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Mesenchymal Stem Cells in the Treatment of Relapsed/Refractory Severe Acquired Aplastic Anemia

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ClinicalTrials.gov Identifier: NCT01297972
Recruitment Status : Completed
First Posted : February 17, 2011
Last Update Posted : February 4, 2014
Sponsor:
Information provided by (Responsible Party):
Diego Villa Clé, University of Sao Paulo

Study Description
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Brief Summary:
Mesenchymal stem cells have been tested in many autoimmune disorders with encouraging results and may be an alternative to the treatment of immune-mediated severe acquired aplastic anemia.

Condition or disease Intervention/treatment Phase
Aplastic Anemia Biological: Intravenous bone marrow mesenchymal stem cells infusion Phase 1 Phase 2

Detailed Description:

Acquired aplastic anemia is a bone marrow failure syndrome characterized by and empty bone marrow and low blood counts. Most of the cases are immune-mediated. Allogeneic bone marrow transplant is the preferable treatment modality for patients younger than 40 years with a matched sibling donor. Patients not eligible for transplant are treated with intensive immunosuppressive therapy often based on anti-thymocyte globulin and cyclosporine.

However, up to one third of patients treated with immunosuppression are refractory and one third of those who response eventually relapse. Refractory and relapsed cases may be the result of insufficient immunosuppression and these cases may benefit from additional immunosuppression. Mesenchymal stem cells infusion may be a potential treatment option, considering its properties to modulate the immune system.

Refractory or relapsed patients with aplastic anemia will be treated with conventional immunosuppressive regimen (anti-thymocyte globulin plus cyclosporine) combined with intravenous infusion of allogeneic unrelated bone marrow mesenchymal stem cells.

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 9 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Bone Marrow Mesenchymal Stem Cells in the Treatment of Refractory Severe Acquired Aplastic Anemia
Study Start Date : February 2011
Actual Primary Completion Date : November 2013
Actual Study Completion Date : November 2013

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Arms and Interventions
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Intervention Details:
  • Biological: Intravenous bone marrow mesenchymal stem cells infusion
    After standard immunosuppressive therapy with rabbit antithymocyte globulin 3,5 mg/Kg/day during 5 days, allogeneic unrelated bone marrow derived mesenchymal stem cells will be infused intravenously. Oral cyclosporine 5 mg/Kg/day (with dose correction weekly to keep serum cyclosporine level between 150-250 mg/dl) up to 6 months will be added.

Outcome Measures
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Primary Outcome Measures :
  1. Number of Participants with Adverse Events as a Measure of Safety and Tolerability of intravenous allogeneic unrelated mesenchymal stem cells infusion in patients with severe acquired aplastic anemia. [ Time Frame: After the mesenchymal stem cells infusion up to 6 mounth after ]
    Adverse events like allergic reactions,infectious diseases,organ dysfunction or other related to mesenchymal stem cells infusion will be assessed.


Secondary Outcome Measures :
  1. Level of cytopenias [ Time Frame: weekly until 6 months ]
  2. Transfusional requirements [ Time Frame: weekly until 6 months ]
    Units of blood or platelets transfused after the mesenchymal stem cells infusion will be measured and compared to previously.

  3. Incidence of infections and febrile neutropenia [ Time Frame: weekly until 6 months ]

Eligibility Criteria
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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Diagnosis of Acquired Aplastic Anemia
  • Relapse/refractory to at least 1 immunosuppressive first line treatment
  • Not eligible to allogeneic bone marrow transplantation

Exclusion Criteria:

  • Previous or current malignancy
  • Active or latent infectious disease
  • Positive serologic tests for HIV, HCV, HBV, HTLV-1 and 2, Syphilis or Chagas disease
  • Previous drug reaction for antithymocyte globulin, cyclosporin or corticosteroids
  • Severe organic impairment (renal, hepatic, cardiac, pulmonary)
  • Uncontrolled hypertension or diabetes
  • Pregnancy
  • Previous history of allergic reaction to penicillin or streptomycin
  • Severe psychiatric disorder
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01297972


Locations
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Brazil
Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo
Ribeirão Preto, São Paulo, Brazil, 14048900
Sponsors and Collaborators
University of Sao Paulo
Investigators
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Principal Investigator: Diego V Clé, MD University of São Paulo
Study Chair: Rodrigo T Calado, MD University of São Paulo
More Information
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Publications:

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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Responsible Party: Diego Villa Clé, MD, University of Sao Paulo
ClinicalTrials.gov Identifier: NCT01297972    
Other Study ID Numbers: CONEP 16119
First Posted: February 17, 2011    Key Record Dates
Last Update Posted: February 4, 2014
Last Verified: February 2014
Keywords provided by Diego Villa Clé, University of Sao Paulo:
Aplastic Anemia
Mesenchymal Stem Cells
Additional relevant MeSH terms:
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Anemia
Anemia, Aplastic
Hematologic Diseases
Bone Marrow Diseases