Hematopoietic Stem Cell Therapy for Patients With Multiple Sclerosis
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Purpose
Multiple sclerosis is disease believed to be due to immune cells, cells which normally protect the body, but are now attacking the tissue in the brain and possibly the spinal cord. The likelihood of progression of this disease is high. This study is designed to examine whether treating patients with high dose cyclophosphamide and CAMPATH-1H (drugs which reduce the function of the immune system) followed by return of previously collected blood stem cells will stop the progression of your multiple sclerosis. Stem cells are undeveloped cells that have the capacity to grow into mature blood cells, which normally circulate in the blood stream. The purpose of the cyclophosphamide and CAMPATH-1H is to destroy the cells in your immune system which are thought to be causing your disease. The purpose of the stem cell infusion is to restore the body's blood production, which will be severely impaired by the high dose chemotherapy and to produce a normal immune system that will no longer attack the body.
| Condition | Intervention | Phase |
|---|---|---|
|
Multiple Sclerosis |
Biological: hematopoietic stem cell transplantation |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Hematopoietic Stem Cell Therapy for Patients With Inflammatory Multiple Sclerosis Failing Interferon Therapy: A Phase II Multi-Center Trial |
- Disease progression, defined as a 1 point increase in the EDSS on consecutive evaluations at least 3 months apart; Survival;Twenty-five meter timed; Nine hole PEG test ambulation; MRI enhancing lesions and T2 burden of disease [ Time Frame: 5 years after transplant ] [ Designated as safety issue: Yes ]
| Enrollment: | 18 |
| Study Start Date: | June 2003 |
| Study Completion Date: | February 2012 |
| Primary Completion Date: | December 2011 (Final data collection date for primary outcome measure) |
-
Biological: hematopoietic stem cell transplantation
Eligibility| Ages Eligible for Study: | 18 Years to 50 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age between 18-50, inclusive.
- Diagnosis of MS using Poser criteria (Appendix A).
- An EDSS of 2.0 - 5.5 (Appendix B).
- Inflammatory disease despite primary disease modifying therapy with at least 3 months of interferon. Failure is defined as two or more clinical relapses with documented neurologic changes within the year prior to the study. (NOTE: Relapses must have required treatment with corticosteroids. Sensory only relapses are excluded.) Failure may also be defined as one relapse within the year prior to study if there is evidence on MRI of active inflammation (i.e., gadolinium enhancement).
Exclusion Criteria:
- Any illness that in the opinion of the investigators would jeopardize the ability of the patient to tolerate aggressive chemotherapy.
- Prior history of malignancy except localized basal cell, squamous skin cancer or carcinoma in situ of the cervix. Other malignancies for which the patient is judged to be cured, such as head and neck cancer, or breast cancer will be considered on an individual basis.
- Positive pregnancy test.
- Inability or unwillingness to pursue effective means of birth control. Effective birth control is defined as 1) refraining from all acts of vaginal intercourse (ABSTINENCE); 2) consistent use of birth control pills; 3) injectable birth control methods (Depo-provera, Norplant); 4) tubal sterilization or male partner who has undergone vasectomy; 5) placement of an IUD (intrauterine device); or 6) use, with every act of intercourse, of diaphragm with contraceptive jelly and/or condoms with contraceptive foam.
- Failure to willingly accept or comprehend irreversible sterility as a side effect of therapy.
- FEV1/FVC < 60% of predicted after bronchodilator therapy (if necessary).
- DLCO < 50% of predicted.
- Resting LVEF < 50 %.
- Bilirubin > 2.0 mg/dl.
- Serum creatinine > 2.0 mg/dl.
- Known hypersensitivity to mouse, rabbit, or E. Coli derived proteins, or to iron compounds/medications.
- Presence of metallic objects implanted in the body that would preclude the ability of the patient to safely have MRI exams.
- Diagnosis of primary progressive MS.
- Platelet count < 100,000/ul.
- Psychiatric illness, mental deficiency or cognitive dysfunction making compliance with treatment or informed consent impossible.
- Active infection except asymptomatic bacteruria.
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Richard Burt, MD, MD, Northwestern University |
| ClinicalTrials.gov Identifier: | NCT00278655 History of Changes |
| Other Study ID Numbers: | DIAD MS.Auto2002 |
| Study First Received: | January 16, 2006 |
| Last Updated: | April 9, 2012 |
| Health Authority: | United States: Food and Drug Administration |
Additional relevant MeSH terms:
|
Multiple Sclerosis Sclerosis Demyelinating Autoimmune Diseases, CNS Autoimmune Diseases of the Nervous System Nervous System Diseases |
Demyelinating Diseases Autoimmune Diseases Immune System Diseases Pathologic Processes |
ClinicalTrials.gov processed this record on May 16, 2013