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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
University of Liege
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Hematological Malignancies focused on measuring HCT, nonmyeloablative, mesenchymal stem cells, GVHD

Eligibility Criteria

undefined - 75 Years (Child, Adult, Older Adult)All SexesAccepts Healthy Volunteers

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

First Posted
July 19, 2007
Last Updated
September 1, 2011
Sponsor
University of Liege
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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
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Mesenchymal Stem Cell Infusion as Prevention for Graft Rejection and Graft-versus-host Disease

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