search
Back to results

Stem Cell Transplantation for Hurler

Primary Purpose

Mucopolysaccharidosis I, Mucopolysaccharidosis VI, Mannosidosis

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Stem Cell Transplant
Busulfan, Cyclophosphamide, ATG
Sponsored by
Masonic Cancer Center, University of Minnesota
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Mucopolysaccharidosis I focused on measuring stem cell transplant, storage disease, errors of metabolism

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Patients with Mucopolysaccharidosis, type I (e.g., Hurler syndrome), Maroteaux-Lamy syndrome (MPS VI), Alpha Mannosidosis, or mucolipidosis type II (I-cell disease) who have an HLA-identical or mismatched (at 1 antigen) related marrow, PBSC, or cord blood donor. Patients with Mucopolysaccharidosis, type I, Maroteaux-Lamy syndrome (MPS VI), Alpha Mannosidosis, or mucolipidosis type II (I-cell disease) who have an HLA-identical or HLA-1 antigen mismatched unrelated marrow, PBSC, or HLA-0-2 antigen mismatched umbilical cord blood donor. Patients with MPS type I, Maroteaux Lamy Syndrome (MPS VI), or mucolipidosis type II (I-cell disease) will have a mental developmental index within two standard deviations of the normal mean, as best as can be determined using Bayley scales of infant development or other standardized testing, recognizing that these may be affected by speech and/or hearing impairment. Adequate organ function: Cardiac: ejection fraction >40%; no decompensated congestive heart failure or uncontrolled arrhythmia Renal: serum creatinine <2.0 mg/dl Hepatic: total bilirubin <3x Upper limits of normal transaminases < 5.0 x Upper limits of normal Signed consent. Exclusion Criteria: Presence of major organ dysfunction (see above) Pregnancy Evidence of HIV infection or known HIV positive serology Patients or parents are psychologically incapable of undergoing BMT with associated strict isolation or documented history of medical non-compliance Patients >50 kg may be at risk for having cell doses below the goal of ≥ 10 x 106 CD 34 cells/kg and therefore will not be eligible to receive unrelated PBSCs.

Sites / Locations

  • Masonic Cancer Center, University of Minnesota

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment Arm

Arm Description

All patients treated with chemotherapy and transplantation.

Outcomes

Primary Outcome Measures

Mean Percentage of Donor Cells in Study Population (Chimerism).
Donor-derived engraftment determined by restriction fragment length polymorphism (RFLP).

Secondary Outcome Measures

Number of Patients Surviving on Study
Number of patients surviving (alive) at specified timepoints.
Number of Patients Who Failed Engraftment.
Toxicity (undesireable effect) of hematologic donor cell engraftment is determined by failure to engraft at Day 42.
Number of Patients With Grade III-IV Acute Graft-versus-host Disease (aGVHD).
Toxicity (undesireable effect) of this stem cell transplant preparative regimen due to acute graft-versus-host disease.

Full Information

First Posted
September 12, 2005
Last Updated
December 3, 2017
Sponsor
Masonic Cancer Center, University of Minnesota
search

1. Study Identification

Unique Protocol Identification Number
NCT00176917
Brief Title
Stem Cell Transplantation for Hurler
Official Title
Hematopoietic Stem Cell Transplantation for Hurler Syndrome, Maroteaux Lamy Syndrome (MPS VI), and Alpha Mannosidase Deficiency (Mannosidosis)
Study Type
Interventional

2. Study Status

Record Verification Date
December 2017
Overall Recruitment Status
Completed
Study Start Date
May 1999 (undefined)
Primary Completion Date
May 2008 (Actual)
Study Completion Date
May 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Masonic Cancer Center, University of Minnesota

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine the safety and engraftment of donor hematopoietic cells using this conditioning regimen in patients undergoing a hematopoietic (blood forming) cell transplant for Hurler syndrome, Maroteaux Lamy syndrome, Mannosidosis, or I-cell disease.
Detailed Description
Prior to transplantation, subjects will receive Busulfan intravenously (IV) via the Hickman line four times daily for 4 days, Cyclophosphamide intravenously via the Hickman line once a day for 4 days, and Anti-Thymocyte Globulin IV via the Hickman line twice daily for three days before the transplant. These three drugs are being given to subjects to help the new marrow "take" and grow. On the day of transplantation, the donor's hematopoietic cells will be transfused via central venous catheter. After hematopoietic cell transplant, subjects will then receive two drugs, cyclosporin and either methylprednisolone or Mycophenolate Mofetil (MMF). Cyclosporin and methylprednisolone or MMF are given to help prevent the complication of graft-versus-host disease and to decrease the chance that the new donor cells will be rejected.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Mucopolysaccharidosis I, Mucopolysaccharidosis VI, Mannosidosis, Mucolipidosis Type II (I-cell Disease)
Keywords
stem cell transplant, storage disease, errors of metabolism

