Mesenchymal Stem Cell Infusion as Prevention for Graft Rejection and Graft-versus-host Disease
Primary Purpose
Hematological Malignancies
Status
Completed
Phase
Phase 2
Locations
Belgium
Study Type
Interventional
Intervention
Mesenchymal stem cell infusion
Sponsored by
About this trial
This is an interventional prevention trial for Hematological Malignancies focused on measuring HCT, nonmyeloablative, mesenchymal stem cells, GVHD
Eligibility Criteria
V.1. Patients
V.1.1. Diseases
Hematological malignancies confirmed histologically and not rapidly progressing:
- AML in CR;
- ALL in CR;
- CML unresponsive/intolerant to Imatinib but not in blast crisis;
- Other myeloproliferative disorders not in blast crisis and not with extensive myelofibrosis;
- MDS with < 5% blasts;
- Multiple myeloma;
- CLL;
- Non-Hodgkin's lymphoma (aggressive NHL should have chemosensitive disease);
- Hodgkin's disease.
V.1.2. Clinical situations
Theoretical indication for a standard allo-transplant, but not feasible because:
- Age > 55 yrs;
- Unacceptable end organ performance;
- Patient's refusal.
- Indication for a standard auto-transplant: perform mini-allotransplantation 2-6 months after standard autotransplant.
V.1.3. Other inclusion criteria
- Male or female; fertile female patients must use a reliable contraception method;
- Age < 75 yrs.
- Informed consent given by patient or his/her guardian if of minor age.
V.1.4. Exclusion criteria
- Any condition not fulfilling inclusion criteria;
- HIV positive;
- Terminal organ failure, except for renal failure (dialysis acceptable);
- Uncontrolled infection, arrhythmia or hypertension;
- Previous radiation therapy precluding the use of 2 Gy TBI;
- HLA-identical donor.
V.2. PBSC donors
V.2.1. Inclusion criteria
- Related to the recipient (sibling, parent or child) or unrelated;
- Male or female;
- Weight > 15 Kg (because of leukapheresis);
- Fulfills generally accepted criteria for allogeneic PBSC donation;
- Informed consent given by donor or his/her guardian if of minor age, as per donor center standard procedures.
V.2.2. Exclusion criteria
- Any condition not fulfilling inclusion criteria;
- HIV positive;
- Unable to undergo leukapheresis because of poor vein access or other reasons.
V.2.3. HLA matching
Related or unrelated donors who have 1-2 HLA mismatches, as either :
- One antigenic mismatch at HLA-A or -B or -C or -DRB1 or -DQB1
- One allelic mismatch at HLA-A or -B or -C or -DRB1 or -DQB1
- Two allelic mismatches at HLA-A or -B or -C or -DRB1 or -DQB1
- One antigenic mismatch + 1 allelic mismatch at HLA-A or -B or -C or -DRB1 or -DQB1.
- One antigenic mismatch at -DQB1 and one other antigenic mismatch at HLA-A or -B or -C or -DRB1
V.3. Cord blood unit
Banked cord blood units will be used if they fulfill the following criteria:
- No more than 2/6 HLA mismatches (antigenic mismatch at HLA-A or HLA-B or allelic mismatch at HLA-DRB1)
- > 2.5 x 107 TNC/kg
- Standard validation by FACT/Netcord criteria.
Sites / Locations
- CHU Sart Tilman
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
1
Arm Description
MSC co-infusion with either HLA-mismatched PBSC or cord blood
Outcomes
Primary Outcome Measures
Day-100 incidence of non-relapse mortality
Secondary Outcome Measures
1. Hematopoietic engraftment and graft rejection. 2. Incidence of grade II-IV and III-IV acute GVHD. 3. Immunologic reconstitution
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00504803
Brief Title
Mesenchymal Stem Cell Infusion as Prevention for Graft Rejection and Graft-versus-host Disease
Official Title
Mesenchymal Stem Cell Infusion as Prevention for Graft Rejection and Graft-versus-host Disease After Allogeneic Hematopoietic Cell Transplantation With Nonmyeloablative Conditioning: a Pilot Study
Study Type
Interventional
2. Study Status
Record Verification Date
September 2011
Overall Recruitment Status
Completed
Study Start Date
December 2006 (undefined)
Primary Completion Date
December 2010 (Actual)
Study Completion Date
December 2010 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Liege
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Mesenchymal Stem Cell Infusion as Prevention for Graft Rejection and Graft-Versus-Host Disease After Allogeneic Hematopoietic Cell Transplantation With Nonmyeloablative Conditioning from HLA-mismatched PBSC or cord blood: a Pilot Study
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hematological Malignancies
Keywords
HCT, nonmyeloablative, mesenchymal stem cells, GVHD
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
30 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
1
Arm Type
Experimental
Arm Description
MSC co-infusion with either HLA-mismatched PBSC or cord blood
Intervention Type
Procedure
Intervention Name(s)
Mesenchymal stem cell infusion
Other Intervention Name(s)
Mesenchymal stem cells
Intervention Description
Infusion of mesenchymal stem cells on the same day as hematopoietic stem cell infusion.
