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Safety Study of MultiStem® in Patients With Acute Leukemia, Chronic Myeloid Leukemia, or Myelodysplasia

Primary Purpose

Hematologic Malignancies

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
MultiStem®
MultiStem®
Sponsored by
Athersys, Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Hematologic Malignancies focused on measuring Leukemia, Graft vs. Host Disease, Hematopoietic Stem Cell Transplant, Bone Marrow Transplant, Myelodysplasia

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients of either sex aged 18-65 years of age
  • Diagnosis of acute myeloid or lymphoblastic leukemia (second or subsequent remission, if not in remission, then <20% bone marrow blasts), chronic myelogenous leukemia resistant to or intolerant of tyrosine kinase inhibitor therapy (accelerated phase, first chronic phase with TKI resistance, or second chronic phase), or myelodysplastic syndrome (intermediate/high or high risk by International Prognostic Scoring System (IPSS), lower risk by IPSS with patient having progressed after prior therapy. Complete remission is defined as the absence of blasts in the peripheral circulation at the time of enrollment and <5% blasts in the marrow within 28 days of enrollment.
  • Life expectancy of at least 100 days
  • Patients scheduled for allogeneic bone marrow transplant or peripheral blood stem cell transplant (PBST) procedure
  • Family-related or unrelated donors
  • HLA matching should either be matched related or matched unrelated donors, 6/6 match or 5/6 single allelic mismatch, with provision that the DRB1 is molecularly matched
  • Performance status (ECOG ≤2)
  • Signed informed consent

Exclusion Criteria:

  • Active infection
  • Known allergies to bovine or porcine products
  • Renal function: Serum creatinine >2 mg/dL or creatinine clearance ≤50 mL/min
  • Hepatic function: Screening ALT or AST ≥3x than the upper limit of normal for the laboratory OR total bilirubin ≥2.0 mg/dL (Exception: acceptable if patient is identified with pre-existing condition e.g., Gilbert's disease that will contribute to baseline elevations of bilirubin)
  • Pulmonary function: FEV1, FVC, DLCO ≤50% predicted
  • Cardiac function: left ventricular ejection fraction ≤50%
  • Patient received an investigational agent within 30 days prior to transplant
  • The patient is pregnant, has a positive serum BhCG, or is lactating
  • Patient on corticosteroids at a dose >0.25 mg/kg/day
  • Planned non-myeloablative transplant
  • Planned cord blood transplant
  • Prior allogeneic myeloablative HSCT
  • HIV seropositive, HTLV seropositive, hepatitis B or C seropositive, varicella virus active infection, or syphilis active infection
  • Other serious medical or psychiatric illness that, in the investigator's opinion, would not permit the patient to be managed according to the protocol

Sites / Locations

  • Mayo Clinic Hospital
  • University Hospitals Case Medical Center
  • Oregon State University Medical Center
  • University of Pennsylvania
  • Texas Transplant Institute
  • UZ Leuven

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Single dose Arm

Repeat Dose Arm

Arm Description

There will be six cohorts of three patients each. Three escalating doses of MultiStem will be evaluated.

There will be six cohorts of three patients each. Four dosing regimens will be evaluated,varying doses at three times weekly or five times weekly.

Outcomes

Primary Outcome Measures

maximum tolerated dose

Secondary Outcome Measures

incidence of grade III/IV GVHD

Full Information

First Posted
May 14, 2008
Last Updated
January 3, 2012
Sponsor
Athersys, Inc
Collaborators
Cato Research
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1. Study Identification

Unique Protocol Identification Number
NCT00677859
Brief Title
Safety Study of MultiStem® in Patients With Acute Leukemia, Chronic Myeloid Leukemia, or Myelodysplasia
Official Title
A Phase I, Multicenter, Dose-Escalation Trial Evaluating Maximum-Tolerated Dose of Single and Repeated Administration of Allogeneic MultiStem® in Patients With Acute Leukemia, Chronic Myeloid Leukemia, or Myelodysplasia
Study Type
Interventional

2. Study Status

Record Verification Date
January 2012
Overall Recruitment Status
Completed
Study Start Date
July 2008 (undefined)
Primary Completion Date
October 2011 (Actual)
Study Completion Date
November 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Athersys, Inc
Collaborators
Cato Research

