A Phase 1 Trial of a Single ProHema® CB Product for Pediatric Patients With Hematologic Malignancies
Hematologic Malignancies
About this trial
This is an interventional treatment trial for Hematologic Malignancies
Eligibility Criteria
Inclusion Criteria:
- Male and female subjects aged 1 to 18 years, inclusive.
Subjects with hematologic malignancies for whom allogeneic stem cell transplantation is deemed clinically appropriate.
- Acute Myelogenous Leukemia (AML) in high risk 1st or subsequent CR
- Acute Lymphoblastic Leukemia (ALL) in CR
- NK cell lymphoblastic leukemia in any CR
- Biphenotypic or undifferentiated leukemia in 1st or subsequent CR
- Myelodysplastic Syndrome (MDS) at any stage.
- Chronic Myelogenous Leukemia (CML) All subjects with evidence of CNS leukemia must be treated and be in CNS CR to be eligible for trial.
- Lack of 5-6/6 HLA matched related or 8/8 HLA A, B, C, DRß1 matched unrelated donor; or unrelated donor not available within appropriate timeframe, as determined by the transplant physician.
- Availability of suitable primary and secondary umbilical cord blood (UCB) units.
Adequate performance status, defined as:
- Subjects ≥ 16 years: Karnofsky score ≥ 70%.
- Subjects < 16 years: Lansky score ≥ 70%.
- Cardiac: Left ventricular ejection fraction at rest must be > 40%, or shortening fraction > 26%.
Pulmonary:
- Subjects > 10 years: DLCO (diffusion capacity) > 50% of predicted (corrected for hemoglobin)
- FEV1, FVC > 50% of predicted; Note: If unable to perform pulmonary tests, then O2 saturation > 92% on room air.
- Renal: Serum creatinine within normal range for age, or if serum creatinine outside normal range for age, then renal function (creatinine clearance or GFR) > 70mL/min/1.73m2.
- Hepatic: Bilirubin ≤ 2.5 mg/dL (except in the case of Gilbert's syndrome or ongoing hemolytic anemia); and ALT, AST and Alkaline Phosphatase ≤ 5 × ULN.
- Signed IRB approved Informed Consent Form (ICF).
Exclusion Criteria:
- Female subjects that are pregnant or breastfeeding.
- Evidence of HIV infection or HIV positive serology.
- Current uncontrolled bacterial, viral or fungal infection.
- Prior allogeneic hematopoietic stem cell transplant.
- Autologous transplant < 12 months prior to enrollment.
- Prior autologous transplant for the disease for which the UCB transplant is being performed.
- Active malignancy other than the one for which the UCB transplant is being performed within 12 months of enrollment.
- Inability to receive TBI.
- Requirement of supplemental oxygen.
- HLA-matched related donor able to donate.
- Use of an investigational drug within 30 days prior to screening.
- Subject is unlikely to comply with the protocol requirements, instructions and study-related restrictions
Sites / Locations
- City of Hope
- Boston Children's Hospital
Arms of the Study
Arm 1
Experimental
ProHema-CB
All subjects will receive treatment with ProHema-CB (ex-vivo modulated human cord blood cells) transplant. ProHema-CB (the prostaglandin derivative, 16,16-dimethyl prostaglandin E2 also referred to as FT1050) will be prepared and administered in one of two formulations, based upon subject weight: For subjects > 35 kg, ProHema-CB will be administered as 150 mL product in a blood bag via gravity infusion. It will be infused at 10 mL to 15 mL per minute, for a total infusion time of 10 to 15 min. For subject's ≤ 35 kg, ProHema-CB will be administered as a 50 mL product in a syringe via syringe pump.o It will be infused at 5 mL/kg per hour for a total infusion time of up to ~1 hour.