Primary Outcome Measure Information:
Title
Day-100 incidence of non-relapse mortality
Time Frame
100 days
Secondary Outcome Measure Information:
Title
1. Hematopoietic engraftment and graft rejection. 2. Incidence of grade II-IV and III-IV acute GVHD. 3. Immunologic reconstitution
Time Frame
365 days
10. Eligibility
Sex
All
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
V.1. Patients
V.1.1. Diseases
Hematological malignancies confirmed histologically and not rapidly progressing:
AML in CR;
ALL in CR;
CML unresponsive/intolerant to Imatinib but not in blast crisis;
Other myeloproliferative disorders not in blast crisis and not with extensive myelofibrosis;
MDS with < 5% blasts;
Multiple myeloma;
CLL;
Non-Hodgkin's lymphoma (aggressive NHL should have chemosensitive disease);
Hodgkin's disease.
V.1.2. Clinical situations
Theoretical indication for a standard allo-transplant, but not feasible because:
Age > 55 yrs;
Unacceptable end organ performance;
Patient's refusal.
Indication for a standard auto-transplant: perform mini-allotransplantation 2-6 months after standard autotransplant.
V.1.3. Other inclusion criteria
Male or female; fertile female patients must use a reliable contraception method;
Age < 75 yrs.
Informed consent given by patient or his/her guardian if of minor age.
V.1.4. Exclusion criteria
Any condition not fulfilling inclusion criteria;
HIV positive;
Terminal organ failure, except for renal failure (dialysis acceptable);
Uncontrolled infection, arrhythmia or hypertension;
Previous radiation therapy precluding the use of 2 Gy TBI;
HLA-identical donor.
V.2. PBSC donors
V.2.1. Inclusion criteria
Related to the recipient (sibling, parent or child) or unrelated;
Male or female;
Weight > 15 Kg (because of leukapheresis);
Fulfills generally accepted criteria for allogeneic PBSC donation;
Informed consent given by donor or his/her guardian if of minor age, as per donor center standard procedures.
V.2.2. Exclusion criteria
Any condition not fulfilling inclusion criteria;
HIV positive;
Unable to undergo leukapheresis because of poor vein access or other reasons.
V.2.3. HLA matching
Related or unrelated donors who have 1-2 HLA mismatches, as either :
One antigenic mismatch at HLA-A or -B or -C or -DRB1 or -DQB1
One allelic mismatch at HLA-A or -B or -C or -DRB1 or -DQB1
Two allelic mismatches at HLA-A or -B or -C or -DRB1 or -DQB1
One antigenic mismatch + 1 allelic mismatch at HLA-A or -B or -C or -DRB1 or -DQB1.
One antigenic mismatch at -DQB1 and one other antigenic mismatch at HLA-A or -B or -C or -DRB1
V.3. Cord blood unit
Banked cord blood units will be used if they fulfill the following criteria:
No more than 2/6 HLA mismatches (antigenic mismatch at HLA-A or HLA-B or allelic mismatch at HLA-DRB1)
> 2.5 x 107 TNC/kg
Standard validation by FACT/Netcord criteria.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Frederic Baron, MD, PhD
Organizational Affiliation
CHU-ULg
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Yves Beguin, MD, PhD
Organizational Affiliation
CHU-ULg
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Chantal Lechanteur, PhD
Organizational Affiliation
CHU-ULg
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Etienne Baudoux, MD
Organizational Affiliation
CHU-ULg
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Evelyne Willems, MD
Organizational Affiliation
CHU-ULg
Official's Role
Study Chair
Facility Information:
Facility Name
CHU Sart Tilman
City
Liege
ZIP/Postal Code
4000
Country
Belgium
12. IPD Sharing Statement
Citations:
PubMed Identifier
20109568
Citation
Baron F, Lechanteur C, Willems E, Bruck F, Baudoux E, Seidel L, Vanbellinghen JF, Hafraoui K, Lejeune M, Gothot A, Fillet G, Beguin Y. Cotransplantation of mesenchymal stem cells might prevent death from graft-versus-host disease (GVHD) without abrogating graft-versus-tumor effects after HLA-mismatched allogeneic transplantation following nonmyeloablative conditioning. Biol Blood Marrow Transplant. 2010 Jun;16(6):838-47. doi: 10.1016/j.bbmt.2010.01.011. Epub 2010 Jan 28.
Results Reference
derived
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Mesenchymal Stem Cell Infusion as Prevention for Graft Rejection and Graft-versus-host Disease
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