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Ex-vivo Expanded γδ T Lymphocytes in Patients With Refractory/Relapsed Acute Myeloid Leukaemia

Primary Purpose

Acute Myeloid Leukemia

Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Ex-vivo Expanded γδ T Lymphocytes
Sponsored by
Wuhan Union Hospital, China
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Myeloid Leukemia focused on measuring gamma-delta T, Refractory/Relapsed

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. History of acute myeloid leukaemia (initially diagnosed by presence of 20% or more blast cells with myeloid or monocytic differentiation confirmed by flow cytometry in peripheral blood or bone marrow)
  2. Relapsed or refractory AML. A. AML relapse after intensive chemotherapy; B. AML relapse after allogeneic HCT; C. AML progression on low intensity therapy (low dose cytarabine, 5-azacytidine or decitabine); D. No response to at least 4 cycles of low intensity therapy; E. AML refractory to 2 cycles of induction chemotherapy.
  3. Presence of > 5% of blasts in bone marrow or peripheral blood smear
  4. Patient not eligible for or does not consent to high dose salvage chemotherapy and/or allogeneic Haematopoietic Cell Transplantation (HCT)
  5. Considered suitable for lymphodepleting chemotherapy
  6. The patient's peripheral superficial venous blood flow smoothly, which can meet the needs of intravenous drip.
  7. Patient's main organs function well. A. Liver function: ALT/AST < 3 times the upper limit of normal (ULN); B. total bilirubin≤34.2μmol/L; C. Renal function: Creatinine < 220μmol/L; D. Pulmonary function: Indoor oxygen saturation≥95%; E. Cardiac Function: Left ventricular ejection fraction (LVEF) ≥40%;
  8. Life expectancy of at least 3 months
  9. Patient ECOG score≤2, Estimated survival time≥3 months.
  10. Ability to be off systemic prednisone and other immunosuppressive drugs for at least 3 days prior to γδ T cells product infusion. Maintenance replacement steroid is allowed.
  11. The patients did not receive any anticancer treatments such as chemotherapy, radiotherapy and immunotherapy (such as immunosuppressive drugs) within 4 weeks before admission, and the toxicity related to previous treatments had returned to < 1 level at admission (except for low toxicity such as alopecia).
  12. Patient able to understand and sign written informed consent
  13. Age 18 years up to the age of 75 (≤ 75)

Exclusion Criteria:

  1. Women who are pregnant (urine/blood pregnancy test positive) or lactating.
  2. Male or female with a conception plan in the past 1 years.
  3. Patients cannot guarantee effective contraception (condom or contraceptives, etc.) within 1 years after enrollment.
  4. Uncontrolled infectious disease within 4 weeks prior to enrollment.
  5. Active hepatitis B/C virus.
  6. HIV infected patients.
  7. Suffering from a serious autoimmune disease or immunodeficiency disease.
  8. The patient is allergic and is allergic to macromolecular biopharmaceuticals such as antibodies or cytokines.
  9. The patient participated in other clinical trials within 6 weeks prior to enrollment.
  10. Systemic use of hormones within 4 weeks prior to enrollment (except for patients with inhaled corticosteroids).
  11. Have a history of epilepsy or other central nervous system diseases.
  12. Having drug abuse/addiction.
  13. According to the researcher's judgment, the patient has other unsuitable grouping conditions.

Sites / Locations

  • Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Ex-vivo Expanded γδ T Lymphocytes

Arm Description

Patients receive ex-vivo expanded γδ T Lymphocytes (Dose escalation, 2*10^6, 4*10^6, 8*10^6 of cells per kg of body weight).

Outcomes

Primary Outcome Measures

Four-months remission rate
Number of patients reaching Complete Remission (CR) according to National Comprehensive Cancer Network (NCCN, Version 1.2015).
Number of participants with adverse events (AEs)
Therapy-related adverse events were recorded and assessed according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE, Version 4.0).

