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Expanded Access Protocol Thymus Transplantation

Primary Purpose

Poor Thymic Function, Immunodeficiency, Athymia

Status
Approved for marketing
Phase
Locations
Study Type
Expanded Access
Intervention
Cultured Thymus Tissue
Blood Draw
Rabbit Anti-Thymocyte Globulin and Cyclosporine or Tacrolimus
Sponsored by
Enzyvant Therapeutics GmBH
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an expanded access trial for Poor Thymic Function focused on measuring Cultured Thymus Tissue Implantation

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)All Sexes

Cultured Thymus Tissue Inclusion Criteria for Implantation:

  • an immunodeficiency or severe autoimmunity for which development of naïve T cells would be expected to lead to lead to clinical improvement.
  • written consent (or consent of parent/legal guardian as applicable), review of medical testing, laboratory studies, and physical examinations are used to determine whether the patient is clinically stable and will potentially benefit from receiving cultured thymus tissue. Each participant is reviewed with the Data Safety and Monitoring Board (DSMB).

Cultured Thymus Tissue Exclusion Criteria for Implantation:

  • Unrepaired cyanotic congenital heart disease
  • Uncontrolled infections. "Uncontrolled" is defined as requiring a ventilator, dialysis, or vasopressor support or anticipated as requiring such support within 6 months.
  • Pregnancy

    • For females of child-bearing potential, a serum pregnancy test is done after consent, at the same time another blood draw is done if possible.
    • Females of child-bearing potential must agree to contraceptive measures as indicated in the consent form.
    • A second serum pregnancy test is done within 48 hours prior to administration of study interventions involving FDA pregnancy class D drugs, chemotherapy drugs, or other drugs or interventions known to pose risks to a potential fetus.
  • HIV Positive
  • History of malignancy
  • CMV Infection

    • For subjects receiving immunosuppression as part of the implantation protocol, CMV infection as documented by >500 copies/ml in blood by PCR on two consecutive assays is an exclusion.

Sites / Locations

    Outcomes

    Primary Outcome Measures

    Secondary Outcome Measures

    Full Information

    First Posted
    October 22, 2014
    Last Updated
    March 23, 2022
    Sponsor
    Enzyvant Therapeutics GmBH
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02274662
    Brief Title
    Expanded Access Protocol Thymus Transplantation
    Official Title
    Expanded Access Protocol Thymus Transplantation for Immunodeficiency, Hematologic Malignancies, and Autoimmune Disease Related to Poor Thymic Function
    Study Type
    Expanded Access

    2. Study Status

    Record Verification Date
    March 2022
    Overall Recruitment Status
    Approved for marketing
    Study Start Date
    undefined (undefined)
    Primary Completion Date
    undefined (undefined)
    Study Completion Date
    undefined (undefined)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Enzyvant Therapeutics GmBH

    4. Oversight

    5. Study Description

    Brief Summary
    The primary purpose is to provide access for patients who have immunodeficiency or severe autoimmune disease related to poor thymic function to cultured thymus tissue for implantation. With no thymus function, bone marrow stem cells do not develop into educated T cells, which fight infection. Eligible participants receive cultured thymus tissue for implantation and may undergo biopsy. Immune suppression may be given depending on the immune status and clinical condition of the participant. Immune function testing is continued for one year post-implantation.
    Detailed Description
    The patients enrolled have a high likelihood of death if they do not receive culture thymus tissue because of lack of thymus function. As there are many types of patients who may be enrolled, study results will not have statistical significance. The study objective is to make cultured thymus tissue available for implantation on an expanded access basis. Data will be collected on survival, naïve T cell development, T cell chimerism, and implant related toxicities, as well as any unexpected study-related serious adverse events. Eligible subjects receive cultured thymus tissue and may undergo allograft biopsy. Immune suppression may be given depending on the subject's immune status and clinical condition. Protocol specified studies continue until approximately one year post-implantation. Study participation lasts approximately two years.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Poor Thymic Function, Immunodeficiency, Athymia, Immunoreconstitution, Thymus Transplantation, Low T Cell Numbers
    Keywords
    Cultured Thymus Tissue Implantation

    7. Study Design

    8. Arms, Groups, and Interventions

    Intervention Type
    Biological
    Intervention Name(s)
    Cultured Thymus Tissue
    Intervention Description
    Subjects receive cultured thymus tissue which is implanted into the quadriceps muscle. Subjects may receive pre and/or post-implantation immunosuppression. Potential subjects are screened for eligibility. The thymus tissue (from an unrelated donor), the donor, and the donor's mother are screened for safety. Cultured thymus tissue is implanted into the subject's quadriceps muscle under general anesthesia in the operating room. Two to three months post-implantation, if medically stable, subjects may undergo an allograft biopsy. Subjects undergo laboratory testing for approximately one year post-implantation. At year 2 post-implantation, subjects are contacted for data collection.
    Intervention Type
    Procedure
    Intervention Name(s)
    Blood Draw
    Other Intervention Name(s)
    Venipuncture
    Intervention Type
    Drug
    Intervention Name(s)
    Rabbit Anti-Thymocyte Globulin and Cyclosporine or Tacrolimus
    Other Intervention Name(s)
    RATGAM and Csa or FK506
    Intervention Description
    RATGAM and Cyclosporine or Tacrolimus may be given, depending on the patient. The doses, timing, and trough levels will vary depending on the patient's clinical condition.

    10. Eligibility

    Sex
    All
    Eligibility Criteria
    Cultured Thymus Tissue Inclusion Criteria for Implantation: an immunodeficiency or severe autoimmunity for which development of naïve T cells would be expected to lead to lead to clinical improvement. written consent (or consent of parent/legal guardian as applicable), review of medical testing, laboratory studies, and physical examinations are used to determine whether the patient is clinically stable and will potentially benefit from receiving cultured thymus tissue. Each participant is reviewed with the Data Safety and Monitoring Board (DSMB). Cultured Thymus Tissue Exclusion Criteria for Implantation: Unrepaired cyanotic congenital heart disease Uncontrolled infections. "Uncontrolled" is defined as requiring a ventilator, dialysis, or vasopressor support or anticipated as requiring such support within 6 months. Pregnancy For females of child-bearing potential, a serum pregnancy test is done after consent, at the same time another blood draw is done if possible. Females of child-bearing potential must agree to contraceptive measures as indicated in the consent form. A second serum pregnancy test is done within 48 hours prior to administration of study interventions involving FDA pregnancy class D drugs, chemotherapy drugs, or other drugs or interventions known to pose risks to a potential fetus. HIV Positive History of malignancy CMV Infection For subjects receiving immunosuppression as part of the implantation protocol, CMV infection as documented by >500 copies/ml in blood by PCR on two consecutive assays is an exclusion.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    John W. Sleasman, M.D.
    Organizational Affiliation
    Duke University Medical Center, Pediatrics, Allergy & Immunology
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Citations:
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    17284531
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    Expanded Access Protocol Thymus Transplantation

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