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Cord Blood Expansion on Mesenchymal Stem Cells
This study is currently recruiting participants.
Verified November 2011 by M.D. Anderson Cancer Center

First Received on July 6, 2007.   Last Updated on November 18, 2011   History of Changes
Sponsor: M.D. Anderson Cancer Center
Information provided by (Responsible Party): M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier: NCT00498316
  Purpose

The goal of this clinical research study is to learn if combining cord blood units will be safe and result in the cells "taking" faster in recipients. The cord blood units will have their cell number increased in the lab using cells from a family member or they will be collected from an unrelated healthy donor.

Objectives:

Primary objective:

  1. To evaluate the safety and feasibility of transplantation of cord blood expanded in mesenchymal stem cell based co-cultures, in patients with hematologic malignancies following high-dose therapy:
  2. To evaluate the rate, extent, and durability of hematopoietic reconstitution

Secondary objectives:

  1. To evaluate the rate and severity of graft versus host disease
  2. To evaluate the rates of infectious complications
  3. To evaluate the rates of disease-free and overall survival

Condition Intervention Phase
Myelodysplastic Syndrome
Leukemia
Procedure: Cord Blood Infusion
Phase I

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: Cord Blood Expansion on Mesenchymal Stem Cells

Resource links provided by NLM:


Further study details as provided by M.D. Anderson Cancer Center:

Primary Outcome Measures:
  • Engraftment and Time to Engraftment [ Time Frame: 100 days after transplant, then every 3 months thereafter ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 125
Study Start Date: July 2007
Estimated Primary Completion Date: July 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Cord Blood Infusion Procedure: Cord Blood Infusion
Cord blood transplantation performed on day 0.

  Show Detailed Description

  Eligibility

Ages Eligible for Study:   1 Year to 80 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Acute Myelogenous Leukemia (AML), Myelodysplastic Syndrome (MDS): induction failure, high-risk for relapse first remission (with high-risk cytogenetics, flt3 mutation positive and/or evidence of minimal residual disease by flow cytometry), secondary leukemia from prior chemotherapy and/or arising from MDS, Langerhan's cell histiocytosis, second or third complete remission, or second relapse.
  2. Acute Lymphoblastic Leukemia (ALL): induction failure, first complete remission with Philadelphia chromosome or translocation (4;11), hypodiploidy, and/or evidence of minimal residual disease by flow cytometry;second third complete remission, or second relapse.
  3. CML second chronic phase or accelerated phase.
  4. Non-Hodgkin's Lymphoma (NHL): Induction failures, second or third complete remission, or relapse (including relapse post autologous)
  5. Hodgkin's Disease (HD): Induction failures, second or third complete remission,or relapse (including relapse post autologous hematopoietic stem cell transplant).
  6. Chronic Lymphocytic Leukemia (CLL): Progressive disease following standard therapy
  7. Multiple Myeloma: stage II or III , symptomatic , secretory Multiple Myeloma requiring treatment.
  8. Age greater than or equal to 1 year but less than or equal to 55 years (Myeloablative Regimen 4). Eligibility for pediatric patients will be determined in conjunction with an MDACC pediatrician. Patients >55 but < 65 years who have a Performance Status of 0 or 1 and no comorbidities may receive the myeloablative regimen 4 at the discretion of the investigator(s).
  9. Age greater than 55 years and less than or equal to 80 years (Nonmyeloablative Regimen 2)
  10. Age greater than or equal to 1 but less than or equal to 80 years old that in the opinion of the investigator(s) would preclude myeloablative therapy and who cannot receive Total Body Irradiation (TBI) may receive reduced intensity regimen 3.
  11. Performance score of at least 60% by Karnofsky or PS less than 3 (ECOG) (age greater than or equal to 12 years), or Lansky Play-Performance Scale of at least 60% or greater (age <12 years)
  12. Left ventricular ejection fraction of at least 40% (Myeloablative Regimen 4, Reduced Intensity Regimen 3) or 30% (Nonmyeloablative Regimen 2)
  13. Pulmonary function test demonstrating a diffusion capacity of least 50% predicted (Myeloablative Regimen 4, Reduced Intensity Regimen 3) or at least 40% predicted (Nonmyeloablative Regimen 2). For children < 7 years of age who are unable to perform PFT, oxygen saturation > 92% on room air by pulse oximetry.
  14. Creatinine < 1.6 mg/dL (Myeloablative Regimen 4, Reduced Intensity Regimen 3) or < 3.0 mg/dL (Nonmyeloablative Regimen 2).
  15. SGPT/bilirubin < / = to 2.0 x normal (Myeloablative Regimen 4, Reduced Intensity Regimen 3) or < / = 4.0 x normal (Nonmyeloablative Regimen 2)
  16. Negative Beta HCG test in a woman with child bearing potential defined as not post-menopausal for 12 months or no previous surgical sterilization and willing to use an effective contraceptive measure while on study.
  17. Unrelated Cord Blood will be used as a source of hematopoietic support if a 5 or 6/6 related or 6/6 unrelated bone marrow donor is not available, or if the tempo of a patient's disease dictates it is not in the patient's best interest to wait for an unrelated marrow donor to be procured.
  18. Patients must have two Cord Blood units available which are matched with the patient at 4, 5, or 6/6 HLA class I (serological) and II (molecular) antigens. Each cord must contain at least 10 million total nucleated cells/Kg recipient body weight (pre-thaw)
  19. Patients must have a family member who is matched at 2, 3, or 4 HLA antigens typed as described above and willing to donate 80-100 ml or bone marrow for MSC generation or the Angioblast Mesenchymal Precursor Cells will be used for the cord blood co-cultures. Patients that are high risk for relapse are eligible to use the Angioblast "off-the-shelf" Mesenchymal Precursor Cells.
  20. Patient must be willing to undergo bone marrow harvest or peripheral blood progenitor cells collection for use in case of engraftment failure.
  21. If the patient is unable / fails to successfully undergo autologous bone marrow harvest or peripheral blood progenitor cells collection a family member must be identified who agrees to donate bone marrow or peripheral blood progenitor cells for T-depleted transplant. A third cord blood unit could be used in case of engraftment failure. This cord blood unit must be identified prior to enrollment in this study.
  22. If the family member is to be used as the donor, he/she must freely document his / her willingness to comply with this donation by signing a donor informed consent form prior to preparative regimen for transplantation. This donor could be the same person who donates the bone marrow aspirate for mesenchymal stem cell generation

