CD45RA Depleted DLI After TCRα/β Depleted Haploidentical HCT (CD45RADLIHaplo)

A Multi-center Phase I/II Trial of Memory T Cell Donor Lymphocyte Infusions After Transplantation of CliniMACS® TCRα/β and CD19 Depleted Stem Cell Grafts From Haploidentical Donors for Hematopoietic Cell Transplantation

The purpose of this clinical trial is to examine safety and toxicity of CD45RA depleted donor lymphocyte infusion (DLI) after transplantation of TCRα/β/CD19 depleted peripheral blood stem cells.

Study Overview

• Status: Recruiting
• Conditions: Hematologic Malignancy
• Intervention / Treatment: Biological: CD45RA depleted donor lymphocyte infusion (DLI)

Detailed Description

Patients will undergo routine reduced intensity conditioning regimen and intravenous infusion of T-cell receptor alpha/beta (TCRα/β)/CD19 depleted peripheral blood stem cells (not content of clinical trial).

If no graft-versus-host disease (GVHD) occurs, patients receive the trial-related memory T cell donor lymphocyte infusion (DLI) on Day 30 after transplantation.

In a dose finding part (phase I) escalating doses will be applied in cohorts of three (three plus three design) patients with a maximum of 18 patients for three dose levels (dose level 1-3). A fourth lower dose level (dose level 0) is started, if >=2 out of 6 patients with dose level 1 develop aGVHD III/IV. The maximum tolerated dose (MTD) will be used for the confirmatory part (phase II) of the study.

• Study Type: Interventional
• Enrollment (Estimated): 60
• Phase: Phase 2; Phase 1

Contacts and Locations

• Study Contact: Name: Wolfgang Bethge, MD, PhD; Phone Number: +49 7071 29-83176; Email: wolfgang.bethge@med.uni-tuebingen.de
• Study Contact Backup: Name: Peter Lang, MD, PhD; Phone Number: +49 7071 29-81386; Email: peter.lang@med.uni-tuebingen.de

Study Locations

• Germany
  • Tuebingen, Germany, 72076
    • Recruiting
    • University Children's Hospital University Clinic Tuebingen
    • Contact: Peter Lang, MD, PhD; Phone Number: +49 7071 29-81386; Email: peter.lang@med.uni-tuebingen.de
    • Contact: Michaela Döring, MD, PhD; Phone Number: +49 7071 29-81386; Email: michaela.doering@med.uni-tuebingen.de
  • Tuebingen,, Germany, 72076
    • Recruiting
    • University Hospital Tuebingen, Department of Hematology, Oncology, Immunology and Rheumatology
    • Contact: Wolfgang Bethge, MD, PhD; Phone Number: +49 (0) 7071 29-83176; Email: wolfgang.bethge@med.uni-tuebingen.de
    • Contact: Christoph Faul, MD, PhD; Phone Number: +49 (0) 7071 29-84087; Email: christoph.faul@med.uni-tuebingen.de

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

Adult and pediatric patients with hematological malignancies in complete remission (CR), partial remission (PR) or with stable disease

• Acute myeloid leukemia (AML):

  • Patients with high-risk AML in first complete remission (CR1)
  • Patients with relapsed or primary therapy-refractory AML

• Acute lymphoid leukemia (ALL):

  • Patients with high-risk ALL in CR1
  • Patients with relapsed or primary refractory ALL
• Hodgkin's disease: Patients with relapsed or primary refractory Hodgkin's disease
• Non-Hodgkin's lymphoma: Patients with relapsed or primary refractory Non- Hodgkin's lymphoma

• Myelodysplastic Syndrome (MDS)/ Myeloproliferative Syndrome (MPS):

  °Patients with refractory MDS/MPS

• Multiple myeloma (MM): Patients with relapsed or refractory multiple myeloma

Exclusion Criteria:

• Age >65 years or <8 weeks
• Patients with progressive disease prior hematopoietic cell transplantation (HCT)
• <3 months after preceding HCT
• Treatment with T-cell or Interleukin-2 (IL-2) targeted medication (e.g. alemtuzumab, basiliximab) within 60 days prior to study product infusion
• Treatment with prednisolone at >2 mg/kg/day (or equivalent dosing of alternative glucocorticosteroids) at time of study product infusion.
• Known allergy/hypersensitivity to any component of the study product
• Treatment with another investigational drug within one month before inclusion
• History of neurological impairment (active seizures, severe peripheral neuropathy, signs of leukoencephalopathy, active Central Nervous System (CNS) infection) Note: For patients with heavy pretreatment with irradiation or intrathecal chemotherapy pre-transplant CNS MRI and neurological consultation are mandatory.
• Fungal infections with radiological and clinical progression
• Liver function abnormalities with bilirubin >2 mg/dL and elevation of transaminases higher than 400 U/L
• Chronic active viral hepatitis
• Ejection fraction <40% or Shortening fraction <20% on echocardiography. Patients with > grade II hypertension by Common Toxicity Criteria (CTC)
• Creatinine clearance below threshold defined for stem cell transplantation according to local clinical standard
• Respiratory failure necessitating supplemental oxygen
• HIV infection
• Female patients who are pregnant or breast feeding, or adults of reproductive potential not willing to use an effective method of birth control during study treatment and for at least 12 months thereafter Note: Women of childbearing potential must have a negative serum pregnancy test at study entry.
• Concurrent severe or uncontrolled medical disease (e.g. uncontrolled diabetes, congestive heart failure, myocardial infarction within 6 months prior to the study, unstable and uncontrolled hypertension, chronic renal disease, or active uncontrolled infection) which by assessment of the treating physician could compromise participation in the study
• Patients with a history of psychiatric illness or a condition which could interfere with their ability to understand the requirements of the study (this includes alcoholism/drug addiction)
• Patients unwilling or unable to comply with the protocol or unable to give informed consent

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

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Single-arm; Donor lymphocytes from allogeneic donors depleted of CD45RA lymphocytes.	Biological: CD45RA depleted donor lymphocyte infusion (DLI); CD45RA depleted donor lymphocyte infusion (DLI) after TCRα/β depleted haploidentical HCT

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Phase I, dose escalation	Safety and toxicity of CD45RA depleted DLI as defined by infusional toxicities and acute GVHD grad III-IV.	100 days
Phase II, extension phase	Acute graft-versus-host disease grade III-IV defined as GVHD occurring within 100 days after HCT	100 days

Collaborators and Investigators

• Sponsor: University Hospital Tuebingen

Study record dates

Study Major Dates

• Study Start (Actual): April 27, 2023
• Primary Completion (Estimated): January 1, 2028
• Study Completion (Estimated): December 1, 2028

Study Registration Dates

• First Submitted: July 4, 2023
• First Submitted That Met QC Criteria: July 4, 2023
• First Posted (Actual): July 13, 2023

Study Record Updates

• Last Update Posted (Actual): April 27, 2025
• Last Update Submitted That Met QC Criteria: April 23, 2025
• Last Verified: April 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neoplasms by Site; Neoplasms; Hematologic Diseases; Hematologic Neoplasms
• Other Study ID Numbers: CD45RADLIHaplo

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No