COVID-19関連の急性呼吸窮迫症候群の治療のための臍帯血由来間葉系幹細胞
急性呼吸窮迫症候群の治療のための臍帯血由来間葉系幹細胞の研究
This is a phase I trial followed by a phase II randomized trial. The purpose of phase I study is the feasibility of treating patients with acute respiratory distress syndrome (ARDS) related to COVID-19 infection (COVID-19) with cord blood-derived mesenchymal stem cells (MSC). The purpose of the phase II trial is to compare the effect of MSC with standard of care in these patients. MSCs are a type of stem cells that can be taken from umbilical cord blood and grown into many different cell types that can be used to treat cancer and other diseases. The MSCs being used for infusion in this trial are collected from healthy, unrelated donors and are stored and grown in a laboratory. Giving MSC infusions may help control the symptoms of COVID-19 related ARDS.
調査の概要
状態
詳細な説明
PRIMARY OBJECTIVE:
1. To assess the safety of administering cord blood derived mesenchymal stem cell (CB-MSC) infusions for treatment of moderate, severe or critical pneumonia.
SECONDARY OBJECTIVES:
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In the group of participants who present intubated on ventilator support, assess the proportion that are able to be successfully extubated.
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In the group of participants who present requiring supplemental oxygen but otherwise breathing without assistance, assess the rate of progression to intubation.
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Estimate the survival rate at day 30 post treatment separately by group.
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Determine the treatment effect on clinical parameters, oxygenation and respiratory parameters:
- Resolution of fever
- Changes in oxygen demand (increased oxygen saturation at similar FiO2 or decreased FiO2 requirement)
- Progression to mechanical ventilation
- Length of Mechanical ventilation
- Decrease in PEEP in intubated participants
- Decrease in FiO2 in intubated participants
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Determine the treatment effect on laboratory markers:
- Complete blood count
- CRP
- Ferritin
- D Dimer
- Procalcitonin
- Cytokine levels
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Estimate hospitalization and ICU stay.
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Report on study related adverse events.
OUTLINE:
Currently not shipping cells outside of MD Anderson Cancer Center in Houston.
PILOT STUDY: Patients receive MSCs intravenously (IV) over 1-2 hours on day 1. participants may receive a second infusion of MSCs within 7 days after the first infusion per physician discretion.
PHASE II STUDY: Patients are randomized to 1 of 2 arms.
ARM I: Patients receive MSCs IV over 1-2 hours on day 1. Patients may receive a second infusion of MSCs within 7 days after the first infusion per physician discretion.
ARM II: Patients receive standard of care.
After completion of study treatment, patients are followed up at days 7, 14, 30, 60, and months 6 and 12.
研究の種類
入学 (推定)
段階
- フェーズ2
- フェーズ 1
連絡先と場所
研究場所
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Texas
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Houston、Texas、アメリカ、77030
- M D Anderson Cancer Center
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-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Age greater than or equal 18 years.
- Participants with chest x-ray findings concerning for pneumonia from any cause, with clinical signs suggestive of at least moderate illness such as respiratory rate >20 breaths per minute or with oxygen saturation less than 93% on room air**
- Participants with COVID-19 associated pneumonia must meet baseline categorization of Moderate, Severe or Critical COVID-19 per FDA Guidance for Industry COVID-19: Developing Drugs and Biologics Products for Treatment or Prevention, February 2021.
- Negative pregnancy test in a woman with childbearing potential defined as not post-menopausal for 12 months or no previous surgical sterilization.
- Participant or legally authorized representative consent. Participants with diminished mental capacity may be allowed on to enroll on the study.
- Because of the nature of COVID-19, participants enrolled on this study with COVID-19 associated pneumonia may have been previously enrolled in other IND trials for their cancer diagnosis or for COVID-19. These enrollments will not exclude them from enrollment to this study.
