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Immune Reconstitution in Oncology Patients Following Autologous Stem Cell Transplant (IROPAST)

13 juli 2015 uppdaterad av: St. Jude Children's Research Hospital

Autologous stem cell rescue is an established therapy in high risk neuroblastoma and relapsed Hodgkin's lymphoma and an experimental therapy in some other solid and brain tumors to facilitate the use of very intense chemotherapy beyond bone marrow tolerance. It is usually tolerated with acceptable toxicity and graft failure is practically not existent. But whereas immune reconstitution in allogeneic hematopoietic stem cell transplantation (HSCT) setting is widely studied, the investigators have no comprehensive data available in the autologous setting regarding recovery of the innate and adaptive immune system. However, observations in patients with autoimmune disease undergoing autologous HSCT suggest not an exact recovery of the patient's pre-transplant immune system but some re-education during reconstitution of immune function.

Also, recent developments of cancer-directed immunotherapy with monoclonal antibodies and immunocytokines rely on activity of the patient's own immune system via complement-mediated or antibody-dependent cellular cytotoxicity. These novel therapies are given either with or shortly after conventional chemotherapy. To find the optimal time point for administration of immunotherapy, it is important to know how and when immune effector cells recover after conventional myelosuppressive and/or immunosuppressive chemotherapy which are used in Induction regimens.

Researchers at St. Jude Children's Research Hospital want to study the research participant's immune profile once prior and at multiple set time points after autologous stem cell infusion during the recovery process. In a subset of participants the investigators want to study the recovery of lymphocyte subsets and function after one course of conventional chemotherapy preceding the high dose chemotherapy and autologous stem cell transplant. That way the investigators hope to learn about the pace and order of recovery and the functional capacity of different compartments of the immune system during reconstitution.

Studieöversikt

Status

Avslutad

Intervention / Behandling

Detaljerad beskrivning

Primary Objective:

  • To describe the immune reconstitution of T cell-, B cell- and natural killer (NK) cell- compartment in patients undergoing autologous stem cell transplant as part of their treatment for a malignancy.

The design for this study will be a prospective, longitudinal observational study. Immune reconstitution will be measured in the course of autologous stem cell transplant using serial blood samples analyzed for cell counts, immune cell phenotyping (demonstrating the expression of specific receptors on the cell surface) and functional lymphocyte assays. These blood samples will be obtained once prior and at defined time points after stem cell infusion either while the research participant is hospitalized or during the scheduled clinic visit.

Immune recovery from conventional chemotherapy will be measured using serial blood samples analyzed for cell counts, immune cell phenotyping, and NK cell functional assays. These blood samples will be obtained once prior and at defined time points after completion of courses #1 and #4 of Induction chemotherapy while the research participant is hospitalized or during the scheduled clinic visit.

Studietyp

Observationell

Inskrivning (Faktisk)

31

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

    • Tennessee
      • Memphis, Tennessee, Förenta staterna, 38103
        • St. Jude Children's Research Hospital

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

Inte äldre än 21 år (Barn, Vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Testmetod

Icke-sannolikhetsprov

Studera befolkning

Participants will have a diagnosis of solid tumor, brain tumor or lymphoma, be 21 years of age or younger, and be enrolled on a protocol likely to include autologous stem cell transplant.

Beskrivning

Inclusion Criteria:

  • Patients with solid tumors, brain tumors or lymphoma regardless of previously received cancer related therapies who are enrolled on a study protocol or treatment plan that includes or will likely include autologous stem cell transplant.
  • Patient age >0 to 21 years

Exclusion Criteria:

  • Patient receiving an autologous transplant for a disease other than listed above.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

Kohorter och interventioner

Grupp / Kohort
Intervention / Behandling
Participants
Participants enrolled on the study will have blood samples obtained.
Research participants agree to have blood samples obtained at the time of diagnosis before any chemotherapy, if available, and prior to high dose chemotherapy regimen with autologous HSCT as well as on days 14, 21, 28, week 8 and months 3, 6, 12 and 18 after autologous HSCT. Research participants with high risk neuroblastoma may also agree to have blood samples taken before and twice in the recovery period (days 0, 7 and 15-18) of Induction chemotherapy courses one and four.
Andra namn:
  • Flebotomi
  • Venpunktion

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change in the immune reconstitution of T cell, B cell, and NK cell compartment.
Tidsram: Days 0, 14, 21, 28, week 8, and months 3, 6, 12, and 18 related to stem cell infusion.

The order and magnitude of recovery of the different subtypes of leukocytes will be summarized by descriptive statistics. The pattern of immune reconstitution will be evaluated using longitudinal approaches such as Mixed effect models or GEE approach and implement in SAS 9.2 using PROC MIXED or PROC GENMOD.

In addition, NK cell number, receptor and ligand genotype and phenotype and functional capacity will be compared at specific time points (28 days, 8 weeks and 6 months post autologous transplant) to the baseline values using paired one sample signed rank test.

Days 0, 14, 21, 28, week 8, and months 3, 6, 12, and 18 related to stem cell infusion.

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 mars 2012

Primärt slutförande (Faktisk)

1 juni 2015

Avslutad studie (Faktisk)

1 juni 2015

Studieregistreringsdatum

Först inskickad

17 februari 2012

Först inskickad som uppfyllde QC-kriterierna

27 februari 2012

Första postat (Uppskatta)

28 februari 2012

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

14 juli 2015

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

13 juli 2015

Senast verifierad

1 juli 2015

Mer information

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

Kliniska prövningar på Blood samples obtained

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