Exclusion Criteria:

  1. HIV positive
  2. Positive Pregnancy Test
  3. Uncontrolled serious medical condition such as persistent septicemia despite adequate antibiotic therapy, decompensated congestive heart failure despite cardiac medications or pulmonary insufficiency requiring intubation. (excluding primary disease for which CB transplantation is proposed), or psychiatric condition that would limit informed consent.
  4. Patients with active (untreated) CNS disease
  5. Availability of appropriate, willing, HLA-matched related marrow donor.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00498316

Contacts
Contact: Elizebeth Shpall, MD 713-745-2161

Locations
United States, Texas
UT MD Anderson Cancer Center Recruiting
Houston, Texas, United States, 77030
Principal Investigator: Elizabeth Shpall, MD            
Sponsors and Collaborators
M.D. Anderson Cancer Center
Investigators
Principal Investigator: Elizabeth Shpall, MD M.D. Anderson Cancer Center
  More Information

Additional Information:
No publications provided

Responsible Party: M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier: NCT00498316     History of Changes
Other Study ID Numbers: 2005-0781
Study First Received: July 6, 2007
Last Updated: November 18, 2011
Health Authority: United States: Food and Drug Administration

Keywords provided by M.D. Anderson Cancer Center:
Myelodysplastic Syndrome
Leukemia
Cord Blood Expansion
Umbilical Cord Blood
Mesenchymal Stem Cells
Acute Myelogenous Leukemia
Acute Lymphoblastic Leukemia
ALL
AML
MDS

Additional relevant MeSH terms:
Leukemia
Myelodysplastic Syndromes
Preleukemia
Neoplasms by Histologic Type
Neoplasms
Bone Marrow Diseases
Hematologic Diseases
Precancerous Conditions

ClinicalTrials.gov processed this record on February 09, 2012