脐带血来源的间充质干细胞用于治疗 COVID-19 相关的急性呼吸窘迫综合征
脐带血间充质干细胞治疗急性呼吸窘迫综合征的研究
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.
研究概览
地位
地位
条件
条件
干预/治疗
干预/治疗
详细说明
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:
-
In the group of participants who present intubated on ventilator support, assess the proportion that are able to be successfully extubated.
-
In the group of participants who present requiring supplemental oxygen but otherwise breathing without assistance, assess the rate of progression to intubation.
-
Estimate the survival rate at day 30 post treatment separately by group.
-
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
-
Determine the treatment effect on laboratory markers:
- Complete blood count
- CRP
- Ferritin
- D Dimer
- Procalcitonin
- Cytokine levels
-
Estimate hospitalization and ICU stay.
-
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.
研究类型
研究类型
注册 (估计的)
注册
阶段
阶段
- 阶段2
- 阶段1
联系人和位置
学习地点
-
-
Texas
-
Houston、Texas、美国、77030
- M D Anderson Cancer Center
-
-
参与标准
资格标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
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
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
手臂数量
武器和干预
参与者组/臂参与者组/臂 |
干预/治疗干预/治疗 |
|---|---|
|
实验性的:Phase II Arm I (mesenchymal stem cells)
Patients receive MSCs as in the Pilot study. |
Given IV
其他名称:
|
|
有源比较器:Phase II Arm II (standard of care)
Patients receive standard of care. |
Receive standard of care
其他名称:
|
|
实验性的: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
其他名称:
|
研究衡量的是什么?
主要结果指标
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
没有 3 级、4 级输注毒性的存活患者(II 期)
大体时间:在 MSC 输注后第 30 天
|
在 MSC 输注后第 30 天
|
|
|
存在 3 级或 4 级输液毒性的患者(II 期)
大体时间:在 MSC 输注后第 30 天
|
在 MSC 输注后第 30 天
|
|
|
死去的患者(第二阶段)
大体时间:在 MSC 输注后第 30 天
|
在 MSC 输注后第 30 天
|
|
|
Incidence of composite serious adverse events (Phase I)
大体时间:Within 30 days of the first mesenchymal stem cell (MSC) infusion
|
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
|
次要结果测量
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
住院(第一阶段)
大体时间:最多 30 天后 MSC 输注
|
最多 30 天后 MSC 输注
|
|
|
重症监护病房(一期)
大体时间:最多 30 天后 MSC 输注
|
最多 30 天后 MSC 输注
|
|
|
Proportion of successfully extubated patients who present intubated on ventilator support (Phase I)
大体时间:Up to day 30 post MSC infusion
|
Will be estimated and reported with 95% confidence intervals. |
Up to day 30 post MSC infusion
|
|
Rate of successful progression to intubation in patients who require supplemental oxygen but who are otherwise able to breathe without assistance (Phase I)
大体时间:Up to day 30 post MSC infusion
|
Will be estimated and reported with 95% confidence intervals. |
Up to day 30 post MSC infusion
|
|
Overall survival rate (Phase I)
大体时间: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 present intubated on ventilator support (Phase I)
大体时间: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)
大体时间:At day 30 post MSC infusion
|
Will be estimated and reported with 95% confidence intervals. |
At day 30 post MSC infusion
|
|
Clinical parameters (Phase I)
大体时间:Up to day 30 post MSC infusion
|
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
|
|
Oxygenation parameters (Phase I)
大体时间:Up to day 30 post MSC infusion
|
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)
大体时间:Up to day 30 post MSC infusion
|
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
|
|
Laboratory markers (Phase I)
大体时间: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)
大体时间:Up to day 30 post MSC infusion
|
All grades of infusion-related adverse events will be summarized by grade and type. |
Up to day 30 post MSC infusion
|
合作者和调查者
调查人员
调查人员
- 首席研究员:Amanda Olson、M.D. Anderson Cancer Center
出版物和有用的链接
研究记录日期
研究主要日期
学习开始 (实际的)
学习开始
初级完成 (估计的)
初级完成
研究完成 (估计的)
研究完成
研究注册日期
首次提交
首次提交
首先提交符合 QC 标准的
首先提交符合 QC 标准的
首次发布 (实际的)
首次发布
研究记录更新
最后更新发布 (实际的)
最后更新发布
上次提交的符合 QC 标准的更新
上次提交的符合 QC 标准的更新
最后验证
最后验证
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
其他研究编号
- 2020-0365
- 2020-0365 (其他标识符:M D Anderson Cancer Center)
- NCI-2020-06741 (注册表标识符:CTRP (Clinical Trial Reporting Program))
药物和器械信息、研究文件
研究美国 FDA 监管的药品
研究美国 FDA 监管的设备产品
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