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Study of Allogeneic Double Negative T Cells (DNT-UHN-1) in Patients With High Risk Acute Myeloid Leukemia

Primary Purpose

Acute Myeloid Leukemia

Status
Unknown status
Phase
Phase 1
Locations
Canada
Study Type
Interventional
Intervention
DNT cells
Sponsored by
University Health Network, Toronto
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia focused on measuring allogenic double negative T cells, DNT cells

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Patient Inclusion Criteria:

  1. Patients with AML who are 18 years of age or older.
  2. Viably frozen cells from the time of diagnosis or relapse are available for sensitivity testing to DNT cells.
  3. Patients have given informed consent.
  4. Patients in remission following FLAG-Ida induction therapy who are receiving consolidation treatment.
  5. Creatinine < 1.5 x ULN within 7 days prior to day 1 of study treatment.
  6. AST, ALP, bilirubin < 1.5x ULN within 7 days prior to day 1 of study treatment.
  7. Female patients of childbearing potential should be willing to use 2 methods of birth control (Refer to section 9.2.15 or be surgically sterile, or abstain from heterosexual activity for the course of the study from day 1 until 1 months following chemotherapy. Patients of childbearing potential are those who have not been surgically sterilized or have not been free from menses for > 2 years.

    Male patients should use condoms or abstain from sex from the time of beginning chemotherapy to 1 month after the chemotherapy.

  8. Patients must be able to comply with study procedures, at the minimum, until all DNT-UHN-1 cells are out of their system.

Patient Exclusion Criteria:

  1. ECOG performance status <2.
  2. Patients with a known persistent infection.
  3. Patients with known active CNS disease.
  4. Life expectancy < 3 months.
  5. Patients should be off Cox2 inhibitors and corticosteroids for at least 3 days prior to and 7 days after infusion of DNT cells.
  6. Patients who are HIV positive.
  7. Patients for whom healthy donor DNT kill <10% of patient's blast cells.

Donor Inclusion Criteria:

  1. Has given written informed consent.
  2. Is 18 years of age or older.
  3. No known prior blood product transfusion or surgery.
  4. Blood electrolytes (Sodium, Potassium, Chloride, Bicarbonate, Magnesium, Phosphate, Calcium) within normal ranges.
  5. Normal complete blood counts.
  6. Normal liver and kidney function (Bilirubin, AST, ALT, ALP, LDH, plasma albumin, creatinine).
  7. Negative for transfusion transmissible illnesses (CMV, HIV I/II, HTLV I/II, Hepatitis B Surface Antigen, Hepatitis B Surface Antibody, Hepatitis B Core Antibody, Hepatitis C Antibody) within 30 days of blood collection for DNT cell expansion for patient infusion.
  8. Negative for evidence of exposure to West Nile Virus, Syphilis within 30 days of blood collection for DNT cell expansion for patient infusion.
  9. DNT cell expansion yield is >108 per mL blood using the standard protocol. Expanded DNT cells show ≥20% cytotoxicity to at least 3 AML cell lines (MV4-11 AML3, and U937).
  10. The donor who meet all donor inclusion/exclusion criteria, whose DNT cells show the most potent killing (minimum >10% killing) of AML patient's blast cells (blast cells frozen at time of diagnosis or relapse) will be approached for participation in this study.

Donor Exclusion Criteria:

  1. With a history of high risk behavior including, but not limited to, a history of piercing (except ear lobes), tattoos or other body modification.
  2. Has serious illnesses such as cardiovascular disease & cancer.
  3. Has sexually transmissible disease.
  4. Has history of intravenous drug use.
  5. Persons who received any vaccinations in past 3 months prior to enrolment into this study.
  6. Persons who travel outside the U.S. and Canada in the past 3 years prior to enrolment into this study, to areas that are considered endemic for malaria.
  7. Persons who have received blood components or other human tissues in the past 12 months prior to enrolment into this study (however this may be reduced to 6 months if nucleic acid testing (NAT) is used for the tests).
  8. Pregnant or lactating.
  9. Persons at risk of transmitting a hematological or immunological disease.
  10. Persons with transmissible genetic diseases in the family.
  11. On prescription medication.
  12. Persons with prion-related disease.
  13. Persons with a neurological disease of an unestablished etiology.
  14. Persons with active encephalitis or meningitis of infectious or unknown etiology.
  15. Persons with rabies or persons who, within the past 6 months, were bitten by an animal and treated as if the animal was rabid.
  16. Persons with a family history of Creutzfeldt-Jakob disease.
  17. Persons who have received human-derived pituitary growth hormone or dura mata.
  18. Persons who have known or suspected sepsis at the time of donation.

