- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT00274846
Donor Peripheral Stem Cell Transplant in Treating Patients With Relapsed Acute Myeloid Leukemia
Allogeneic Natural Killer Cells in Patients With Relapsed Acute Myelogenous Leukemia
RATIONALE: Giving chemotherapy before a donor peripheral blood stem cell transplant helps stop the growth of cancer cells. It also helps stop the patient's immune system from rejecting the donor's stem cells. When the healthy stem cells and natural killer (NK) cells from a donor are infused into the patient they may help the patient's bone marrow make stem cells, red blood cells, white blood cells, and platelets.
PURPOSE: This clinical trial is studying how well a peripheral stem cell transplant using NK cells from a donor works in treating patients with relapsed acute myeloid leukemia.
Studieoversikt
Status
Forhold
Detaljert beskrivelse
OBJECTIVES:
Primary
- Evaluate the in vivo expansion of natural killer (NK) cells 14 days after treatment with allogeneic NK cell-enriched peripheral blood stem cell transplantation in patients with relapsed acute myeloid leukemia.
Secondary
- Determine the response rate, in terms of complete remission, in patients treated with this regimen.
- Correlate complete remission rate with NK cell expansion, interleukin-15 levels, and donor/recipient killer immunoglobulin receptor (KIR) ligand matching status in patients treated with this regimen.
- Determine the overall and progression-free survival of patients treated with this regimen.
- Determine the toxicity of this regimen in these patients.
OUTLINE: This is an open-label study.
- Induction therapy: Patients receive fludarabine IV on days -6 to -2 and cyclophosphamide IV on day -5 or on days -5 and -4.
- Allogeneic natural killer (NK) cell-enriched peripheral blood stem cell transplantation: Patients receive allogeneic NK cell-enriched peripheral blood stem cells IV over 15-60 minutes on day 0. Patients also receive interleukin-2 subcutaneously beginning on day 0 and continuing 3 times a week for up to 2 weeks.
After completion of study treatment, patients are followed periodically for 3 months.
Studietype
Registrering (Faktiske)
Fase
- Fase 2
Kontakter og plasseringer
Studiesteder
-
-
Minnesota
-
Minneapolis, Minnesota, Forente stater, 55455
- Masonic Cancer Center
-
-
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria:
Diagnosis of acute myeloid leukemia (AML) meeting 1 of the following criteria:
- Primary refractory disease (no complete response [CR] after ≥ 2 induction therapies)
- Relapsed disease not in CR after ≥ 1 course of standard reinduction therapy
- Secondary AML from myelodysplastic syndromes
- Disease relapsed ≥ 2 months after transplant and no option of donor lymphocyte infusions (e.g., recipients of autologous or umbilical cord blood transplants)
- Chronic myelogenous leukemia with myeloid blast crisis not in second chronic phase after at least one cycle of standard chemotherapy and imatinib
- Over 60 years of age with relapse within 6 months after completion of last chemotherapy
- Over 60 years of age with blast count < 30% within 10 days before study entry
- Related HLA-haploidentical natural killer cell donor available
- No severe organ damage (by clinical or laboratory assessment)
- Performance status 50-100%
- No evidence of active infection on chest X-ray
- No active fungal infection
Exclusion Criteria:
- Active central nervous system (CNS) leukemia
- Pleural effusions large enough to be detectable by chest x-ray
- Pregnant or nursing (positive pregnancy test)
- Fertile patients must use effective contraception
- Less than 60 days since prior transplant
- Less than 3 days since prior prednisone
- Less than 3 days since other prior immunosuppressive medication
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: N/A
- Intervensjonsmodell: Enkeltgruppeoppdrag
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
---|---|
Eksperimentell: Intent-to-Treat
All patients treated with natural killer (NK) cells (at a dose of 1.5-8 x 10^7/kg.)
|
10 million units three times a week for a total of 6 doses.
