- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03587272
Minimizing Toxicity in HLA-identical Related Donor Transplantation for Children With Sickle Cell Disease (SUN)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Robert Nickel, MD
- Phone Number: 202-476-5000
- Email: RNickel@childrensnational.org
Study Contact Backup
- Name: Fahmida Hoq, MBBS
- Phone Number: 202-476-5000
- Email: FHoq@childrensnational.org
Study Locations
-
-
Alberta
-
Calgary, Alberta, Canada, T3B 6A8
- Recruiting
- Alberta Children's Hospital
-
Contact:
- Gregory Guilcher
-
Contact:
- Phone Number: 1-403-955-7272
- Email: Greg.Guilcher@AHS.ca
-
Principal Investigator:
- Gregory Guilcher, MD
-
-
Ontario
-
Toronto, Ontario, Canada, M5G 1X8
- Recruiting
- The Hospital for Sick Children
-
Contact:
- Brandon Rothberg
-
Contact:
- Phone Number: 202042 416-813-7654
- Email: brandon.rothberg@sickkids.ca
-
Principal Investigator:
- KY Chiang, MD
-
-
-
-
District of Columbia
-
Washington, District of Columbia, United States, 20010
- Recruiting
- Children's National Health System
-
Contact:
- Fahmida Hoq, MBBS, MS
- Phone Number: 202-476-3634
- Email: fhoq@childrensnational.org
-
Contact:
- Mariam Odinakachukwu
- Phone Number: 202-476-2957
- Email: mailto:modinakach@childrensnational.org
-
-
Illinois
-
Chicago, Illinois, United States, 60611
- Recruiting
- Ann & Robert H. Lurie Children's Hospital of Chicago
-
Contact:
- Olga Jonas
- Phone Number: 312-227-4871
- Email: ojonas@luriechildrens.org
-
Contact:
- Ella Ramsey
- Email: dramsey@luriechildrens.org
-
Principal Investigator:
- Sonali Chaudhury, MD
-
-
North Carolina
-
Charlotte, North Carolina, United States, 28203
- Recruiting
- Levine Children's Hospital
-
Contact:
- Janice Hollifield
- Phone Number: 980-442-2342
- Email: Janice.hollifield@atriumhealth.org
-
Principal Investigator:
- Michael Kent, MD
-
-
Ohio
-
Columbus, Ohio, United States, 43205
- Recruiting
- Nationwide Children's Hospital
-
Contact:
- Hemalatha Rangarajan
- Phone Number: 614-355-1689
- Email: Hemalatha.Rangarajan@nationwidechildrens.org
-
Principal Investigator:
- Hemalatha Rangarajan, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion criteria:
Patients with genotypes hemoglobin SS and Sβ0 thalassemia must have at least one of the following:
- History of an abnormal transcranial Doppler measurement defined as TCD velocity ≥200 cm/sec by the non-imaging technique (or ≥185 cm/sec by the imaging technique) measured at a minimum of two separate occasions.
- History of cerebral infarction on brain MRI (overt stroke, or silent stroke if ≥3 mm in one dimension, visible in two planes on fluid-attenuated inversion recovery T2-weighted images).
- History of two or more episodes of acute chest syndrome (ACS) in lifetime.
- History of three or more SCD pain events requiring treatment with an opiate or IV pain medication (inpatient or outpatient) in lifetime.
- History of any hospitalization for SCD pain or ACS while receiving hydroxyurea treatment.
- History of two or more episodes of priapism (erection lasting ≥4 hours or requiring emergent medical care).
- Administration of regular RBC transfusions (≥8 transfusions in the previous 12 months).
- At least two episodes of splenic sequestration requiring red blood cell transfusion or splenectomy after at least one episode of splenic sequestration.
Patients with all other sickle genotypes (hemoglobin SC, Sβ+ thalassemia) must have at least one of the following:
- Clinically significant neurologic event (overt stroke).
- History of two or more episodes of ACS in the 2-years period preceding enrollment.
- History of three or more SCD pain events requiring treatment with an opiate or IV pain medication (inpatient or outpatient) in the 1-year period preceding enrollment.
