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CIK-Cells in Relapsing Patients With Acute Leukemia or Myelodysplastic Syndromes After SCT.

Primary Purpose

Myelodysplastic Syndromes, Acute Leukemia

Status
Active
Phase
Phase 1
Locations
Germany
Study Type
Interventional
Intervention
CIK-Cells
Sponsored by
Peter Bader
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myelodysplastic Syndromes focused on measuring acute leukemia, myelodysplastic syndrome (MDS), Stem Cell Transplantation

Eligibility Criteria

0 Years - 80 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Acute leukemia and MDS patients with molecular or cytogenetic relapse in peripheral blood (PB) or bone marrow (BM) samples obtained during monitoring for relapse after allogeneic SCT.

MRD detected by Ig/TCR gene rearrangement testing or any detected disease specific DNA or RNA sequence or disease specific cell surface Proteins or mixed recipient chimerism (MC) ≥ 1% and < 40%, or levels ≥ 10-4 of BCR-ABL/ABL ratio or any other disease specific cytogenetic abnormality will trigger CIK cell interventions.

  • Respecting MC, MC = 1% of autologous/recipient signals in PB samples must be confirmed by another PB or BM sample within one week. Patients with MC = 1% of autologous/recipient signals in CD33+ and/or CD34+ subpopulations in PB samples must be confirmed by BM analyses within one week. Acute leukemia and MDS patients with MC = 1% of autologous/recipient signals including signals in CD33+ and/or CD34+ subpopulations in BM samples must not be confirmed.
  • Acute leukemia and MDS patients with frank relapse ≥ 120 days after allogeneic SCT who achieved complete remission (CR) or blast clearance (i.e. <5% blasts) in the bone marrow after re-induction chemotherapy.
  • All patients must be in complete remission or have achieved blast clearance (i.e. <5% blasts) in the bone marrow before 1st CIK cell treatment (bone marrow assessment at a maximum of 7 days in advance of 1st treatment is obligatory).
  • Patients without immunosuppressive agents and steroids for at least 7 days.
  • Patients without chemo- or immune therapy during CIK cell treatment, except patients with thyrosine-kinase inhibitors (TKI) for treatment of BCR-ABL positive leukemia. Last DLI treatment must be 4 weeks before 1st CIK cell treatment.
  • Patients with < grade II aGvHD.
  • Patients with Karnowsky or Lansky performance status ≥ 50%.
  • Patients and/or his/her legal representative having reviewed the patient information/informed consent form and have had their questions answered and have given written informed consent.

Exclusion Criteria:

  • Acute leukemia and MDS patients with hematologic relapse < day 120 after allogeneic stem cell transplantation.
  • Patients with 5% and more malignant cells in a representative bone marrow analysis performed at a maximum of 7 days before 1st CIK cell treatment (obligatory).
  • Patients with immunosuppressive agents or steroids.
  • Patients with chemo- or immune therapy, except patients with thyrosine-kinase inhibitors (TKI) for BCR-ABL positive leukemias.
  • Patients with ≥ grade II GvHD.
  • Patients with rapid T cell regeneration and any signs of GvHD
  • Patients with Karnowsky or Lansky performance status < 50%.
  • Patients and/or his/her legal representative having reviewed the patient information/informed consent form and have had their questions answered and have not given written informed consent.
  • HIV-positive patients.
  • HBV/HCV positive patients.
  • Patients with prior solid organ transplantation.
  • Patients treated with any other investigational product within the last 28 days or five half-lives (whichever is longer).
  • Hypersensitivity to any component of the study drug
  • Female patients of child-bearing potential not agreeing to use a highly effective method of birth control resulting in a low failure rate (i.e. < 1%) when used consistently and correctly.
  • Male patients with female partners of childbearing potential not agreeing to use a highly effective method birth control resulting in a low failure rate (i.e. < 1%) when used consistently and correctly.
  • Pregnancy/Breastfeeding.
  • Patients with severe infections or signs/symptoms of infection within 2 weeks prior to study start.