For any subject less than 45 kilograms the IL-2 will be given at 5 million units per meter squared three times weekly for a total of 6 doses
Andre navn:
Cells infused per kg.
1.5-8.0
x 10^7/kg Total cells infused(for 70 kg.
adult) 1.05 - 5.6 x 10^9
Andre navn:
Days -5 and -4: 60 mg/kg
Andre navn:
Days -5 through -2: 25 mg/m^2
Andre navn:
Day 0 infuse natural killer cells
Andre navn:
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
Number of Patients With Natural Killer (NK) Cell Expansion
Tidsramme: Study Day 14
|
Evaluation of expansion of donor allogeneic natural killer (NK) cells at day 14 following infusion (>100 donor-derived NK cells per uL of patient blood detectable at day +14).
|
Study Day 14
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
---|---|---|
Number of Patients With Complete Remission
Tidsramme: Day 28-35
|
Clinical response is determined by achievement of a complete remission (CR) as judged by morphological criteria (< 1% blasts in bone marrow with neutrophil recovery).
|
Day 28-35
|
Median Time to Disease Relapse (Months)
Tidsramme: From 1st Day of treatment until death or receipt of bone marrow transplant.
|
Follow-up continued every 3 months after the allogeneic natural killer (NK) cell infusion, unless they were transplanted, relapsed or had progressive disease.
Time in months to relapse of disease is calculcated from 1st day of treatment with NK cells.
Relapse occurs when leukemia is detected in bone marrow or blood.
|
From 1st Day of treatment until death or receipt of bone marrow transplant.
|
Overall Survival Time of Patients With Complete Remission
Tidsramme: From Day 1 of Treatment until death or patient received bone marrow transplant.
|
Median number of months patients were alive after NK cell infusion.
|
From Day 1 of Treatment until death or patient received bone marrow transplant.
|
Number of Patients With Complete Remission and Natural Killer Cell Expansion
Tidsramme: Day 14
|
Includes patients who had both a complete remission of disease and an expansion of natural killer cells.
|
Day 14
|
Samarbeidspartnere og etterforskere
Etterforskere
- Studiestol: Jeffrey Miller, MD, Masonic Cancer Center, University of Minnesota
Publikasjoner og nyttige lenker
Studierekorddatoer
Studer hoveddatoer
Studiestart
Primær fullføring (Faktiske)
Studiet fullført (Faktiske)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Anslag)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
- akutt myeloid leukemi hos voksne med 11q23 (MLL) abnormiteter
- akutt myeloid leukemi hos voksne med inv(16)(p13;q22)
- akutt myeloid leukemi hos voksne med t(15;17)(q22;q12)
- akutt myeloid leukemi hos voksne med t(16;16)(p13;q22)
- akutt myeloid leukemi hos voksne med t(8;21)(q22;q22)
- sekundær akutt myeloid leukemi
- tilbakevendende akutt myeloid leukemi hos voksne
- tilbakevendende akutt myeloid leukemi i barndommen
Ytterligere relevante MeSH-vilkår
- Neoplasmer etter histologisk type
- Neoplasmer
- Leukemi
- Fysiologiske effekter av legemidler
- Molekylære mekanismer for farmakologisk virkning
- Anti-infeksjonsmidler
- Antivirale midler
- Anti-HIV-midler
- Antiretrovirale midler
- Antirevmatiske midler
- Antimetabolitter, antineoplastisk
- Antimetabolitter
- Antineoplastiske midler
- Immunsuppressive midler
- Immunologiske faktorer
- Antineoplastiske midler, Alkylering
- Alkyleringsmidler
- Myeloablative agonister
- Aldesleukin
- Cyklofosfamid
- Fludarabin
- Fludarabinfosfat
Andre studie-ID-numre
- CDR0000450852
- UMN-2004LS073 (Annen identifikator: Clinical Trials Office, University of Minnesota)
- UMN-MT2004-25 (Annen identifikator: Blood and Marrow Transplantation Program)
Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .
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