- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00033475
Reduced Immunosuppressive Therapy With or Without Donor White Blood Cells in Treating Patients With Lymphoproliferative Disease After Organ Transplantation
Cytotoxic T Cell Therapy for Post Transplant Lymphoproliferative Disease: Randomized Controlled Trial in Transplant Recipients
RATIONALE: Some types of lymphoproliferative disease are associated with Epstein-Barr virus. Combining reduced immunosuppressive therapy with donor white blood cells that have been treated in the laboratory to kill cells infected with Epstein-Barr virus may be an effective treatment for lymphoproliferative disease.
PURPOSE: Randomized phase III trial to compare the effectiveness of reducing immunosuppressive therapy with or without donor white blood cells in treating patients who have Epstein-Barr virus-associated lymphoproliferative disease after organ transplantation.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
OBJECTIVES:
- Determine the efficacy of treatment with partially HLA-matched allogeneic cytotoxic T cells and reduction of immunosuppression, in terms of survival rate and time to remission in patients with Epstein-Barr virus-associated B-cell lymphoproliferative disease after solid organ transplantation.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to transplanted organ type and transplant center. Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients undergo sliding-scale reduction of immunosuppressive drugs from 1 of 5 regimens at physician's discretion. Patients then receive partially HLA-matched allogeneic cytotoxic T cells IV over 5 minutes once weekly for a total of 4 weeks.
- Arm II: Patients undergo reduction of immunosuppression as in arm I alone. Patients are followed monthly for 6 months and then every 3 months for 2 years.
PROJECTED ACCRUAL: A total of 50 patients will be accrued for this study.
Study Type
Enrollment (Estimated)
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
England
-
Birmingham, England, United Kingdom, B4 6NH
- Birmingham Children's Hospital
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Cambridge, England, United Kingdom, CB3 8RE
- Papworth Hospital
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London, England, United Kingdom, SE5 8RX
- King's College Hospital
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London, England, United Kingdom, NW3 2PF
- Royal Free and University College Medical School
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Manchester, England, United Kingdom, M23 9LJ
- Wythenshawe Hospital
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Manchester, England, United Kingdom, M27 4HA
- Central Manchester and Manchester Children's University Hospitals NHS Trust
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Sheffield, England, United Kingdom, S5 7AU
- Northern General Hospital
-
Sutton, England, United Kingdom, SM2 5NG
- Institute of Cancer Research - UK
-
-
Scotland
-
Edinburgh, Scotland, United Kingdom, EH16 4SA
- Royal Infirmary of Edinburgh at Little France
-
Edinburgh, Scotland, United Kingdom, EH8 1QH
- University of Edinburgh
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Edinburgh, Scotland, United Kingdom, EH9 1QH
- University of Edinburgh Laboratory for Clinical and Molecular Virology
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Glasgow, Scotland, United Kingdom, G4 0SF
- Royal Infirmary - Castle
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
DISEASE CHARACTERISTICS:
Diagnosis of post-transplant lymphoproliferative disease (PTLD) after solid organ (heart, heart/lung, liver, liver/gut, pancreas, or kidney) transplantation
- Epstein-Barr virus-positive tumor
- Newly diagnosed disease
- Measurable disease by clinical methods or radiography
- Must have partially matched donor cytotoxic T cells (CTL) available
- No known panel reactivity to any of the HLA types of CTL available for therapy
PATIENT CHARACTERISTICS:
Age:
- Any age
Performance status:
- Karnofsky 20-100%
Life expectancy:
- Not specified
Hematopoietic:
- Not specified
Hepatic:
- Not specified
Renal:
- Not specified
Other:
- Not pregnant
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- Not specified
Chemotherapy:
- Not specified
Endocrine therapy:
- Not specified
Radiotherapy:
- Not specified
Surgery:
- Not specified
Other:
- No prior therapy for PTLD
- No concurrent antiviral drugs (e.g., acyclovir or ganciclovir) for PTLD
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
|---|
|
Stable disease
|
|
Complete response
|
|
Survival at 2 years
|
|
Partial response
|
|
Progressive disease
|
|
Time to complete remission
|
Collaborators and Investigators
Sponsor
Investigators
- Study Chair: Dorothy H. Crawford, MD, University of Edinburgh
Study record dates
Study Major Dates
Study Start (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimated)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CDR0000069288
- CRUK-EBV-CTL
- LCMV-CTL
- EU-20057
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