Post-transplant Autologous Cytokine-induced Killer (CIK) Cells for Treatment of High Risk Hematologic Malignancies
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Purpose
The purpose of the study is to conduct a phase I study of adoptive immunotherapy with autologous, ex-vivo expanded cytokine-induced killer (CIK) cells to reduce the relapse rate in autologous stem cell transplant patients with high-risk hematologic malignancies.
| Condition | Intervention | Phase |
|---|---|---|
|
Leukemia Multiple Myeloma |
Drug: CIK cells Drug: busulfan Drug: etoposide Drug: bcnu Drug: cyclophosphamide Drug: gemcitabine Drug: vinorelbine Drug: melphalan |
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: Prevention |
| Official Title: | A Phase I/II Study of Post-transplant Autologous Cytokine-induced Killer (CIK) Cells for the Treatment of High-risk Hematologic Malignancies |
- To document the toxicities of infusion of autologous CIK cells [ Time Frame: Day 42 post autologous stem cell transplant ] [ Designated as safety issue: Yes ]
- Measure freedom from progression (FFP) [ Time Frame: 1 and 2 years post-transplant ] [ Designated as safety issue: No ]
- Measure event free survival [ Time Frame: 1 and 2 years post-transplant ] [ Designated as safety issue: No ]
- Measure overall survival [ Time Frame: 1 and 2 years post-transplant ] [ Designated as safety issue: No ]
- Measure disease response [ Time Frame: at day 40-60, day 90, day 180, and yearly ] [ Designated as safety issue: No ]
| Enrollment: | 22 |
| Study Start Date: | May 2006 |
| Study Completion Date: | March 2011 |
| Primary Completion Date: | March 2011 (Final data collection date for primary outcome measure) |
-
Drug: CIK cells
- Myleran
- Busulfex IV
- Eposin
- Etopophos
- Vepesid
- VP-16
- Endoxan
- Cytoxan
- Neosar
- Procytox
- Revimmune
- cytophosphane
- Alkeran
- Melphalan hydrochloride
Disease relapse remains the major cause of treatment failure in autologous stem cell transplantation for patients with high-risk disease. Relapse after autologous transplant is in part due to the persistence of residual cancer cells. Cellular immunotherapy using activated autologous effector cells to recognize and kill tumor targets in a minimal disease state after transplant is a strategy being explored to reduce relapse and improve survival. We hypothesize that cytokine-induced killer (CIK) cell-based immunotherapy can reduce the relapse rate after high-risk autologous stem cell transplantation by treating post-transplant minimal residual disease.
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Patients between 18 and 75 years of age, inclusive candidates for standard autologous SCT who are at high risk for relapse:
- Acute myelogenous leukemia (AML), high risk, in CR1 or beyond without a donor (CR1 defined as: normal bone marrow morphology, resolution of any previously abnormal karyotype, neutrophils > 1000/ul, platelets > 100,000/ul, independence from red cell transfusion, no evidence extramedullary leukemia)
- Hodgkin's lymphoma relapsed or refractory, with the presence of >= 1 adverse risk factor (Adverse risk factors are defined as stage IV involvement of the lung or bone marrow, constitutional symptoms, and the presence of more than minimal residual disease before the preparatory regimen)
- Multiple myeloma with high risk features with only single autologous transplant option. High risk features defined as IgA myeloma, B2M > 2.5 mg/ml with normal kidney function, complex karyotypes or isolated chromosome 13 abnormalities, standard-dose therapy > 12 months, or inability to achieve at least 50% reduction of plasma cells in the bone marrow or 50% reduction in the paraprotein concentration after initial induction chemotherapy prior to transplant.
- Patients must have ECOG performance status < 2
- Patients must have adequate renal function with a serum creatinine of < 2 mg/dl or creatinine clearance > 50 ml/min.
- Patients must have adequate liver function with a total bilirubin < 2 mg/dl or transaminases < 3 times the upper limit of normal.
- Patients must have negative antibody serology for human immunodeficiency virus (HIV1 and 2)
- Adult women and minorities will be included. Patients with childbearing potential must use effective contraception.
- Patients must sign informed consent prior to initiation of any study-related treatments.
Exclusion Criteria:
- ECOG performance status > 2
- LVEF < 45%
- Pulmonary diffusion capacity < 50% predicted
- Total bilirubin > 2 mg/dl
- Creatinine > 2 mg/dl
- Pregnancy
- Patients positive for HIV
- Patients with engraftment failure at day 42 post transplant defined as failure to achieve a granulocyte count > 500/ul on 3 successive daily determinations and an unsupported platelet count of >= 50,000/ul by day 42
- Patients with active, uncontrolled infection that is expected to continue beyond day 42-63.
- Patients who fail to collect sufficient quantities of stem cells (> 1.6 x 10^9 cells) during apheresis to support CIK cell expansion cultures.
Contacts and Locations| United States, California | |
| Stanford University School of Medicine | |
| Stanford, California, United States, 94305 | |
| Principal Investigator: | Sally Arai | Stanford University |
More Information
No publications provided
| Responsible Party: | Sally Arai, Stanford University School of Medicine |
| ClinicalTrials.gov Identifier: | NCT00477035 History of Changes |
| Other Study ID Numbers: | BMT173, 95889, BMT173 |
| Study First Received: | May 18, 2007 |
| Last Updated: | May 19, 2011 |
| Health Authority: | United States: Institutional Review Board United States: Food and Drug Administration |
Additional relevant MeSH terms:
|
Leukemia Multiple Myeloma Neoplasms, Plasma Cell Hematologic Neoplasms Neoplasms by Histologic Type Neoplasms Hemostatic Disorders Vascular Diseases Cardiovascular Diseases Paraproteinemias Blood Protein Disorders Hematologic Diseases Hemorrhagic Disorders Lymphoproliferative Disorders Immunoproliferative Disorders |
Immune System Diseases Neoplasms by Site Busulfan Cyclophosphamide Melphalan Gemcitabine Vinorelbine Etoposide Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions Antineoplastic Agents, Alkylating Alkylating Agents Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on May 19, 2013