the main group closing for fitting the stopping rules.
The details of pharmacological GVHD prevention are Sirolimus 1 mg -3 till +30 4-8 ng/ml
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Active Comparator: Ruxolitinib
Drug therapy (pharmacological prophylaxis of GVHD) Ruxolitinib
|
Pharmacological prophylaxis of GVHD is one of the key subjects of evaluation in the current study.
Since the optimal pharmacological approach is not known, the allocation of the patients to study groups will be by randomization procedure, although not for the purpose of direct comparison, but for unbiased descriptive analysis.
There will be four main groups and an additional group to be open for allocation based on the main group closing for fitting the stopping rules.
The details of pharmacological GVHD prevention regimens are Ruxolitinib 5 mg -2 till +30
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Active Comparator: Abatacept
Drug therapy (pharmacological prophylaxis of GVHD) Abatacept
|
Pharmacological prophylaxis of GVHD is one of the key subjects of evaluation in the current study.
Since the optimal pharmacological approach is not known, the allocation of the patients to study groups will be by randomization procedure, although not for the purpose of direct comparison, but for unbiased descriptive analysis.
There will be four main groups and an additional group to be open for allocation based on the main group closing for fitting the stopping rules.
Abatacept 10 mg/kg -1, +7, +14, +28
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Feasibility- Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Time Frame: day 30
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proportion of patients who received an infusion of the planned dose of regulatory T lymphocytes (at least 80%)
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day 30
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Safety- Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Time Frame: 120 days after HSCT
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Cumulative risk of GVHD Grade III-IV (target < 5%)
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120 days after HSCT
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Cumulative probability of engraftment
Time Frame: up to 100 day
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up to 100 day
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Time to engraftment of neutrophils and platelets
Time Frame: 100 day after HSCT
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100 day after HSCT
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Cumulative risk of acute GVHD Grade II-IV
Time Frame: up to 100 days after HSCT
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up to 100 days after HSCT
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Cumulative risk of viral
Time Frame: at 120 day after HSCT
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(CMV, ADV, EBV, HHV-6) DNA detection in blood, peak viral DNA load and the duration of detectable viral DNA (each virus separately)
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at 120 day after HSCT
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cumulative risk of developing severe chronic GVHD
Time Frame: at 2 years
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Severity of chronic GVHD
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at 2 years
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Cumulative risk of leukemia relapse
Time Frame: at 2 years
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at 2 years
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Cumulative risk of non-relapse mortality
Time Frame: at 100 days and 2 years
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at 100 days and 2 years
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Overall survival
Time Frame: at 3 years
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at 3 years
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Event-free survival
Time Frame: at 3 years
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at 3 years
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GVHD- and relapse-free survival
Time Frame: at 3 years
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at 3 years
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Collaborators and Investigators
Sponsor
Sponsor
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
Keywords
Additional Relevant MeSH Terms
- Pathologic Processes
- Neoplasms
- Disease Attributes
- Immune System Diseases
- Neoplasms by Histologic Type
- Hematologic Diseases
- Lymphatic Diseases
- Lymphoproliferative Disorders
- Immunoproliferative Disorders
- Leukemia, Myeloid
- Leukemia, Lymphoid
- Leukemia
- Pathological Conditions, Signs and Symptoms
- Hemic and Lymphatic Diseases
- Recurrence
- Leukemia, Myeloid, Acute
- Precursor Cell Lymphoblastic Leukemia-Lymphoma
- Immunoconjugates
- Peptides
- Amino Acids, Peptides, and Proteins
- Proteins
- Organic Chemicals
- Polycyclic Compounds
- Antibodies
- Immunoglobulins
- Blood Proteins
- Serum Globulins
- Globulins
- Macrolides
- Lactones
- Macrocyclic Compounds
- Peptides, Cyclic
- Cyclosporins
- Abatacept
- Sirolimus
- Cyclosporine
- ruxolitinib
Other Study ID Numbers
Other Study ID Numbers
- NCHPOI- 2025-14
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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