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
41 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment Arm
Arm Type
Experimental
Arm Description
All patients treated with chemotherapy and transplantation.
Intervention Type
Procedure
Intervention Name(s)
Stem Cell Transplant
Other Intervention Name(s)
Bone Marrow Transplant
Intervention Description
The purpose of hematopoietic cell transplantation is to introduce hematopoietic cells from a normal donor that contains the enzyme able to get rid of the substances that have accumulated in the body of patients with storage diseases. Hematopoietic cells can come from bone marrow, peripheral blood (i.e., the blood circulating in our body's blood vessels) or umbilical cord blood (i.e. blood taken from the umbilical cord after a baby is born and umbilical cord is cut).
Intervention Type
Drug
Intervention Name(s)
Busulfan, Cyclophosphamide, ATG
Other Intervention Name(s)
Busulfex, Cytoxan, Thymoglobulin
Intervention Description
Prior to transplantation, subjects will receive BUSULFAN intravenously (IV) via the Hickman line twice daily for 4 days, CYCLOPHOSPHAMIDE intravenously via the Hickman line once a day for 4 days, and ANTI-THYMOCYTE GLOBULIN IV via the Hickman line twice daily for three days before the transplant. These three drugs are being given to help the new marrow "take" and grow. METHYLPREDNISOLONE will be given as a pre-medication for the ATG.
Primary Outcome Measure Information:
Title
Mean Percentage of Donor Cells in Study Population (Chimerism).
Description
Donor-derived engraftment determined by restriction fragment length polymorphism (RFLP).
Time Frame
at 21 days, 42 days, 60 days, 100 days, 6 months, and 1 year
Secondary Outcome Measure Information:
Title
Number of Patients Surviving on Study
Description
Number of patients surviving (alive) at specified timepoints.
Time Frame
at 100 days, 1 year, and 3 years post transplant
Title
Number of Patients Who Failed Engraftment.
Description
Toxicity (undesireable effect) of hematologic donor cell engraftment is determined by failure to engraft at Day 42.
Time Frame
Day 42 Post Transplant
Title
Number of Patients With Grade III-IV Acute Graft-versus-host Disease (aGVHD).
Description
Toxicity (undesireable effect) of this stem cell transplant preparative regimen due to acute graft-versus-host disease.
Time Frame
Day 100 Post Transplant

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with Mucopolysaccharidosis, type I (e.g., Hurler syndrome), Maroteaux-Lamy syndrome (MPS VI), Alpha Mannosidosis, or mucolipidosis type II (I-cell disease) who have an HLA-identical or mismatched (at 1 antigen) related marrow, PBSC, or cord blood donor. Patients with Mucopolysaccharidosis, type I, Maroteaux-Lamy syndrome (MPS VI), Alpha Mannosidosis, or mucolipidosis type II (I-cell disease) who have an HLA-identical or HLA-1 antigen mismatched unrelated marrow, PBSC, or HLA-0-2 antigen mismatched umbilical cord blood donor. Patients with MPS type I, Maroteaux Lamy Syndrome (MPS VI), or mucolipidosis type II (I-cell disease) will have a mental developmental index within two standard deviations of the normal mean, as best as can be determined using Bayley scales of infant development or other standardized testing, recognizing that these may be affected by speech and/or hearing impairment. Adequate organ function: Cardiac: ejection fraction >40%; no decompensated congestive heart failure or uncontrolled arrhythmia Renal: serum creatinine <2.0 mg/dl Hepatic: total bilirubin <3x Upper limits of normal transaminases < 5.0 x Upper limits of normal Signed consent. Exclusion Criteria: Presence of major organ dysfunction (see above) Pregnancy Evidence of HIV infection or known HIV positive serology Patients or parents are psychologically incapable of undergoing BMT with associated strict isolation or documented history of medical non-compliance Patients >50 kg may be at risk for having cell doses below the goal of ≥ 10 x 106 CD 34 cells/kg and therefore will not be eligible to receive unrelated PBSCs.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Paul Orchard, MD
Organizational Affiliation
Masonic Cancer Center, University of Minnesota
Official's Role
Principal Investigator
Facility Information:
Facility Name
Masonic Cancer Center, University of Minnesota
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Stem Cell Transplantation for Hurler

We'll reach out to this number within 24 hrs