MIC Cell Therapy for Individualized Immunosuppression in Living Donor Kidney Transplant Recipients (TOL-1)
Primary Purpose
Kidney Failure, Chronic
Status
Completed
Phase
Phase 1
Locations
Germany
Study Type
Interventional
Intervention
Mitomycin C-induced peripheral blood mononuclear cells (MICs)
Sponsored by
About this trial
This is an interventional prevention trial for Kidney Failure, Chronic
Eligibility Criteria
Inclusion Criteria:
- Chronic kidney disease stage KDIGO 4 or 5
- First kidney transplant from a living donor
- Age ≥ 18 years
- ABO compatible
- CDC-PRA < 20%
- No donor-specific antibodies
- Negative CDC and ELISA crossmatch
- Immunosuppression with cyclosporin A, EC-MPS and methylprednisolone
- Informed consent
- Adequate contraception (women with child bearing potential)
Exclusion Criteria:
- Psychiatric disorder
- Heart failure (NYHA III or IV)
- Severe liver disease
- Active hepatitis B or C or HIV infection
- Active bacterial, fungal or viral disease
- Malignancy or malignancy in the last 5 years before screening
- Preexisting immunosuppression
- Vaccination with a live vaccine in the last 3 months before screening
- S/p splenectomy
- Substance abuse
- Pregnancy or lactation
- Women: Child/pregnancy with the intended donor
- Allergy against the investigational drug or part of it
- Other diseases that prohibit participation in the study (in the opinion of the investigator)
- Participation in an other interventional study
Sites / Locations
- University of Heidelberg
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Intervention arm
Arm Description
Patients receive MIC cell therapy together with standard immunosuppressive therapy
Outcomes
Primary Outcome Measures
The primary outcome measure is the frequency of adverse events after intravenous administration of MICs within 30 days after transplantation.
Secondary Outcome Measures
Cumulative incidence of infection
Cumulative incidence of CMV reactivation
Number of patients with PTLD
Number of patients with delayed graft function
Number of patients with a pos. CDC and/or ELISA crossmatch
Number of patients with DSA
Incidence of biopsy-proven cellular rejection
Incidence of biopsy-proven antibody-mediated rejection
Number of patients with stable graft function (S-creatinine < 2mg/dL)
Patient and graft survival
Full Information
NCT ID
NCT02560220
First Posted
August 6, 2015
Last Updated
July 23, 2018
Sponsor
Heidelberg University
Collaborators
WiSP GmbH, German Federal Ministry of Economics and Technology
1. Study Identification
Unique Protocol Identification Number
NCT02560220
Brief Title
MIC Cell Therapy for Individualized Immunosuppression in Living Donor Kidney Transplant Recipients
Acronym
TOL-1
Official Title
A Single-arm Phase-I Trial for the Determination of Safety and Feasibility of the Intravenous Administration of Mitomycin C-treated Donor Peripheral Blood Mononuclear Cells (MICs) for Individualized Immunosuppression in Living Donor Kidney Transplant Recipients (TOL-1 Study)
Study Type
Interventional
2. Study Status
Record Verification Date
July 2018
Overall Recruitment Status
Completed
Study Start Date
August 5, 2015 (Actual)
Primary Completion Date
April 18, 2017 (Actual)
Study Completion Date
April 18, 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Heidelberg University
Collaborators
WiSP GmbH, German Federal Ministry of Economics and Technology
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
A phase- I clinical trial to determine safety and feasibilty of intravenous administration of mitomycin C-treated donor peripheral blood mononuclear cells in patients with chronic kidney disease stage KDIGO 4 or 5 (i.e. GFR 15-30 mL/min or < 15 mL/min) who receive a kidney transplant from a living donor.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Kidney Failure, Chronic
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
14 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Intervention arm
Arm Type
Experimental
Arm Description
Patients receive MIC cell therapy together with standard immunosuppressive therapy
Intervention Type
Biological
Intervention Name(s)
Mitomycin C-induced peripheral blood mononuclear cells (MICs)
Intervention Description
MICs are given intravenously 2 or 7 days before kidney transplantation from a living donor
Primary Outcome Measure Information:
Title
The primary outcome measure is the frequency of adverse events after intravenous administration of MICs within 30 days after transplantation.
