search
Back to results

Umbilical Cord Derived Mesenchymal Stem Cells for Treatment-induced Myelosuppression in Hematologic Malignancies

Primary Purpose

Hematologic Neoplasms, Neutropenia, Anemia

Status
Not yet recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
umbilical cord derived mesenchymal stem cells
Sponsored by
Wuhan Union Hospital, China
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hematologic Neoplasms focused on measuring umbilical cord derived mesenchymal stem cells, treatment-induced myelosuppression, neutropenia, anemia, thrombocytopenia, infections, bleeding, hematologic malignancies, leukemia, lymphoma, multiple myeloma, chemotherapy, targeted therapy, hematopoietic stem cell transplantation

Eligibility Criteria

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

Inclusion Criteria: Aged between 18 and 75 years old; Either type of primary hematologic malignancies listed below: Acute myeloid leukemia (AML, AML subtype M3 excluded) or acute lymphoblastic leukemia (ALL) diagosed according to the 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia, either treatment naive participants who are going to receive first induction therapy, or participants who failed first induction therapy and are going to receive re-inducton therapy; AML or ALL participants who achieved remission and are going to receive consolidation therapy; Relapsed/refractory AML or ALL participants who are going to receive first re-induction therapy; Phase II trial will also include: participants with primary hematological maligancies who are going to receive autologous hematopoietic stem cell transplantation (allo-HSCT) whereas are poor mobilizers (CD34+cell count in peripheral blood was below 11-19/μL before collection, or the amount of CD34+ cells transfused was below 2×10^6/kg in allo-HSCT), and the participants' peripheral superficial veins have smooth blood flow which can meet the demand for intravenous drip; The participant or his/her legal guardian is adequately informed of the nature and risks of the study, voluntarily participates in the study with signed informed consent; Male or female; Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 to 2 (by the day anti-cancer therapy is initiated) Estimated survival of at least 3 months; Adequate major organ function: Respiratory function: indoor oxygen saturation of at least 95%; Cardiac function: ejection fraction of left ventricular of at least 45%; Hepatic function: alanine aminotransferase/aspartate aminotransferase of at most 2.5 times/upper limit of normal value and serum total bilirubin of at most 1.5 times/upper limit of normal value; Renal function: Serum creatinine of at most 1.5 times/upper limit of normal value; Participants who do not receive any type of anti-cancer therapy within 2 weeks before enrollment (radiation therapy, chemotherapy and/or immune therapy, et al.), and treatment-associated toxicities induced by previous therapy has recovered to Grade 1 or below (except for low grade toxities such as alopecia). Exclusion Criteria: Overt central nervous system manifestations of hematologic malignancies at diagnosis; Secondary hematological maligancies; Body mass index (BMI) of more than 30 kg/m^2; Myelosuppression induced by conditions other than anti-cancer therapy; Previous radiation therapy performed on sternum or pelvis; Specifically diagnosed and uncontrolled infection at enrollment (Uncontrolled is defined as exhibiting ongoing signs and symptoms of infection without improvement despite anti-infective agents) ; Uncontrolled active bleeding at enrollment; Severe underlying comorbidities affecting survival, including cachexia, severe malnutrition, etc; Estimated survival of at most 48 hours; Active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection; History of or current human immunodeficiency virus (HIV) infection; Continuous usage of immunosuppressants or received organ transplantation in the last 6 months; Participation in clinical trials of other drugs within 6 weeks before enrollment; Previous participation in clinical stem cell research; Receiving any agent concurrently with UC-MSCs infusion which inhibits cell division (hydroxyurea, low-dose cytarabine or methotrexate, etc) ; Severe allergic constitution, or known or suspected allergy to the study drug and its components; Known contraindication to receiving hematopoietic growth factors, transfusion of blood components, anti-infective agents; Female participants who are pregnant or breast feeding; Participants with fertility plan; Note: For female participants, they should be surgical sterilized or post-menopausal, or agree to utilize a medically recognised method of contraception (such as intrauterine device, condom) during treatment period of the study and within 6 months after the end of treatment period of the study; For male participants, they should be surgical sterilized or agree to utilize a medically recognised method of contraception (such as intrauterine device, condom) during treatment period of the study and within 6 months after the end of treatment period of the study; Participants suffering from mental illness; Presence of drug abuse/addiction; History of other malignancies other than hematological malignancies within 3 years; Participants without signed informed consent; Participants with poor compliance and are unable to complete the whole course of the study; Participants with circumstances that, in the opinion of the investigator, may increase the risk of the participants or interfere with conduct of the clinical trial and the judgment of results (excessive tension, sensitivity or cognitive impairment, etc) ; Participants with other circumstances that are ineligible for enrollment in this study, in the opinion of the investigator.