- History of any hospitalization for SCD pain or ACS while receiving hydroxyurea treatment.
- History of two or more episodes of priapism (erection lasting ≥4 hours or requiring emergent medical care).
- Administration of regular RBC transfusions (≥8 transfusions in the previous 12 months).
- At least two episodes of splenic sequestration requiring red blood cell transfusion or splenectomy after at least one episode of splenic sequestration.
Exclusion Criteria:
- • General: Life expectancy less than 6 months. Pregnant or breastfeeding patients.
- Infection Disease: Uncontrolled bacterial, viral or fungal infections (undergoing appropriate treatment and with progression of clinical symptoms) within 1 month prior to conditioning. Patients with febrile illness or suspected minor infection should await clinical resolution prior to starting conditioning. Patients with confirmed seropositivity for HIV and patients with active Hepatitis B or C determined by serology and/or NAAT are excluded.
- Liver: Direct (conjugated) bilirubin > 1.5 mg/dL, transaminases >5x upper limit of normal for age.
- Cardiac: Left ventricular shortening fraction <25% or ejection fraction <50% by ECHO.
- Kidney: Estimated creatinine clearance less than 60 mL/min/1.73m2.
- Pulmonary function: Diffusion capacity of carbon monoxide (DLCO) <35% (adjusted for hemoglobin). Baseline oxygen saturation <85% or PaO2 <70.
- Heme: History of RBC alloantibodies against donor RBC antigens (even if current antibody screen is negative). Major ABO incompatibility with donor.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: SUN regimen
Alemtuzumab, low dose total body irradiation, Sirolimus HLA-identical sibling donor transplantation using alemtuzumab, low dose total-body irradiation, and sirolimus (Sickle transplant Using a Nonmyeloablative approach, "SUN") can decrease the toxicity of transplant while achieving a high cure rate for children with sickle cell disease (SCD). |
The conditioning regimen (SUN regimen) will consist of alemtuzumab daily for 5 days (0.03mg/kg on Day -7, 0.1mg/kg on Day -6, 0.3mg/kg on Days -5 to -3) and low dose total body irradiation (TBI) 300 cGY on Day -2 with gonadal shielding if possible. The HSCT graft will be G-CSF mobilized PBSCs with minimum CD34+ of 5 x106/kg recipient weight, goal of 10 x 106/kg (no upper limit). A peripheral blood stem cell (PBSC) graft was selected as it engrafts faster than bone marrow and would lead to shorter period of neutropenia and infection and less thrombocytopenia and need for platelet transfusion. GVHD prophylaxis will be sirolimus with a loading dose 3 mg/m2 on day -1. Sirolimus will be continued at 1 mg/m2/day starting on day 0 and dose adjusted to maintain a target trough level 5-15 ng/mL for the first 3 months and 5-10 ng/mL for the remainder of the first year. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Acute GVHD
Time Frame: 100 days post transplant
|
Acute grade II-IV GVHD
|
100 days post transplant
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
PedsQL 4.0 Measurement model for the Pediatric Quality of Life Inventory
Time Frame: Day +30, and day +100 post transplant
|
PedsQL 4.0 assessments of health related quality of life before/after transplant
|
Day +30, and day +100 post transplant
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Patient-Reported Outcomes Measurement Information System (PROMIS)
Time Frame: Day +30, and day +100 post transplant
|
PROMIS assessments of health related quality of life before/after transplant
|
Day +30, and day +100 post transplant
|
Platelet transfusion
Time Frame: 100 days post transplant
|
Number of platelet transfusions
|
100 days post transplant
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Rober Nickel, MD, Children's National Health System
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
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
- Hematologic Diseases
- Genetic Diseases, Inborn
- Anemia
- Anemia, Hemolytic, Congenital
- Anemia, Hemolytic
- Hemoglobinopathies
- Anemia, Sickle Cell
- Physiological Effects of Drugs
- Anti-Infective Agents
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Antineoplastic Agents, Immunological
- Anti-Bacterial Agents
- Antibiotics, Antineoplastic
- Antifungal Agents
- Sirolimus
- Alemtuzumab
Other Study ID Numbers
- IRB 10322
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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