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine if MultiStem® can safely be given to patients with acute leukemia, chronic myeloid leukemia, or myelodysplasia after they have received hematopoietic stem cell transplantation.
Detailed Description
Graft-vs.-Host Disease (GVHD) is one of the major limitations of allogeneic hematopoietic stem cell transplants (HSCT). This complication is major cause of morbidity and mortality and is thought to be initiated by activation of donor T-cells through recognition of "foreign" cells resident in the transplant recipient. Acute GVHD is associated with damage to the liver, skin, gastrointestinal tract and mucosa. Moderate to severe GVHD Grades II-IV occurs in 30-50% of matched related HSCTs and 50-70% of unrelated donor recipients. Severe GHVD requires intense immunosuppression involving steroids and additional agents to get it under control, and patients may develop severe infections as a result of such immunosuppression. An agent or cell therapy that could reduce the incidence and/or severity of GVHD without increasing relapse or infectious risk in HSCT patients would provide substantial benefits.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hematologic Malignancies
Keywords
Leukemia, Graft vs. Host Disease, Hematopoietic Stem Cell Transplant, Bone Marrow Transplant, Myelodysplasia

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
36 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Single dose Arm
Arm Type
Experimental
Arm Description
There will be six cohorts of three patients each. Three escalating doses of MultiStem will be evaluated.
Arm Title
Repeat Dose Arm
Arm Type
Experimental
Arm Description
There will be six cohorts of three patients each. Four dosing regimens will be evaluated,varying doses at three times weekly or five times weekly.
Intervention Type
Biological
Intervention Name(s)
MultiStem®
Intervention Description
Patients will receive a single IV infusion of MultiStem® 2 days after HSCT.
Intervention Type
Biological
Intervention Name(s)
MultiStem®
Intervention Description
Patients will receive either 3 weekly IV infusions or 5 weekly infusions of MultiStem®
Primary Outcome Measure Information:
Title
maximum tolerated dose
Time Frame
30 days
Secondary Outcome Measure Information:
Title
incidence of grade III/IV GVHD
Time Frame
100 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients of either sex aged 18-65 years of age Diagnosis of acute myeloid or lymphoblastic leukemia (second or subsequent remission, if not in remission, then <20% bone marrow blasts), chronic myelogenous leukemia resistant to or intolerant of tyrosine kinase inhibitor therapy (accelerated phase, first chronic phase with TKI resistance, or second chronic phase), or myelodysplastic syndrome (intermediate/high or high risk by International Prognostic Scoring System (IPSS), lower risk by IPSS with patient having progressed after prior therapy. Complete remission is defined as the absence of blasts in the peripheral circulation at the time of enrollment and <5% blasts in the marrow within 28 days of enrollment. Life expectancy of at least 100 days Patients scheduled for allogeneic bone marrow transplant or peripheral blood stem cell transplant (PBST) procedure Family-related or unrelated donors HLA matching should either be matched related or matched unrelated donors, 6/6 match or 5/6 single allelic mismatch, with provision that the DRB1 is molecularly matched Performance status (ECOG ≤2) Signed informed consent Exclusion Criteria: Active infection Known allergies to bovine or porcine products Renal function: Serum creatinine >2 mg/dL or creatinine clearance ≤50 mL/min Hepatic function: Screening ALT or AST ≥3x than the upper limit of normal for the laboratory OR total bilirubin ≥2.0 mg/dL (Exception: acceptable if patient is identified with pre-existing condition e.g., Gilbert's disease that will contribute to baseline elevations of bilirubin) Pulmonary function: FEV1, FVC, DLCO ≤50% predicted Cardiac function: left ventricular ejection fraction ≤50% Patient received an investigational agent within 30 days prior to transplant The patient is pregnant, has a positive serum BhCG, or is lactating Patient on corticosteroids at a dose >0.25 mg/kg/day Planned non-myeloablative transplant Planned cord blood transplant Prior allogeneic myeloablative HSCT HIV seropositive, HTLV seropositive, hepatitis B or C seropositive, varicella virus active infection, or syphilis active infection Other serious medical or psychiatric illness that, in the investigator's opinion, would not permit the patient to be managed according to the protocol
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Richard Maziarz, MD
Organizational Affiliation
Oregon Health and Science University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Steven Devine, MD
Organizational Affiliation
Ohio State University
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Hillard Lazarus, MD
Organizational Affiliation
Case Western Reserve University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mayo Clinic Hospital
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85054
Country
United States
Facility Name
University Hospitals Case Medical Center
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Facility Name
Oregon State University Medical Center
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Texas Transplant Institute
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
UZ Leuven
City
Leuven
Country
Belgium

12. IPD Sharing Statement

Learn more about this trial

Safety Study of MultiStem® in Patients With Acute Leukemia, Chronic Myeloid Leukemia, or Myelodysplasia

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