search
Back to results

Dendritic Cell Vaccination for Patients With Acute Myeloid Leukemia in Remission (CCRG 05-001)

Primary Purpose

Acute Myeloid Leukemia (AML)

Status
Completed
Phase
Phase 1
Locations
Belgium
Study Type
Interventional
Intervention
injection of antigen-loaded cultured dendritic cells
Sponsored by
University Hospital, Antwerp
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia (AML) focused on measuring AML in remission

Eligibility Criteria

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

Inclusion Criteria:

  1. Tumor type: Acute Myeloid Leukemia (AML) according to the WHO criteria (ea at least 20% blasts in the marrow). All FAB subtypes except M3. Patients with Myelodysplastic Syndrome, category of Refractory Anemia with Excess Blasts (RAEB): RAEB I (WHO: medullary blast count ≤ 10% and a peripheral blast count ≤ 5%) and RAEB II (WHO: medullary blast count > 10% and/or > 5% peripheral blasts) can be included in the study in absence of other non-experimental treatment modalities.
  2. Extent of disease: remission (partial or complete) or smouldering course. Complete remission (CR) is defined as no blasts in the peripheral blood and no more than 5% blasts in the bone marrow. This definition is related to the hematological remission if it is not specified. Partial remission (PR) is defined as a decrease of at least 50% in the percentage of blasts to 5 to 25% in the bone marrow aspirate. Smouldering course is defined as a relatively low marrow blast count and slowly progressive disease.
  3. Overexpression of WT1 RNA (>50 copies of WT1 per 1000 copies ABL in bone marrow or >2 copy/1000 copies ABL in peripheral blood) as assessed by quantitative RT-PCR at the time of presentation.
  4. Prior treatments : Patients must have received at least one prior antileukemic chemotherapeutic regimen and must be more than 1 month past the last treatment and/or 6 months past allogeneic/autologous stem cell transplantation.
  5. Age: ≥ 18 years
  6. High risk of relapse because of (and/or)

    • Age > 60 years (if <60 y, no sibling allotransplant donor available)
    • Poor risk cytogenetic or molecular markers at presentation
    • Hyperleukocytosis at presentation
    • Second complete remission after relapse
  7. Performance status: WHO PS grade 0-1 (Appendix B)
  8. Objectively assessable parameters of life expectancy: more than 3 months
  9. Prior and concomitant associated diseases allowed with the exception of underlying autoimmune disease and positive serology for HIV/HBV/HCV
  10. No concomitant use of immunosuppressive drugs
  11. Adequate renal and liver function, i.e. creatinin and bilirubin = 1.2 times the upper limit of normal
  12. Absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial
  13. Women of child-bearing potential should use adequate contraception prior to study entry and for the duration of study participation

Exclusion Criteria:

  1. Subjects with concurrent additional malignancy (with exception of Non-melanoma skin cancers and carcinoma in situ of the cervix)
  2. Subjects who are pregnant
  3. Subjects who have sensitivity to drugs that provide local anesthesia
  4. Age < 18 years

Sites / Locations

  • Antwerp University Hospital/Center for Cellular Therapy and Regenerative Medicine

Outcomes

Primary Outcome Measures

acute toxicity of intradermal injections of WT1 mRNA-electroporated autologous dendritic cells
feasibility to generate functional DC vaccines from leukapheresis material from AML patient in remission

Secondary Outcome Measures

T cell immunogenicity of WT1 mRNA-loaded dendritic cell vaccines in AML patients in remission

Full Information

First Posted
January 30, 2009
Last Updated
February 5, 2010
Sponsor
University Hospital, Antwerp
search

1. Study Identification

Unique Protocol Identification Number
NCT00834002
Brief Title
Dendritic Cell Vaccination for Patients With Acute Myeloid Leukemia in Remission
Acronym
CCRG 05-001
Official Title
Wilms Tumor Gene (WT1) mRNA-transfected Autologous Dendritic Cell Vaccination for Patients With Acute Myeloid Leukemia (AML): a Phase I Trial
Study Type
Interventional

2. Study Status

Record Verification Date
August 2009
Overall Recruitment Status
Completed
Study Start Date
March 2005 (undefined)
Primary Completion Date
November 2007 (Actual)
Study Completion Date
December 2008 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
University Hospital, Antwerp

