- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01326273
Autologous Cytomegalovirus (CMV) Specific CD8+ T Cells as Treatment for CMV Reactivation
Adoptive Transfer of Autologous CMV Specific CD8+ T Cells After Allogeneic Stem Cell Transplantationas Treatment for CMV Reactivation: A Phase I/II Clinical Trial.
Study Overview
Status
Conditions
Detailed Description
Allogeneic Hematopoietic Stem Cell transplantation (allo-SCT) remains the only curative approach for a number of patients with hematological malignancies. However, the use of allo-SCT can expose patients to prolonged periods of immunosupression during which time viral infections can be a significant cause of morbidity and mortality.
Human cytomegalovirus (CMV) infection and reactivation still represents one of the most important and lifethreatening complications in immunocompromised patients. Prophylaxis or early treatment with antiviral drugs after CMV reactivation have reduced the mortality related to this complication. However, the antiviral drugs have many side-effects and are costly. Furthermore, CMV infection refractory to antiviral treatment after alloSCT is associated with a high mortality. A number of studies have shown the efficacy of selecting Tcells against the virus from the donor and infusing them into the recipient (adoptive transfer of immunity) to prevent or treat CMV reactivation. However this approach relies on the donor having preexisitng immunity to CMV (50% of the healthy population is CMV seronegative and therefore have no preexisting immunity against CMV). We propose an alternative approach to collect CMV specific Tcells from the seropositive recipient prior to transplantation; the autologous CMV specific T cells will then be infused back into the recipient at the time of CMV reactivation post-transplant.
This approach is especially relevant where the donor is CMV seronegative or unavailable or following the use of cord blood transplant where there is no memory T cell response to CMV.
Study Type
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
-
-
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London, United Kingdom, W12 0HS
- Hammersmith Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients must have received an allogeneic stem cell transplant from any donor, as treatment for a haematological malignancy.
- HLAA0201 positive at one allele
- CMV seropositive
- The patient must be willing and capable of donating lymphocytes for CMVspecific CD8+ T cell selection using apheresis techniques
- The patient must be in complete remission with no evidence of circulating blasts or other malignant cells
- Patient must be fit to undergo leukapheresis
- Patients must have signed an informed consent form before undergoing LP prior to alloSCT
Indications for infusion of autologous CMV specific CD8+ Tcells:
- Therapeutic: CMV disease following allogeneic stem cell transplantation
- Preemptive: CMV reactivation (by CMV DNA PCR)
- autologous CMV specific CD8+ T-cells must be infused into the patient no later than 72 following CMV reactivation.
- Steroids should be withdrawn at least 1 week before the infusion of CMVspecific CD8+ T-cell
- Patients must have signed an informed consent form before the infusion of autologous CMV specific CD8+ T-cells
Exclusion Criteria:
- Patient CMV seronegative
- No informed consent
- Patient positive at the time of LP for one of the following infectious agents: HIV, HBV, HCV,Syphilis, HTLV 1 and 2
- Patient with circulating leukemic blasts at the time of LP
Exclusion criteria for infusion of autologous CMV specific CD8+ T cells:
Severe GvHD (grade IIII-V) requiring full dose immunosuppressive treatment
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Response to adoptive transfer of autologous CMV-specific CD8+ T-cells
Time Frame: Up to three years
|
Response to CMV-specific CD8+ T-cells administration will be measured and defined as a CMV DNA PCR< 50 copies.
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Up to three years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The occurrence of subsequent CMV reactivations
Time Frame: Up to three years
|
The occurrence of subsequent CMV reactivations.
|
Up to three years
|
Rate of complete response
Time Frame: Up to three years
|
The rate of complete response will be analyzed and compared to patients treated with anti-viral drugs only.
|
Up to three years
|
Rate of early complete response
Time Frame: Up to three years
|
The rate of early complete response will be analyzed and compared to patients treated with anti-viral drugs only.
|
Up to three years
|
Rate of subsequent CMV reactivation
Time Frame: Up to three years
|
The rate of subsequent CMV reactivation will be analyzed and compared to patients treated with anti-viral drugs only.
|
Up to three years
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Other Study ID Numbers
- JROHH0202
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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