Exclusion Criteria:
- Moribund participants not expected to survive up to 48 hours
- Participants with severe chronic liver disease (Childs-Pugh score > 10)
- Pregnant and/or lactating women
- Participants on extracorporeal membrane oxygenation
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:Phase II Arm I (mesenchymal stem cells)
Patients receive MSCs as in the Pilot study. |
Given IV
他の名前:
|
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アクティブコンパレータ:Phase II Arm II (standard of care)
Patients receive standard of care. |
Receive standard of care
他の名前:
|
|
実験的:Pilot study (mesenchymal stem cells)
Patients receive MSCs IV over 1-2 hours on day 1. Patients may receive a second infusion of MSCs within 7 days after the first infusion per physician discretion. |
Given IV
他の名前:
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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グレード3、4の注入毒性なしで生存している患者(フェーズII)
時間枠:MSC注入後30日目
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MSC注入後30日目
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-グレード3または4の注入毒性で生存している患者(フェーズII)
時間枠:MSC注入後30日目
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MSC注入後30日目
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生存していない患者 (フェーズ II)
時間枠:MSC注入後30日目
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MSC注入後30日目
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Incidence of composite serious adverse events (Phase I)
時間枠:Within 30 days of the first mesenchymal stem cell (MSC) infusion
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Serious adverse events with be comprised of grade 3 or 4 graft versus host disease or death and will be estimated and reported overall and by group, along with 95% confidence intervals. |
Within 30 days of the first mesenchymal stem cell (MSC) infusion
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
入院(フェーズⅠ)
時間枠:MSC注入後30日目まで
|
MSC注入後30日目まで
|
|
|
集中治療室滞在(フェーズⅠ)
時間枠:MSC注入後30日目まで
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MSC注入後30日目まで
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Proportion of successfully extubated patients who present intubated on ventilator support (Phase I)
時間枠:Up to day 30 post MSC infusion
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Will be estimated and reported with 95% confidence intervals. |
Up to day 30 post MSC infusion
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Rate of successful progression to intubation in patients who require supplemental oxygen but who are otherwise able to breathe without assistance (Phase I)
時間枠:Up to day 30 post MSC infusion
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Will be estimated and reported with 95% confidence intervals. |
Up to day 30 post MSC infusion
|
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Overall survival rate (Phase I)
時間枠:At day 30 post MSC infusion
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Will be estimated and reported with 95% confidence intervals. |
At day 30 post MSC infusion
|
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Survival rate in patients who present intubated on ventilator support (Phase I)
時間枠:At day 30 post MSC infusion
|
Will be estimated and reported with 95% confidence intervals. |
At day 30 post MSC infusion
|
|
Survival rate in patients who require supplemental oxygen but who are otherwise able to breathe without assistance (Phase I)
時間枠:At day 30 post MSC infusion
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Will be estimated and reported with 95% confidence intervals. |
At day 30 post MSC infusion
|
|
Clinical parameters (Phase I)
時間枠:Up to day 30 post MSC infusion
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The effect of MSCs on clinical parameters will be assessed. Continuous clinical parameters will be summarized by means, medians, standard deviations, ranges, and quartiles. Categorical parameters will be summarized by frequency tables. |
Up to day 30 post MSC infusion
|
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Oxygenation parameters (Phase I)
時間枠:Up to day 30 post MSC infusion
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The effect of MSCs on oxygenation parameters will be assessed. Continuous oxygenation parameters will be summarized by means, medians, standard deviations, ranges, and quartiles. Categorical parameters will be summarized by frequency tables. |
Up to day 30 post MSC infusion
|
|
Respiratory parameters (Phase I)
時間枠:Up to day 30 post MSC infusion
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The effect of MSCs on respiratory parameters will be assessed. Continuous respiratory parameters will be summarized by means, medians, standard deviations, ranges, and quartiles. Categorical parameters will be summarized by frequency tables. |
Up to day 30 post MSC infusion
|
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Laboratory markers (Phase I)
時間枠:Up to day 30 post MSC infusion
|
The effect of MSCs on laboratory markers will be assessed. Continuous laboratory parameters will be summarized by means, medians, standard deviations, ranges, and quartiles. Categorical parameters will be summarized by frequency tables. |
Up to day 30 post MSC infusion
|
|
Incidence of infusion-related adverse events (Phase I)
時間枠:Up to day 30 post MSC infusion
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All grades of infusion-related adverse events will be summarized by grade and type. |
Up to day 30 post MSC infusion
|
協力者と研究者
捜査官
- 主任研究者:Amanda Olson、M.D. Anderson Cancer Center
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- 2020-0365
- 2020-0365 (その他の識別子:M D Anderson Cancer Center)
- NCI-2020-06741 (レジストリ識別子:CTRP (Clinical Trial Reporting Program))
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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