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
RATIONALE: Vaccines made from a patient's white blood cells (dendritic cells) and a specific leukemia antigen (Wilms tumor antigen-1) may induce an effective immune response to kill residual leukemic cells and/or prevent leukemia relapse. PURPOSE: This phase I/II trial is studying the feasibility, safety and efficacy of intradermal mRNA-transfected dendritic cell vaccination therapy in patients with acute myeloid leukemia.
Detailed Description
Autologous dendritic cell (DC) vaccination is a promising strategy for adjuvant cancer therapy in the setting of minimal residual disease (MRD). We performed a phase I/II trial in patients with acute myeloid leukemia (AML) where patients received intradermal injections of autologous DC loaded with mRNA coding for the Wilms' tumor protein (WT1). WT1 is highly overexpressed in leukemia and the level of WT1 RNA in peripheral blood is a useful biomarker for molecular diagnosis en follow-up in the MRD setting. We want to prospectively monitor WT1 RNA expression in the peripheral blood of vaccinated and non-vaccinated AML patients in order to evaluate its predictive value as a biomarker for relapse and to assess the clinical efficacy of DC vaccination in acute myeloid leukemia patients. We believe, on the basis of already available evidence, that the use of WT1 both as a target for immunotherapy as well as a biomarker not holds promise to assess the efficacy of new experimental therapeutic interventions such as DC vaccination.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia (AML)
Keywords
AML in remission

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
injection of antigen-loaded cultured dendritic cells
Intervention Description
intradermal injection of WT1-RNA-electroporated autologous dendritic cell vaccine (therapeutic cell vaccine)
Primary Outcome Measure Information:
Title
acute toxicity of intradermal injections of WT1 mRNA-electroporated autologous dendritic cells
Title
feasibility to generate functional DC vaccines from leukapheresis material from AML patient in remission
Secondary Outcome Measure Information:
Title
T cell immunogenicity of WT1 mRNA-loaded dendritic cell vaccines in AML patients in remission

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Tumor type: Acute Myeloid Leukemia (AML) according to the WHO criteria (ea at least 20% blasts in the marrow). All FAB subtypes except M3. Patients with Myelodysplastic Syndrome, category of Refractory Anemia with Excess Blasts (RAEB): RAEB I (WHO: medullary blast count ≤ 10% and a peripheral blast count ≤ 5%) and RAEB II (WHO: medullary blast count > 10% and/or > 5% peripheral blasts) can be included in the study in absence of other non-experimental treatment modalities. Extent of disease: remission (partial or complete) or smouldering course. Complete remission (CR) is defined as no blasts in the peripheral blood and no more than 5% blasts in the bone marrow. This definition is related to the hematological remission if it is not specified. Partial remission (PR) is defined as a decrease of at least 50% in the percentage of blasts to 5 to 25% in the bone marrow aspirate. Smouldering course is defined as a relatively low marrow blast count and slowly progressive disease. Overexpression of WT1 RNA (>50 copies of WT1 per 1000 copies ABL in bone marrow or >2 copy/1000 copies ABL in peripheral blood) as assessed by quantitative RT-PCR at the time of presentation. Prior treatments : Patients must have received at least one prior antileukemic chemotherapeutic regimen and must be more than 1 month past the last treatment and/or 6 months past allogeneic/autologous stem cell transplantation. Age: ≥ 18 years High risk of relapse because of (and/or) Age > 60 years (if <60 y, no sibling allotransplant donor available) Poor risk cytogenetic or molecular markers at presentation Hyperleukocytosis at presentation Second complete remission after relapse Performance status: WHO PS grade 0-1 (Appendix B) Objectively assessable parameters of life expectancy: more than 3 months Prior and concomitant associated diseases allowed with the exception of underlying autoimmune disease and positive serology for HIV/HBV/HCV No concomitant use of immunosuppressive drugs Adequate renal and liver function, i.e. creatinin and bilirubin = 1.2 times the upper limit of normal Absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial Women of child-bearing potential should use adequate contraception prior to study entry and for the duration of study participation Exclusion Criteria: Subjects with concurrent additional malignancy (with exception of Non-melanoma skin cancers and carcinoma in situ of the cervix) Subjects who are pregnant Subjects who have sensitivity to drugs that provide local anesthesia Age < 18 years
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Zwi Berneman, MD, PHD
Organizational Affiliation
University Hospital, Antwerp
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Ann Van de Velde, MD
Organizational Affiliation
University Hospital, Antwerp
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Viggo FI Van Tendeloo, PhD
Organizational Affiliation
University Hospital, Antwerp
Official's Role
Principal Investigator
Facility Information:
Facility Name
Antwerp University Hospital/Center for Cellular Therapy and Regenerative Medicine
City
Edegem
ZIP/Postal Code
2650
Country
Belgium

12. IPD Sharing Statement

Learn more about this trial

Dendritic Cell Vaccination for Patients With Acute Myeloid Leukemia in Remission

We'll reach out to this number within 24 hrs