Clinical Trial: A Study of CD45RA+ Depleted Haploidentical Stem Cell Transplantation in Children With Relapsed or Refractory Solid Tumors and Lymphomas

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional

Official Title: A Phase I Study of CD45RA+ Depleted Haploidentical Stem Cell Transplantation in Children With Relapsed or Refractory Solid Tumors and Lymphomas

Brief Summary: This is a phase I study designed to determine the feasibility of transplantation using a novel transplant approach that employs a two-stage haploidentical cell infusion following myeloablative conditioning. This strategy, which includes selective depletion of naïve T cells, may speed immune reconstitution thereby potentially reducing the limitations of traditional haploidentical hematopoietic stem cell transplantation (HSCT) and increasing its potential therapeutic application. Additionally, the investigators intend to explore overall survival, event-free survival, hematopoietic cell recovery and engraftment as well as infection rates and complications in these patients.

Detailed Summary:

Twelve participants and 12 donors will be enrolled on this study. Donors will undergo seven days of hematopoietic stem cell (HSC) mobilization followed by two apheresis collections. Each apheresis collection will be processed by the CliniMACS system.

DONORS: A mobilization regimen of granulocyte colony stimulating factor (G-CSF) will be used to obtain a peripheral blood stem cell (PBSC) product from the donor. Apheresis will be performed for a minimum of two consecutive days, including one day for each cell product delivered.

STUDY PARTICIPANTS: Participants will undergo a two-stage haploidentical cell infusion following myeloablative conditioning. The first cell infusion will be a CD3-depleted product and the second infusion will be a CD45RA-depleted product.

Primary Objective:

  • To determine the feasibility of haploidentical HSCT using two infusions engineered by negative selection on the Miltenyi CliniMACS system- the first by selective depletion of CD3+ cells, followed by a second depleted of CD45RA+ cells, in children with relapsed or refractory solid tumors or lymphomas.

Secondary Objectives:

  • To estimate hematopoietic cell recovery and engraftment rates for the patients.
  • To estimate infection rates and complications.
  • To estimate the one-year overall survival (OS) and event-free survival (EFS) for the study patients.

Sponsor: St. Jude Children's Research Hospital

Current Primary Outcome: Feasibility of haploidentical HSCT [ Time Frame: 30 days post transplantation ]

Feasibility is defined as engraftment (ANC≥ 500/mm3 for 3 consecutive tests performed on different days) evaluated before day +30.


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • hematopoietic cell recovery and engraftment rates [ Time Frame: 30 days post transplantation ]
    They will be reported and presented descriptively. Specifically, the hematopoietic cell recovery and engraftment rates will be reported with a Blyth-Still-Casella 95% confidence interval.
  • infection rates and complications [ Time Frame: up to 5 years ]
    The proportion of patients who develop infections and complications will be estimated and a Blyth-Still-Casella 95% confidence interval will be provided.
  • overall survival (OS) [ Time Frame: up to 1 year after transplantation ]
    Defined based on any death. The Kaplan-Meier Estimate will be provided.
  • event-free survival [ Time Frame: up to 1 year after transplantation ]
    The Kaplan-Meier Estimate will be provided.


Original Secondary Outcome:

Information By: St. Jude Children's Research Hospital

Dates:
Date Received: June 19, 2012
Date Started: August 20, 2012
Date Completion: July 31, 2022
Last Updated: March 30, 2017
Last Verified: October 2016