Sites / Locations

  • Wuhan Central Hospital
  • Wuhan Union Hospital
  • Wuhan Tongji Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

umbilical cord derived mesenchymal stem cells (UC-MSCs)

Arm Description

In the Phase Ib study, participants will be those with treatment-induced myelosuppression and acute myeloid leukemia/acute lymphoblastic leukemia, UC-MSCs will be preset with 5 escalation dose levels: dose A , dose B, dose C ,dose D and dose E, frequency of infusion will be preset with 3 escalation levels: frequency 1, frequency 2, frequency 3, total course of treatment: 2 weeks; In the Phase II study, participants will be those with treatment-induced myelosuppression and acute myeloid leukemia/acute lymphoblastic leukemia/primary hematological maligancies who are going to receive hematopoietic stem cell transplantation, UC-MSCs will be preset according to the recommended phase II dose (RP2D) from the Phase Ib study, total course of treatment: 2 weeks.

Outcomes

Primary Outcome Measures

Dose-limiting toxicities(DLT)
During the DLT observation period, the subject has an adverse event that is reasonably related to UC-MSCs infusion (possibly, likely or definitely related).
Incidence of Adverse Events (AEs) and Serious Adverse Events (SAEs)
To investigate the safety characteristics, percentages will be calculated and grade will be evaluated.
Maximum tolerated dose (MTD)
During the dose-escalation phase, the highest dose of dose-limiting toxicity for subjects less than or equal to 1/3 in the dose group of at least 6 evaluble subjects of the study drug after the last UC-MSCs dose.

Secondary Outcome Measures

Time to absolute neutrophil count recovery
To investigate the efficacy characteristics, time will be measured in days.
Incidence of febrile neutropenia
To investigate the efficacy characteristics, percentages will be calculated.
Duration of febrile neutropenia
To investigate the efficacy characteristics, the duration will be measured in days.
Incidence of severe thrombocytopenia
To investigate the efficacy characteristics, percentages will be calculated.
Time to severe thrombocytopenia recovery
To investigate the efficacy characteristics, time will be measured in days.
Incidence of severe anemia
To investigate the efficacy characteristics, percentages will be calculated.
Time to severe anemia recovery
To investigate the efficacy characteristics, time will be measured in days.
Incidence of infetion
To investigate the efficacy characteristics, percentages will be calculated.
Duration of infetion
To investigate the efficacy characteristics, the duration will be measured in days.
Incidence of bleeding
To investigate the efficacy characteristics, percentages will be calculated.
Duration of bleeding
To investigate the efficacy characteristics, the duration will be measured in days.
Application rate of blood transfusion
To investigate the efficacy characteristics, percentages will be calculated.
Application rate of anti-infective agents
To investigate the efficacy characteristics, percentages will be calculated.
Time to achievement of complete remission
To investigate the efficacy characteristics, time will be measured in days.
Duration of complete remission
To investigate the safety characteristics, the duration will be measured in days or months.
Event free survival
From enrollment to the day of any event.
Overall survival
From enrollment to the day of death caused by any reason.
Incidence of infusion reactions in 2 years
To investigate the safety characteristics, percentages will be calculated.
Incidence of secondary tumor in 2 years
To investigate the safety characteristics, percentages will be calculated.
Cumulative incidence of relapse of primary disease in 2 years
To investigate the safety characteristics, percentages will be calculated.