Secondary Outcome Measures

Overall survival
OS was calculated from the first infusion to death or last follow-up (censored).
Event-free survival
EFS was calculated from the first infusion to death, progression of the disease, relapse or gene recurrence, whichever came first, or last visit (censored).
Relapse-free survival
RFS was calculated from the first infusion to relapse or last visit (censored).
Quantity of gamma-delta T cells in bone marrow cells and peripheral blood cells
Persistence of γδ T cells assessed by number and phenotype of γδ T cells using flow cytometry assay in peripheral blood and bone marrow from patients
lymphocyte subsets function assessment of bone marrow cells and peripheral blood cells
Assessment of lymphocyte subsets function using flow cytometry assay in peripheral blood and bone marrow from patients.

Full Information

First Posted
July 2, 2019
Last Updated
August 5, 2019
Sponsor
Wuhan Union Hospital, China
Collaborators
Jinan University, China
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1. Study Identification

Unique Protocol Identification Number
NCT04008381
Brief Title
Ex-vivo Expanded γδ T Lymphocytes in Patients With Refractory/Relapsed Acute Myeloid Leukaemia
Official Title
Efficacy and Safety of Ex-vivo Expanded γδ T Lymphocytes in Patients With Refractory/Relapsed Acute Myeloid Leukaemia: a Single-center, Open-label, Single-arm Clinical Study.
Study Type
Interventional

2. Study Status

Record Verification Date
August 2019
Overall Recruitment Status
Unknown status
Study Start Date
September 1, 2019 (Anticipated)
Primary Completion Date
July 1, 2022 (Anticipated)
Study Completion Date
January 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Wuhan Union Hospital, China
Collaborators
Jinan University, China

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 investigates the potential curative properties of ex-vivo expanded gamma delta T-cells obtained from a blood-related donor for patients with relapsed or refractory acute myeloid leukemia.
Detailed Description
This is a single-center, open-label, single-arm study to evaluate the safety and efficacy of ex-vivo expanded γδ T-lymphocytes in patients with relapsed or refractory acute myeloid leukemia. PBMCs will be separated from peripheral blood of suitable donors. After making them potential cancer killer γδ T Cells, they will be infused to the patients as an immunotherapy treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Myeloid Leukemia
Keywords
gamma-delta T, Refractory/Relapsed