Sites / Locations

  • Princess Margaret Cancer CentreRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Patient Arm

Donor Arm

Arm Description

Patients will receive DNT cells from healthy donors.

Healthy volunteer donors will donate blood.

Outcomes

Primary Outcome Measures

Number of patients with adverse events and abnormal laboratory studies.
Patients will be assessed for adverse events based upon, but not limited to, monitoring of vital signs and prescribed laboratory studies. Adverse events (AE) will use the descriptions and grading scales found in the revised NCI Common Terminology Criteria for Adverse Events (CTCAE). This study will utilize the CTCAE Version 4.03 for adverse event reporting.

Secondary Outcome Measures

Number of cells with disease specific mutations per patient
Quantitive real time polymerase chain reaction (PCR) analysis for disease specific mutations will be performed on the bone marrow aspirate.
Leukemia load
Peripheral blood will be obtained after DNT cell infusion to monitor leukemia load and residual disease by determining the frequency of leukemic cell markers on cells using flow cytometry.

Full Information

First Posted
January 4, 2017
Last Updated
April 16, 2021
Sponsor
University Health Network, Toronto
Collaborators
Ozmosis Research Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03027102
Brief Title
Study of Allogeneic Double Negative T Cells (DNT-UHN-1) in Patients With High Risk Acute Myeloid Leukemia
Official Title
Phase I Study of Allogeneic Double Negative T Cells (DNT-UHN-1) in Patients With High Risk Acute Myeloid Leukemia
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Unknown status
Study Start Date
August 15, 2017 (Actual)
Primary Completion Date
September 2021 (Anticipated)
Study Completion Date
September 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Health Network, Toronto
Collaborators
Ozmosis Research Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This study aims to determine the safety and toxicity of incremental doses of Double Negative T (DNT) cells in human subjects with high risk acute myeloid leukemia (AML). DNT cells are mature T lymphocytes that comprise ~1% of white blood cells in humans. Injection of DNTs from healthy donors has been demonstrated to be effective against AML cells. DNT cells will be collected from healthy volunteers and injected into patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia
Keywords
allogenic double negative T cells, DNT cells