Sites / Locations

  • University Hospital Heidelberg, Ruprecht Karls University, Hospital for children and adolescents, Pediatrics III, Department of Oncology, Haematology, Immunology and Pneumology
  • Division for Stem Cell Transplantation and Immunology, Department for Children and Adolescents, University Hospital Frankfurt
  • Internal Medicine II, Department of Hematology, Oncology, Rheumatology and Infectious Diseases, Goethe-University Frankfurt/Main
  • University Medicine Duesseldorf, Department of Paediatric Oncology, Haematology and Immunology, Bone Marrow Transplantation Unit
  • Internal Medicine III, Department of Hematology and Oncology, Johannes Gutenberg University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

CIK-Cells

Arm Description

IL-15 activated CIK cells individually generated from PB mononuclear cells of the original stem cell donors.

Outcomes

Primary Outcome Measures

The occurrence of grade three or four acute Graft versus Host Disease (aGvHD)
Extensive chronic Graft versus Host Disease (cGvHD)

Secondary Outcome Measures

Efficacy of CIK-Cells analyzed by progression free survival
Overall survival

Full Information

First Posted
March 31, 2016
Last Updated
March 31, 2022
Sponsor
Peter Bader
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1. Study Identification

Unique Protocol Identification Number
NCT02752243
Brief Title
CIK-Cells in Relapsing Patients With Acute Leukemia or Myelodysplastic Syndromes After SCT.
Official Title
A Prospective Phase I/II Study to Investigate the Feasibility, Safety and Efficacy of IL-15 Activated Cytokine Induced Killer (CIK) Cells in Relapsing Patients With Acute Leukemia or Myelodysplastic Syndromes After Allogeneic SCT
Study Type
Interventional

2. Study Status

Record Verification Date
March 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
March 2016 (undefined)
Primary Completion Date
March 2023 (Anticipated)
Study Completion Date
March 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Peter Bader

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Multi-site, non-randomized Phase I/II study involving children and adults.
Detailed Description
This is a phase I/II multicenter-study to investigate the feasibility safety and efficacy of interleukin (IL)-15 activated CIK cells in patients with acute leukemia or myelodysplastic syndrome (MDS) showing evidence of relapse after allogeneic stem cell transplantation (SCT). CIK cell infusions will be given with an interval of 4-6 weeks according to a dose escalation schedule in patients with impending relapse after allogeneic SCT. In presence of acute graft versus host disease (aGvHD) ≥ grade II, the next scheduled infusion will not be administered.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myelodysplastic Syndromes, Acute Leukemia
Keywords
acute leukemia, myelodysplastic syndrome (MDS), Stem Cell Transplantation