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
38 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Ex-vivo Expanded γδ T Lymphocytes
Arm Type
Experimental
Arm Description
Patients receive ex-vivo expanded γδ T Lymphocytes (Dose escalation, 2*10^6, 4*10^6, 8*10^6 of cells per kg of body weight).
Intervention Type
Biological
Intervention Name(s)
Ex-vivo Expanded γδ T Lymphocytes
Intervention Description
Patients receive ex-vivo expanded γδ T Lymphocytes (Dose escalation, 2*10^6, 4*10^6, 8*10^6 of cells per kg of body weight).
Primary Outcome Measure Information:
Title
Four-months remission rate
Description
Number of patients reaching Complete Remission (CR) according to National Comprehensive Cancer Network (NCCN, Version 1.2015).
Time Frame
4 months
Title
Number of participants with adverse events (AEs)
Description
Therapy-related adverse events were recorded and assessed according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE, Version 4.0).
Time Frame
3 years
Secondary Outcome Measure Information:
Title
Overall survival
Description
OS was calculated from the first infusion to death or last follow-up (censored).
Time Frame
3 years
Title
Event-free survival
Description
EFS was calculated from the first infusion to death, progression of the disease, relapse or gene recurrence, whichever came first, or last visit (censored).
Time Frame
3 years
Title
Relapse-free survival
Description
RFS was calculated from the first infusion to relapse or last visit (censored).
Time Frame
3 years
Title
Quantity of gamma-delta T cells in bone marrow cells and peripheral blood cells
Description
Persistence of γδ T cells assessed by number and phenotype of γδ T cells using flow cytometry assay in peripheral blood and bone marrow from patients
Time Frame
3 years
Title
lymphocyte subsets function assessment of bone marrow cells and peripheral blood cells
Description
Assessment of lymphocyte subsets function using flow cytometry assay in peripheral blood and bone marrow from patients.
Time Frame
3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: History of acute myeloid leukaemia (initially diagnosed by presence of 20% or more blast cells with myeloid or monocytic differentiation confirmed by flow cytometry in peripheral blood or bone marrow) Relapsed or refractory AML. A. AML relapse after intensive chemotherapy; B. AML relapse after allogeneic HCT; C. AML progression on low intensity therapy (low dose cytarabine, 5-azacytidine or decitabine); D. No response to at least 4 cycles of low intensity therapy; E. AML refractory to 2 cycles of induction chemotherapy. Presence of > 5% of blasts in bone marrow or peripheral blood smear Patient not eligible for or does not consent to high dose salvage chemotherapy and/or allogeneic Haematopoietic Cell Transplantation (HCT) Considered suitable for lymphodepleting chemotherapy The patient's peripheral superficial venous blood flow smoothly, which can meet the needs of intravenous drip. Patient's main organs function well. A. Liver function: ALT/AST < 3 times the upper limit of normal (ULN); B. total bilirubin≤34.2μmol/L; C. Renal function: Creatinine < 220μmol/L; D. Pulmonary function: Indoor oxygen saturation≥95%; E. Cardiac Function: Left ventricular ejection fraction (LVEF) ≥40%; Life expectancy of at least 3 months Patient ECOG score≤2, Estimated survival time≥3 months. Ability to be off systemic prednisone and other immunosuppressive drugs for at least 3 days prior to γδ T cells product infusion. Maintenance replacement steroid is allowed. The patients did not receive any anticancer treatments such as chemotherapy, radiotherapy and immunotherapy (such as immunosuppressive drugs) within 4 weeks before admission, and the toxicity related to previous treatments had returned to < 1 level at admission (except for low toxicity such as alopecia). Patient able to understand and sign written informed consent Age 18 years up to the age of 75 (≤ 75) Exclusion Criteria: Women who are pregnant (urine/blood pregnancy test positive) or lactating. Male or female with a conception plan in the past 1 years. Patients cannot guarantee effective contraception (condom or contraceptives, etc.) within 1 years after enrollment. Uncontrolled infectious disease within 4 weeks prior to enrollment. Active hepatitis B/C virus. HIV infected patients. Suffering from a serious autoimmune disease or immunodeficiency disease. The patient is allergic and is allergic to macromolecular biopharmaceuticals such as antibodies or cytokines. The patient participated in other clinical trials within 6 weeks prior to enrollment. Systemic use of hormones within 4 weeks prior to enrollment (except for patients with inhaled corticosteroids). Have a history of epilepsy or other central nervous system diseases. Having drug abuse/addiction. According to the researcher's judgment, the patient has other unsuitable grouping conditions.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yu Hu, M.D. Ph.D
Phone
86-13986183871
Email
dr_huyu@126.com
First Name & Middle Initial & Last Name or Official Title & Degree
Heng Mei, M.D. Ph.D
Phone
86-13886160811
Email
hmei@hust.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Heng Mei, M.D. Ph.D
Organizational Affiliation
Wuhan Union Hospital, China
Official's Role
Principal Investigator
Facility Information:
Facility Name
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
City
Wuhan
State/Province
Hubei
ZIP/Postal Code
430022
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yu Hu, M.D., Ph.D
Phone
86-13986183871
Email
dr_huyu@126.com
First Name & Middle Initial & Last Name & Degree
Heng Mei, M.D., Ph.D
Phone
86-13886160811
Email
hmei@hust.edu.cn

12. IPD Sharing Statement

Plan to Share IPD
No

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Ex-vivo Expanded γδ T Lymphocytes in Patients With Refractory/Relapsed Acute Myeloid Leukaemia

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