Full Information

First Posted
January 1, 2023
Last Updated
January 3, 2023
Sponsor
Wuhan Union Hospital, China
Collaborators
Wuhan TongJi Hospital, Wuhan Central Hospital
search

1. Study Identification

Unique Protocol Identification Number
NCT05672420
Brief Title
Umbilical Cord Derived Mesenchymal Stem Cells for Treatment-induced Myelosuppression in Hematologic Malignancies
Official Title
A Multicenter, Phase Ib/II Trial of the Safety and Efficacy of Umbilical Cord Derived Mesenchymal Stem Cells in Treatment-induced Myelosuppression in Patients With Hematologic Malignancies (USMYE Trial)
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
January 1, 2023 (Anticipated)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
January 31, 2025 (Anticipated)

3. Sponsor/Collaborators

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

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
The purpose of the study is to explore the safety and efficacy of umbilical cord derived mesenchymal stem cells in treatment-induced myelosuppression in patients with hematologic malignancies.
Detailed Description
Despite the improved prognosis of patients with hematologic malignancies, almost all patients will experience severe myelosuppression induced by anti-cancer treatment, leading to a series of complications such as infection due to neutropenia, bleeding due to thrombocytopenia and/or impaired major organ function such as cardiac function due to anemia, which are the main reasons for dose reduction, dose interrruptions of anti-cancer treatment, failure of hematopoietic stem cell transplantation, and also patients' treatment-related death. It is of significant clinical importance and an urgent need to promote early recovery of myelosuppression and reduce risks of related complications as well as medical burdens. Umbilical cord derived mesenchymal stem cells (UC-MSCs), as a kind of stem cells with multipotential, can widely act on the functional cell units of bone marrow microenvironment and promote the repairment and regeneration of key cells such as hematopoietic stem cells, mesenchymal stem cells and endothelial cells, thus making it an ideal means for effectively promoting recovery of myelosuppression. Patients with hematologic malignancies and treatment-induced myelosuppression will be invited to participate in the Phase Ib/II study, to receive UC-MSCs intravenous infusion and follow-up visits of up to 2 years after enrollment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hematologic Neoplasms, Neutropenia, Anemia, Thrombocytopenia, Infections, Bleeding
Keywords
umbilical cord derived mesenchymal stem cells, treatment-induced myelosuppression, neutropenia, anemia, thrombocytopenia, infections, bleeding, hematologic malignancies, leukemia, lymphoma, multiple myeloma, chemotherapy, targeted therapy, hematopoietic stem cell transplantation