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
24 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Patient Arm
Arm Type
Experimental
Arm Description
Patients will receive DNT cells from healthy donors.
Arm Title
Donor Arm
Arm Type
No Intervention
Arm Description
Healthy volunteer donors will donate blood.
Intervention Type
Biological
Intervention Name(s)
DNT cells
Intervention Description
DNT cells will be expanded (increased in numbers) in the laboratory, in order to enhance their tumour destroying potential before infusion into AML patients.
Primary Outcome Measure Information:
Title
Number of patients with adverse events and abnormal laboratory studies.
Description
Patients will be assessed for adverse events based upon, but not limited to, monitoring of vital signs and prescribed laboratory studies. Adverse events (AE) will use the descriptions and grading scales found in the revised NCI Common Terminology Criteria for Adverse Events (CTCAE). This study will utilize the CTCAE Version 4.03 for adverse event reporting.
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Number of cells with disease specific mutations per patient
Description
Quantitive real time polymerase chain reaction (PCR) analysis for disease specific mutations will be performed on the bone marrow aspirate.
Time Frame
2 years
Title
Leukemia load
Description
Peripheral blood will be obtained after DNT cell infusion to monitor leukemia load and residual disease by determining the frequency of leukemic cell markers on cells using flow cytometry.
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Patient Inclusion Criteria: Patients with AML who are 18 years of age or older. Viably frozen cells from the time of diagnosis or relapse are available for sensitivity testing to DNT cells. Patients have given informed consent. Patients in remission following FLAG-Ida induction therapy who are receiving consolidation treatment. Creatinine < 1.5 x ULN within 7 days prior to day 1 of study treatment. AST, ALP, bilirubin < 1.5x ULN within 7 days prior to day 1 of study treatment. Female patients of childbearing potential should be willing to use 2 methods of birth control (Refer to section 9.2.15 or be surgically sterile, or abstain from heterosexual activity for the course of the study from day 1 until 1 months following chemotherapy. Patients of childbearing potential are those who have not been surgically sterilized or have not been free from menses for > 2 years. Male patients should use condoms or abstain from sex from the time of beginning chemotherapy to 1 month after the chemotherapy. Patients must be able to comply with study procedures, at the minimum, until all DNT-UHN-1 cells are out of their system. Patient Exclusion Criteria: ECOG performance status <2. Patients with a known persistent infection. Patients with known active CNS disease. Life expectancy < 3 months. Patients should be off Cox2 inhibitors and corticosteroids for at least 3 days prior to and 7 days after infusion of DNT cells. Patients who are HIV positive. Patients for whom healthy donor DNT kill <10% of patient's blast cells. Donor Inclusion Criteria: Has given written informed consent. Is 18 years of age or older. No known prior blood product transfusion or surgery. Blood electrolytes (Sodium, Potassium, Chloride, Bicarbonate, Magnesium, Phosphate, Calcium) within normal ranges. Normal complete blood counts. Normal liver and kidney function (Bilirubin, AST, ALT, ALP, LDH, plasma albumin, creatinine). Negative for transfusion transmissible illnesses (CMV, HIV I/II, HTLV I/II, Hepatitis B Surface Antigen, Hepatitis B Surface Antibody, Hepatitis B Core Antibody, Hepatitis C Antibody) within 30 days of blood collection for DNT cell expansion for patient infusion. Negative for evidence of exposure to West Nile Virus, Syphilis within 30 days of blood collection for DNT cell expansion for patient infusion. DNT cell expansion yield is >108 per mL blood using the standard protocol. Expanded DNT cells show ≥20% cytotoxicity to at least 3 AML cell lines (MV4-11 AML3, and U937). The donor who meet all donor inclusion/exclusion criteria, whose DNT cells show the most potent killing (minimum >10% killing) of AML patient's blast cells (blast cells frozen at time of diagnosis or relapse) will be approached for participation in this study. Donor Exclusion Criteria: With a history of high risk behavior including, but not limited to, a history of piercing (except ear lobes), tattoos or other body modification. Has serious illnesses such as cardiovascular disease & cancer. Has sexually transmissible disease. Has history of intravenous drug use. Persons who received any vaccinations in past 3 months prior to enrolment into this study. Persons who travel outside the U.S. and Canada in the past 3 years prior to enrolment into this study, to areas that are considered endemic for malaria. Persons who have received blood components or other human tissues in the past 12 months prior to enrolment into this study (however this may be reduced to 6 months if nucleic acid testing (NAT) is used for the tests). Pregnant or lactating. Persons at risk of transmitting a hematological or immunological disease. Persons with transmissible genetic diseases in the family. On prescription medication. Persons with prion-related disease. Persons with a neurological disease of an unestablished etiology. Persons with active encephalitis or meningitis of infectious or unknown etiology. Persons with rabies or persons who, within the past 6 months, were bitten by an animal and treated as if the animal was rabid. Persons with a family history of Creutzfeldt-Jakob disease. Persons who have received human-derived pituitary growth hormone or dura mata. Persons who have known or suspected sepsis at the time of donation.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Mark Minden, MD
Phone
416-946-2015
Email
mark.minden@uhn.ca
Facility Information:
Facility Name
Princess Margaret Cancer Centre
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G2M9
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mark Minden

12. IPD Sharing Statement

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Study of Allogeneic Double Negative T Cells (DNT-UHN-1) in Patients With High Risk Acute Myeloid Leukemia

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