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Cumulative incidence of infection
Time Frame
30 days
Title
Cumulative incidence of CMV reactivation
Time Frame
30 days
Title
Number of patients with PTLD
Time Frame
30 days
Title
Number of patients with delayed graft function
Time Frame
7 days
Title
Number of patients with a pos. CDC and/or ELISA crossmatch
Time Frame
day -1 before transplantation
Title
Number of patients with DSA
Time Frame
day -1 before transplantation and day 7 and 30 after transplantation
Title
Incidence of biopsy-proven cellular rejection
Time Frame
30 days
Title
Incidence of biopsy-proven antibody-mediated rejection
Time Frame
30 days
Title
Number of patients with stable graft function (S-creatinine < 2mg/dL)
Time Frame
30 days
Title
Patient and graft survival
Time Frame
30 days
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Chronic kidney disease stage KDIGO 4 or 5
First kidney transplant from a living donor
Age ≥ 18 years
ABO compatible
CDC-PRA < 20%
No donor-specific antibodies
Negative CDC and ELISA crossmatch
Immunosuppression with cyclosporin A, EC-MPS and methylprednisolone
Informed consent
Adequate contraception (women with child bearing potential)
Exclusion Criteria:
Psychiatric disorder
Heart failure (NYHA III or IV)
Severe liver disease
Active hepatitis B or C or HIV infection
Active bacterial, fungal or viral disease
Malignancy or malignancy in the last 5 years before screening
Preexisting immunosuppression
Vaccination with a live vaccine in the last 3 months before screening
S/p splenectomy
Substance abuse
Pregnancy or lactation
Women: Child/pregnancy with the intended donor
Allergy against the investigational drug or part of it
Other diseases that prohibit participation in the study (in the opinion of the investigator)
Participation in an other interventional study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Martin Zeier, MD
Organizational Affiliation
Heidelberg University
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Heidelberg
City
Heidelberg
State/Province
Baden-Wuerttemberg
ZIP/Postal Code
69120
Country
Germany
12. IPD Sharing Statement
Citations:
PubMed Identifier
26077202
Citation
Morath C, Schmitt A, Zeier M, Schmitt M, Sandra-Petrescu F, Opelz G, Terness P, Schaier M, Kleist C. Cell therapy for immunosuppression after kidney transplantation. Langenbecks Arch Surg. 2015 Jul;400(5):541-50. doi: 10.1007/s00423-015-1313-z. Epub 2015 Jun 17.
Results Reference
background
PubMed Identifier
25495457
Citation
Kleist C, Sandra-Petrescu F, Jiga L, Dittmar L, Mohr E, Greil J, Mier W, Becker LE, Lang P, Opelz G, Terness P. Generation of suppressive blood cells for control of allograft rejection. Clin Sci (Lond). 2015 May;128(9):593-607. doi: 10.1042/CS20140258.
Results Reference
background
PubMed Identifier
26074415
Citation
Dittmar L, Mohr E, Kleist C, Ehser S, Demirdizen H, Sandra-Petrescu F, Hundemer M, Opelz G, Terness P. Immunosuppressive properties of mitomycin C-incubated human myeloid blood cells (MIC) in vitro. Hum Immunol. 2015 Jul;76(7):480-7. doi: 10.1016/j.humimm.2015.06.008. Epub 2015 Jun 11.
Results Reference
background
PubMed Identifier
19017789
Citation
Terness P, Oelert T, Ehser S, Chuang JJ, Lahdou I, Kleist C, Velten F, Hammerling GJ, Arnold B, Opelz G. Mitomycin C-treated dendritic cells inactivate autoreactive T cells: toward the development of a tolerogenic vaccine in autoimmune diseases. Proc Natl Acad Sci U S A. 2008 Nov 25;105(47):18442-7. doi: 10.1073/pnas.0807185105. Epub 2008 Nov 18.
Results Reference
background
PubMed Identifier
31990685
Citation
Morath C, Schmitt A, Kleist C, Daniel V, Opelz G, Susal C, Ibrahim E, Kalble F, Speer C, Nusshag C, Pego da Silva L, Sommerer C, Wang L, Ni M, Huckelhoven-Krauss A, Czock D, Merle U, Mehrabi A, Sander A, Hackbusch M, Eckert C, Waldherr R, Schnitzler P, Muller-Tidow C, Hoheisel JD, Mustafa SA, Alhamdani MS, Bauer AS, Reiser J, Zeier M, Schmitt M, Schaier M, Terness P. Phase I trial of donor-derived modified immune cell infusion in kidney transplantation. J Clin Invest. 2020 May 1;130(5):2364-2376. doi: 10.1172/JCI133595.
Results Reference
derived
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MIC Cell Therapy for Individualized Immunosuppression in Living Donor Kidney Transplant Recipients
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