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
181 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
umbilical cord derived mesenchymal stem cells (UC-MSCs)
Arm Type
Experimental
Arm Description
In the Phase Ib study, participants will be those with treatment-induced myelosuppression and acute myeloid leukemia/acute lymphoblastic leukemia, UC-MSCs will be preset with 5 escalation dose levels: dose A , dose B, dose C ,dose D and dose E, frequency of infusion will be preset with 3 escalation levels: frequency 1, frequency 2, frequency 3, total course of treatment: 2 weeks; In the Phase II study, participants will be those with treatment-induced myelosuppression and acute myeloid leukemia/acute lymphoblastic leukemia/primary hematological maligancies who are going to receive hematopoietic stem cell transplantation, UC-MSCs will be preset according to the recommended phase II dose (RP2D) from the Phase Ib study, total course of treatment: 2 weeks.
Intervention Type
Biological
Intervention Name(s)
umbilical cord derived mesenchymal stem cells
Intervention Description
umbilical cord derived mesenchymal stem cells, intravenous infusion
Primary Outcome Measure Information:
Title
Dose-limiting toxicities(DLT)
Description
During the DLT observation period, the subject has an adverse event that is reasonably related to UC-MSCs infusion (possibly, likely or definitely related).
Time Frame
4 days after the last UC-MSCs dose, up to 12 days
Title
Incidence of Adverse Events (AEs) and Serious Adverse Events (SAEs)
Description
To investigate the safety characteristics, percentages will be calculated and grade will be evaluated.
Time Frame
From the day that the last UC-MSCs dose is used to up to 21 days
Title
Maximum tolerated dose (MTD)
Description
During the dose-escalation phase, the highest dose of dose-limiting toxicity for subjects less than or equal to 1/3 in the dose group of at least 6 evaluble subjects of the study drug after the last UC-MSCs dose.
Time Frame
From the day that the last UC-MSCs dose is used to up to 4 days
Secondary Outcome Measure Information:
Title
Time to absolute neutrophil count recovery
Description
To investigate the efficacy characteristics, time will be measured in days.
Time Frame
From the start of anti-cancer therapy or completion of hematopoietic stem cell transplantation to up to 42 days
Title
Incidence of febrile neutropenia
Description
To investigate the efficacy characteristics, percentages will be calculated.
Time Frame
From the start of anti-cancer therapy or completion of hematopoietic stem cell transplantation to up to 42 days
Title
Duration of febrile neutropenia
Description
To investigate the efficacy characteristics, the duration will be measured in days.
Time Frame
From the start of anti-cancer therapy or completion of hematopoietic stem cell transplantation to up to 42 days
Title
Incidence of severe thrombocytopenia
Description
To investigate the efficacy characteristics, percentages will be calculated.
Time Frame
From the start of anti-cancer therapy or completion of hematopoietic stem cell transplantation to up to 42 days
Title
Time to severe thrombocytopenia recovery
Description
To investigate the efficacy characteristics, time will be measured in days.
Time Frame
From the start of anti-cancer therapy or completion of hematopoietic stem cell transplantation to up to 42 days
Title
Incidence of severe anemia
Description
To investigate the efficacy characteristics, percentages will be calculated.
Time Frame
From the start of anti-cancer therapy or completion of hematopoietic stem cell transplantation to up to 42 days
Title
Time to severe anemia recovery
Description
To investigate the efficacy characteristics, time will be measured in days.
Time Frame
From the start of anti-cancer therapy or completion of hematopoietic stem cell transplantation to up to 42 days
Title
Incidence of infetion
Description
To investigate the efficacy characteristics, percentages will be calculated.
Time Frame
From the start of anti-cancer therapy or completion of hematopoietic stem cell transplantation to up to 42 days
Title
Duration of infetion
Description
To investigate the efficacy characteristics, the duration will be measured in days.
Time Frame
From the start of anti-cancer therapy or completion of hematopoietic stem cell transplantation to up to 42 days
Title
Incidence of bleeding
Description
To investigate the efficacy characteristics, percentages will be calculated.
Time Frame
From the start of anti-cancer therapy or completion of hematopoietic stem cell transplantation to up to 42 days
Title
Duration of bleeding
Description
To investigate the efficacy characteristics, the duration will be measured in days.
Time Frame
From the start of anti-cancer therapy or completion of hematopoietic stem cell transplantation to up to 42 days
Title
Application rate of blood transfusion
Description
To investigate the efficacy characteristics, percentages will be calculated.
Time Frame
From the start of anti-cancer therapy or completion of hematopoietic stem cell transplantation to up to 42 days
Title
Application rate of anti-infective agents
Description
To investigate the efficacy characteristics, percentages will be calculated.
Time Frame
From the start of anti-cancer therapy or completion of hematopoietic stem cell transplantation to up to 42 days
Title
Time to achievement of complete remission
Description
To investigate the efficacy characteristics, time will be measured in days.
Time Frame
From enrollment to up to 28 days
Title
Duration of complete remission
Description
To investigate the safety characteristics, the duration will be measured in days or months.
Time Frame
From enrollment to maximun up to 2 years
Title
Event free survival
Description
From enrollment to the day of any event.
Time Frame
From enrollment to maximun up to 2 years
Title
Overall survival
Description
From enrollment to the day of death caused by any reason.
Time Frame
From enrollment to maximun up to 2 years
Title
Incidence of infusion reactions in 2 years
Description
To investigate the safety characteristics, percentages will be calculated.
Time Frame
2 years since the last UC-MSCs infusion
Title
Incidence of secondary tumor in 2 years
Description
To investigate the safety characteristics, percentages will be calculated.
Time Frame
2 years since the last UC-MSCs infusion
Title
Cumulative incidence of relapse of primary disease in 2 years
Description
To investigate the safety characteristics, percentages will be calculated.
Time Frame
2 years since the last UC-MSCs infusion

