Reduced Immunosuppressive Therapy With or Without Donor White Blood Cells in Treating Patients With Lymphoproliferative Disease After Organ Transplantation
Recruitment status was Active, not recruiting
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Purpose
RATIONALE: Some types of lymphoproliferative disease are associated with Epstein-Barr virus. Combining reduced immunosuppressive therapy with donor white blood cells that have been treated in the laboratory to kill cells infected with Epstein-Barr virus may be an effective treatment for lymphoproliferative disease.
PURPOSE: Randomized phase III trial to compare the effectiveness of reducing immunosuppressive therapy with or without donor white blood cells in treating patients who have Epstein-Barr virus-associated lymphoproliferative disease after organ transplantation.
| Condition | Intervention | Phase |
|---|---|---|
|
Lymphoproliferative Disorder |
Biological: therapeutic allogeneic lymphocytes |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Primary Purpose: Treatment |
| Official Title: | Cytotoxic T Cell Therapy for Post Transplant Lymphoproliferative Disease: Randomized Controlled Trial in Transplant Recipients |
- Complete response [ Designated as safety issue: No ]
- Partial response [ Designated as safety issue: No ]
- Stable disease [ Designated as safety issue: No ]
- Progressive disease [ Designated as safety issue: No ]
- Time to complete remission [ Designated as safety issue: No ]
- Survival at 2 years [ Designated as safety issue: No ]
| Estimated Enrollment: | 50 |
| Study Start Date: | March 2001 |
OBJECTIVES:
- Determine the efficacy of treatment with partially HLA-matched allogeneic cytotoxic T cells and reduction of immunosuppression, in terms of survival rate and time to remission in patients with Epstein-Barr virus-associated B-cell lymphoproliferative disease after solid organ transplantation.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to transplanted organ type and transplant center. Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients undergo sliding-scale reduction of immunosuppressive drugs from 1 of 5 regimens at physician's discretion. Patients then receive partially HLA-matched allogeneic cytotoxic T cells IV over 5 minutes once weekly for a total of 4 weeks.
- Arm II: Patients undergo reduction of immunosuppression as in arm I alone. Patients are followed monthly for 6 months and then every 3 months for 2 years.
PROJECTED ACCRUAL: A total of 50 patients will be accrued for this study.
Eligibility| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Diagnosis of post-transplant lymphoproliferative disease (PTLD) after solid organ (heart, heart/lung, liver, liver/gut, pancreas, or kidney) transplantation
- Epstein-Barr virus-positive tumor
- Newly diagnosed disease
- Measurable disease by clinical methods or radiography
- Must have partially matched donor cytotoxic T cells (CTL) available
- No known panel reactivity to any of the HLA types of CTL available for therapy
PATIENT CHARACTERISTICS:
Age:
- Any age
Performance status:
- Karnofsky 20-100%
Life expectancy:
- Not specified
Hematopoietic:
- Not specified
Hepatic:
- Not specified
Renal:
- Not specified
Other:
- Not pregnant
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- Not specified
Chemotherapy:
- Not specified
Endocrine therapy:
- Not specified
Radiotherapy:
- Not specified
Surgery:
- Not specified
Other:
- No prior therapy for PTLD
- No concurrent antiviral drugs (e.g., acyclovir or ganciclovir) for PTLD
Contacts and Locations| United Kingdom | |
| Birmingham Children's Hospital | |
| Birmingham, England, United Kingdom, B4 6NH | |
| Papworth Hospital | |
| Cambridge, England, United Kingdom, CB3 8RE | |
| Royal Free and University College Medical School | |
| London, England, United Kingdom, NW3 2PF | |
| King's College Hospital | |
| London, England, United Kingdom, SE5 8RX | |
| Central Manchester and Manchester Children's University Hospitals NHS Trust | |
| Manchester, England, United Kingdom, M27 4HA | |
| Wythenshawe Hospital | |
| Manchester, England, United Kingdom, M23 9LJ | |
| Northern General Hospital | |
| Sheffield, England, United Kingdom, S5 7AU | |
| Institute of Cancer Research - UK | |
| Sutton, England, United Kingdom, SM2 5NG | |
| University of Edinburgh | |
| Edinburgh, Scotland, United Kingdom, EH8 1QH | |
| Royal Infirmary of Edinburgh at Little France | |
| Edinburgh, Scotland, United Kingdom, EH16 4SA | |
| University of Edinburgh Laboratory for Clinical and Molecular Virology | |
| Edinburgh, Scotland, United Kingdom, EH9 1QH | |
| Royal Infirmary - Castle | |
| Glasgow, Scotland, United Kingdom, G4 0SF | |
| Study Chair: | Dorothy H. Crawford, MD | University of Edinburgh |
More Information
Additional Information:
No publications provided
| ClinicalTrials.gov Identifier: | NCT00033475 History of Changes |
| Other Study ID Numbers: | CDR0000069288, CRUK-EBV-CTL, LCMV-CTL, EU-20057 |
| Study First Received: | April 9, 2002 |
| Last Updated: | February 6, 2009 |
| Health Authority: | United States: Federal Government |
Keywords provided by National Cancer Institute (NCI):
|
post-transplant lymphoproliferative disorder |
Additional relevant MeSH terms:
|
Lymphoproliferative Disorders Lymphatic Diseases Immunoproliferative Disorders Immune System Diseases |
ClinicalTrials.gov processed this record on June 18, 2013