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Pilot Study: Effects of G-CSF on T Cell Function

Pilot Study of the Effects of G-CSF on T Cell Function

This study will evaluate changes in T cells-infection-fighting white blood cells of the immune system-in people given a drug called G-CSF before donating stem cells (immature bone marrow cells) for transplantation. Originally, bone marrow cells were obtained using a needle inserted into the hipbone of the donor. However, when it was discovered that immature bone marrow cells also circulate in the blood, scientists began to develop techniques to collect quantities of these cells from the blood instead of the bone. G-CSF is a blood cell growth factor that pushes stem cells from the bone marrow into the bloodstream. Stem cell donors are given this drug 5 to 6 days before donation to make more cells available in the circulating blood for collection.

Stem cell transplantation requires careful regulation of immune cell function to allow the donated stem cells to grow in the transplant recipient, to prevent the transplanted cells from damaging the recipient, and to allow the recipient's new immune system to develop normally so it can fight infections. Studies comparing the outcome of patients transplanted with bone marrow cells with those transplanted with stem cells suggest that the G-CSF given to stem cell donors affects the function of T cells in transplant recipients. This study will collect white cells containing T cells before and after G-CSF administration to determine the effects of the drug on both T cells and stem cells.

Healthy normal volunteers 18 years of age and older who meet the health criteria for donating blood may participate in this study. Pregnant and breastfeeding women are not eligible.

Participants will undergo the following procedures:

  • Blood sample collection (15 milliliters, or 3 teaspoons) to measure blood cell counts
  • Electrocardiogram to assess heart function
  • Apheresis to donate white blood cells. Participants will undergo two apheresis procedures-once before receiving G-CSF and a second time immediately after finishing the 5-day course of the drug. For this procedure, whole blood is removed using a needle placed in an arm vein. The blood is circulated through a cell separator machine, where the white cells are removed and collected in a plastic bag. The rest of the blood, including the red cells, platelets, and plasma, are returned to the donor through a needle in the other arm. The procedure takes 2 to 3 hours, during which time the donor lies quietly.

연구 개요

상태

완전한

정황

상세 설명

T cells play a critical role in hematopoietic stem cell transplantation. Many transplant protocols involving HLA matched sibling donors make use of T cell mediated graft-versus-leukemia or graft-versus-cancer effects to clear and/or prevent the recurrent growth of malignant cells. Donor T cells are also responsible for reconstituting cellular immune function following transplantation, but often cause graft-versus-host disease (GVHD). Over the past several years the major source of hematopoietic stem cells for transplantation has changed from marrow to granulocyte-colony stimulating factor (G-CSF)-mobilized peripheral blood stem cells (PBSCs). Despite the fact that patients transplanted with allogeneic G-CSF-mobilized PBSCs receive approximately 10-fold more T-cells than those transplanted with marrow, the incidence and severity of acute GVHD is similar among the two groups, although chronic GVHD is higher in PBSC recipients. Using cellular function assays some investigators have shown that G-CSF affects T cell function. When healthy subjects are given G-CSF, a decrease is seen in the concentration of circulating type 1 helper T cells (Th1) with subsequent falls in the cytokine levels produced by these cells. In contrast, an increase occurs in the concentration of type 2 helper T cells (TH2) and the level of cytokines produced. The purpose of this study is to assess G-CSF-induced changes in T cells. cDNA microarrays will be used to compare genes expressed in CD4 and CD8 cells before and after G-CSF is given. Up to fifteen healthy subjects will be given a typical PBSC mobilization regimen for allogeneic transplants: 10 micrograms/kg/day of G-CSF for 5 days. Peripheral blood mononuclear cells will be collected by apheresis before the mobilization regimen is given and the day after the mobilization is complete. CD4, CD8, and CD34+ cells will be isolated from the peripheral blood mononuclear cells and gene expression will be assessed using cDNA microarrays containing over 8,000 genes.

연구 유형

관찰

등록

15

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

    • Maryland
      • Bethesda, Maryland, 미국, 20892
        • Warren G. Magnuson Clinical Center (CC)

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

  • 어린이
  • 성인
  • 고령자

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연구 대상 성별

모두

설명

INCLUSION CRITERIA:

Both male and female subjects will be studied.

Subjects will be enrolled without regard to their ethnic group.

Only adults and children 18 years of age or older will be studied.

Subjects must weigh at least 110 pounds.

EXCLUSION CRITERIA:

Any subject that does not pass the health criteria for blood donors established by the American Association of Blood Banks will be excluded.

Subjects will be excluded if they have any of the following conditions: pregnancy, uncontrolled hypertension, heart disease, history of allergic reactions to G-CSF, history of allergic reactions to E. coli, abnormal hemoglobin or white blood cell counts, a malignancy, or asthma.

Subjects with family members with conditions that may require a transplant in the future will be excluded.

Subjects with an enlarged spleen by history or physical exam will be excluded.

Subjects with hemoglobin less than 12.5 or greater than 19.0 gm/dL, platelet counts less than 150 x 10(9)/L or greater than 500 x 10(9)/L and an absolute neutrophil count of less than 1.5 x 10(9)/L or greater than 10.0 x 10(9)/L will not be eligible.

Subjects with an abnormal EKG will be excluded from the study.

Pregnant and lactating women will be excluded.

If a subject's veins are judged to be too small to support the intravenous catheter required for the procedure, they will be excluded.

If at the time of each apheresis procedure the nurses are unable to obtain adequate antecubital vein access, the subject will be excluded.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

공동 작업자 및 조사자

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간행물 및 유용한 링크

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연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작

2002년 5월 1일

연구 완료

2004년 3월 1일

연구 등록 날짜

최초 제출

2002년 6월 6일

QC 기준을 충족하는 최초 제출

2002년 6월 6일

처음 게시됨 (추정)

2002년 6월 7일

연구 기록 업데이트

마지막 업데이트 게시됨 (추정)

2008년 3월 4일

QC 기준을 충족하는 마지막 업데이트 제출

2008년 3월 3일

마지막으로 확인됨

2004년 3월 1일

추가 정보

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

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