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: Aged between 18 and 75 years old; Either type of primary hematologic malignancies listed below: Acute myeloid leukemia (AML, AML subtype M3 excluded) or acute lymphoblastic leukemia (ALL) diagosed according to the 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia, either treatment naive participants who are going to receive first induction therapy, or participants who failed first induction therapy and are going to receive re-inducton therapy; AML or ALL participants who achieved remission and are going to receive consolidation therapy; Relapsed/refractory AML or ALL participants who are going to receive first re-induction therapy; Phase II trial will also include: participants with primary hematological maligancies who are going to receive autologous hematopoietic stem cell transplantation (allo-HSCT) whereas are poor mobilizers (CD34+cell count in peripheral blood was below 11-19/μL before collection, or the amount of CD34+ cells transfused was below 2×10^6/kg in allo-HSCT), and the participants' peripheral superficial veins have smooth blood flow which can meet the demand for intravenous drip; The participant or his/her legal guardian is adequately informed of the nature and risks of the study, voluntarily participates in the study with signed informed consent; Male or female; Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 to 2 (by the day anti-cancer therapy is initiated) Estimated survival of at least 3 months; Adequate major organ function: Respiratory function: indoor oxygen saturation of at least 95%; Cardiac function: ejection fraction of left ventricular of at least 45%; Hepatic function: alanine aminotransferase/aspartate aminotransferase of at most 2.5 times/upper limit of normal value and serum total bilirubin of at most 1.5 times/upper limit of normal value; Renal function: Serum creatinine of at most 1.5 times/upper limit of normal value; Participants who do not receive any type of anti-cancer therapy within 2 weeks before enrollment (radiation therapy, chemotherapy and/or immune therapy, et al.), and treatment-associated toxicities induced by previous therapy has recovered to Grade 1 or below (except for low grade toxities such as alopecia). Exclusion Criteria: Overt central nervous system manifestations of hematologic malignancies at diagnosis; Secondary hematological maligancies; Body mass index (BMI) of more than 30 kg/m^2; Myelosuppression induced by conditions other than anti-cancer therapy; Previous radiation therapy performed on sternum or pelvis; Specifically diagnosed and uncontrolled infection at enrollment (Uncontrolled is defined as exhibiting ongoing signs and symptoms of infection without improvement despite anti-infective agents) ; Uncontrolled active bleeding at enrollment; Severe underlying comorbidities affecting survival, including cachexia, severe malnutrition, etc; Estimated survival of at most 48 hours; Active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection; History of or current human immunodeficiency virus (HIV) infection; Continuous usage of immunosuppressants or received organ transplantation in the last 6 months; Participation in clinical trials of other drugs within 6 weeks before enrollment; Previous participation in clinical stem cell research; Receiving any agent concurrently with UC-MSCs infusion which inhibits cell division (hydroxyurea, low-dose cytarabine or methotrexate, etc) ; Severe allergic constitution, or known or suspected allergy to the study drug and its components; Known contraindication to receiving hematopoietic growth factors, transfusion of blood components, anti-infective agents; Female participants who are pregnant or breast feeding; Participants with fertility plan; Note: For female participants, they should be surgical sterilized or post-menopausal, or agree to utilize a medically recognised method of contraception (such as intrauterine device, condom) during treatment period of the study and within 6 months after the end of treatment period of the study; For male participants, they should be surgical sterilized or agree to utilize a medically recognised method of contraception (such as intrauterine device, condom) during treatment period of the study and within 6 months after the end of treatment period of the study; Participants suffering from mental illness; Presence of drug abuse/addiction; History of other malignancies other than hematological malignancies within 3 years; Participants without signed informed consent; Participants with poor compliance and are unable to complete the whole course of the study; Participants with circumstances that, in the opinion of the investigator, may increase the risk of the participants or interfere with conduct of the clinical trial and the judgment of results (excessive tension, sensitivity or cognitive impairment, etc) ; Participants with other circumstances that are ineligible for enrollment in this study, in the opinion of the investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Qiubai Li, Professor
Phone
(027) 85726387
Email
qiubaili@hust.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Qiubai Li, Professor
Organizational Affiliation
Wuhan Union Hospital, China
Official's Role
Study Director
Facility Information:
Facility Name
Wuhan Central Hospital
City
Wuhan
State/Province
Hubei
ZIP/Postal Code
430014
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hongxiang Wang, Professor
Email
whitely1972@sina.com
First Name & Middle Initial & Last Name & Degree
Hongxiang Wang, Professor
Facility Name
Wuhan Union Hospital
City
Wuhan
State/Province
Hubei
ZIP/Postal Code
430022
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Qiubai Li, Professor
Phone
(027) 85726387
Email
qiubaili@hust.edu.cn
First Name & Middle Initial & Last Name & Degree
Qiubai Li, Professor
Facility Name
Wuhan Tongji Hospital
City
Wuhan
State/Province
Hubei
ZIP/Postal Code
430030
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yicheng Zhang, Professor
Email
yczhang@tjh.tjmu.edu.cn
First Name & Middle Initial & Last Name & Degree
Yicheng Zhang, Professor

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Umbilical Cord Derived Mesenchymal Stem Cells for Treatment-induced Myelosuppression in Hematologic Malignancies

We'll reach out to this number within 24 hrs