Cytotoxic T-Lymphocytes for EBV-positive Lymphoma, GRALE (GRALE)
Hodgkin's Disease, Non-Hodgkin's Lymphoma, Lymphoproliferative Disease
About this trial
This is an interventional treatment trial for Hodgkin's Disease focused on measuring EBV, Hodgkin's Lymphoma, Non-Hodgkin's Lymphoma, Lymphoma Relapse, Autologous or Syngeneic Stem Cell Transplant, T/NK-lymphoproliferative disease, LMP, BARF1, EBNA1
Eligibility Criteria
Inclusion Criteria at time of Procurement
- Any patient, regardless of age or sex, with EBV-positive Hodgkin's or non-Hodgkin's Lymphoma, (regardless of the histological subtype) or EBV (associated)-T/NK-lymphoproliferative disease or Severe Chronic Active EBV (CAEBV) who may subsequently be eligible for the treatment component
- EBV positive tumor (can be pending at this time)
- Weighs at least 12kg
- Informed consent explained to, understood by and signed by patient/guardian. Patient/guardian given copy of informed consent.
Inclusion Criteria at time of Infusion
Any patient, regardless of age or sex, with EBV-positive Hodgkin's or non-Hodgkin's Lymphoma (regardless of histologic subtype), or EBV (associated)-T/NK-lymphoproliferative disease or Severe Chronic Active EBV (CAEBV)* and
In second or subsequent relapse (or first relapse or with active disease if immunosuppressive chemotherapy contraindicated or multiply relapsed patients in remission who have a high risk of relapse)** OR any patient with primary disease or in first remission if immunosuppressive chemotherapy is contraindicated, e.g. patients who develop Hodgkin disease after solid organ transplantation or if the Lymphoma is a second malignancy e.g. a Richter's transformation of CLL. (Group A)
OR
In remission or with minimal residual disease status after autologous or syngeneic SCT. (Group B)
- EBV positive tumor
- Patients with life expectancy greater than or equal 6 weeks.
- Patients with bilirubin less than or equal to 3x upper limit of normal, AST less than or equal 5x upper limit of normal, and hemoglobin greater than or equal to 7.0 (may be a transfused value).
- Patients with a creatinine less than or equal to 2x upper limit of normal for age
- Pulse oximetry of > 90% on room air
- Patients should have been off other investigational therapy for 4 weeks prior to entry in this study. PD1/PDL inhibitors will be allowed if medically indicated.
- Patients with a Karnofsky/Lansky score of greater than or equal to 50
- Sexually active patients must be willing to utilize one of the more effective birth control methods during the study and for 6 months after the study is concluded. The male partner should use a condom.
Informed consent explained to, understood and signed by patient/guardian. Patient/guardian given copy of informed consent.
CAEBV is defined as patients with high EBV viral load in plasma or PBMC (> 4000 genomes per ug PBMC DNA) and/or biopsy tissue positive for EBV
- Patients with relapsed or refractory lymphoma that are eligible for a stem cell transplant will not be treated on this study as an alternative to transplant.
Exclusion Criteria at Time of Procurement
1. Active infection with HIV, HTLV, HBV, HCV (can be pending at this time)
Exclusion Criteria at Time of Infusion
- Pregnant or lactating
- Severe intercurrent infection.
- Current use of systemic corticosteroids > 0.5 mg/kg/day
Sites / Locations
- Houston Methodist HospitalRecruiting
- Texas Children's HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
EBV-specific T cells: A
EBV-specific T cells: B
Group A: Patients in second or subsequent relapse (or first relapse or with active disease if immunosuppressive chemotherapy contraindicated or multiple relapsed patients in remission who are at a high risk of relapse)** or any patient with primary disease or in first or subsequent remission if immunosuppressive chemotherapy is contraindicated. Patients will be treated at Dose Level 3. Each patient will receive 2 injections, 14 days apart, according to the following dosing schedule: Day 0: 1 x 10^8 cells/m2 Day 14: 2 x 10^8 cells/m2 ** Patients with relapsed or refractory lymphoma that are eligible for a stem cell transplant will not be treated on this study as an alternative to transplant.
Group B: Patients in remission or with minimal residual disease (MRD) status after autologous or syngeneic SCT. Patients will be treated at Dose Level 3. Each patient will receive 2 injections, 14 days apart, according to the following dosing schedule: Day 0: 1 x 10^8 cells/m2 Day 14: 2 x 10^8 cells/m2