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
32 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CIK-Cells
Arm Type
Experimental
Arm Description
IL-15 activated CIK cells individually generated from PB mononuclear cells of the original stem cell donors.
Intervention Type
Drug
Intervention Name(s)
CIK-Cells
Intervention Description
IL-15 activated CIK cells individually generated from PB mononuclear cells of the original stem cell donors.
Primary Outcome Measure Information:
Title
The occurrence of grade three or four acute Graft versus Host Disease (aGvHD)
Time Frame
two until four weeks after CIK-Cell Infusion
Title
Extensive chronic Graft versus Host Disease (cGvHD)
Time Frame
two until four weeks after CIK-Cell Infusion
Secondary Outcome Measure Information:
Title
Efficacy of CIK-Cells analyzed by progression free survival
Time Frame
one year
Title
Overall survival
Time Frame
one year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
0 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Acute leukemia and MDS patients with molecular or cytogenetic relapse in peripheral blood (PB) or bone marrow (BM) samples obtained during monitoring for relapse after allogeneic SCT. MRD detected by Ig/TCR gene rearrangement testing or any detected disease specific DNA or RNA sequence or disease specific cell surface Proteins or mixed recipient chimerism (MC) ≥ 1% and < 40%, or levels ≥ 10-4 of BCR-ABL/ABL ratio or any other disease specific cytogenetic abnormality will trigger CIK cell interventions. Respecting MC, MC = 1% of autologous/recipient signals in PB samples must be confirmed by another PB or BM sample within one week. Patients with MC = 1% of autologous/recipient signals in CD33+ and/or CD34+ subpopulations in PB samples must be confirmed by BM analyses within one week. Acute leukemia and MDS patients with MC = 1% of autologous/recipient signals including signals in CD33+ and/or CD34+ subpopulations in BM samples must not be confirmed. Acute leukemia and MDS patients with frank relapse ≥ 120 days after allogeneic SCT who achieved complete remission (CR) or blast clearance (i.e. <5% blasts) in the bone marrow after re-induction chemotherapy. All patients must be in complete remission or have achieved blast clearance (i.e. <5% blasts) in the bone marrow before 1st CIK cell treatment (bone marrow assessment at a maximum of 7 days in advance of 1st treatment is obligatory). Patients without immunosuppressive agents and steroids for at least 7 days. Patients without chemo- or immune therapy during CIK cell treatment, except patients with thyrosine-kinase inhibitors (TKI) for treatment of BCR-ABL positive leukemia. Last DLI treatment must be 4 weeks before 1st CIK cell treatment. Patients with < grade II aGvHD. Patients with Karnowsky or Lansky performance status ≥ 50%. Patients and/or his/her legal representative having reviewed the patient information/informed consent form and have had their questions answered and have given written informed consent. Exclusion Criteria: Acute leukemia and MDS patients with hematologic relapse < day 120 after allogeneic stem cell transplantation. Patients with 5% and more malignant cells in a representative bone marrow analysis performed at a maximum of 7 days before 1st CIK cell treatment (obligatory). Patients with immunosuppressive agents or steroids. Patients with chemo- or immune therapy, except patients with thyrosine-kinase inhibitors (TKI) for BCR-ABL positive leukemias. Patients with ≥ grade II GvHD. Patients with rapid T cell regeneration and any signs of GvHD Patients with Karnowsky or Lansky performance status < 50%. Patients and/or his/her legal representative having reviewed the patient information/informed consent form and have had their questions answered and have not given written informed consent. HIV-positive patients. HBV/HCV positive patients. Patients with prior solid organ transplantation. Patients treated with any other investigational product within the last 28 days or five half-lives (whichever is longer). Hypersensitivity to any component of the study drug Female patients of child-bearing potential not agreeing to use a highly effective method of birth control resulting in a low failure rate (i.e. < 1%) when used consistently and correctly. Male patients with female partners of childbearing potential not agreeing to use a highly effective method birth control resulting in a low failure rate (i.e. < 1%) when used consistently and correctly. Pregnancy/Breastfeeding. Patients with severe infections or signs/symptoms of infection within 2 weeks prior to study start.
Facility Information:
Facility Name
University Hospital Heidelberg, Ruprecht Karls University, Hospital for children and adolescents, Pediatrics III, Department of Oncology, Haematology, Immunology and Pneumology
City
Heidelberg
State/Province
Baden-Württemberg
ZIP/Postal Code
69120
Country
Germany
Facility Name
Division for Stem Cell Transplantation and Immunology, Department for Children and Adolescents, University Hospital Frankfurt
City
Frankfurt / Main
State/Province
Hessen
ZIP/Postal Code
60590
Country
Germany
Facility Name
Internal Medicine II, Department of Hematology, Oncology, Rheumatology and Infectious Diseases, Goethe-University Frankfurt/Main
City
Frankfurt / Main
State/Province
Hessen
ZIP/Postal Code
60590
Country
Germany
Facility Name
University Medicine Duesseldorf, Department of Paediatric Oncology, Haematology and Immunology, Bone Marrow Transplantation Unit
City
Duesseldorf
State/Province
North Rhine-Westphalia
ZIP/Postal Code
40225
Country
Germany
Facility Name
Internal Medicine III, Department of Hematology and Oncology, Johannes Gutenberg University
City
Mainz
State/Province
Rhineland Palatinate
ZIP/Postal Code
55101
Country
Germany

12. IPD Sharing Statement

Plan to Share IPD
No

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CIK-Cells in Relapsing Patients With Acute Leukemia or Myelodysplastic Syndromes After SCT.

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