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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Hematopoietic stem cell transplantation | Experimental | All participants will undergo hematopoietic stem cell transplantation after receiving conditioning regimen. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Hematopoietic stem cell transplantation | Biological | Autologous hematopoietic stem cell transplantation |
|
| Measure | Description | Time Frame |
|---|---|---|
| Disease Progression | Data are reporting number of participants with disease progression. Disease progression is defined as a 1 point increase in the Expanded Disability Status Scale (EDSS) on consecutive evaluations at least 3 months apart. | 3 years after transplant |
| Measure | Description | Time Frame |
|---|---|---|
| Survival | Data are reporting the number of participants who survived three years after the transplant Survival of 21 participants was evaluated at three years after the transplant | three years |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Richard Burt, MD | Northwestern University | Principal Investigator |
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21 eligible patients had relapsing remitting MS not responding to interferon and had had two corticosteroid -treated relapses within the previous 12 months or one relapse and gadolinium-enhancing lesions seen on MRI and separate from the relapse.
Between January 2003 and February 2005 in Northwestern Memorial Hospital 21 patients with relapsing-remitting multiple sclerosis (MS) underwent autologous hematopoietic stem cell transplantation in order to evaluate the safety and clinical outcome of autologous non-myeloablative hematopoetic stem cell transplantation in MS.
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| ID | Title | Description |
|---|---|---|
| FG000 | Autologous Hematopoietic Stem Cell Transplantation | Patient's own blood stem cells collected after mobilization with cyclophosphamide (2.0 gm/m²)and granulocyte colony-stimulating factor (G-CSF) (5-10mcg/kg/day.Collected stem cells given back to the patient after receiving conditioning regimen (Cyclophosphamide 50 mg/kg/day for four days and either 20 mg alemtuzumab or 6mg/kg rabbit antithymocyte globulin. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Stem Cell Transplantation | All participants will undergo stem cell transplantation after receiving conditioning regimen. hematopoietic stem cell transplantation : Autologous hematopoietic stem cell transplantation |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Disease Progression | Data are reporting number of participants with disease progression. Disease progression is defined as a 1 point increase in the Expanded Disability Status Scale (EDSS) on consecutive evaluations at least 3 months apart. | Posted | Number | participants | 3 years after transplant |
|
three years
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Stem Cell Transplantation | All participants will undergo stem cell transplantation after receiving conditioning regimen. hematopoietic stem cell transplantation : Autologous hematopoietic stem cell transplantation |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Transient neurological symptoms | Nervous system disorders | Systematic Assessment | One patient had Transient neurological symptoms that manifested as leftsided hypoaesthesia, which was attributed to a filgrastim-related flair. The neurological symptoms resolved when the drug was discontinued. |
The study had following limitations: small number of enrolled participants and no randomization.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr Richard Burt | Northwestern University | 312-908-0059 | rburt@northwestern.edu |
| ID | Term |
|---|---|
| D009103 | Multiple Sclerosis |
| ID | Term |
|---|---|
| D020278 | Demyelinating Autoimmune Diseases, CNS |
| D020274 | Autoimmune Diseases of the Nervous System |
| D009422 | Nervous System Diseases |
| D003711 | Demyelinating Diseases |
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| ID | Term |
|---|---|
| D018380 | Hematopoietic Stem Cell Transplantation |
| ID | Term |
|---|---|
| D033581 | Stem Cell Transplantation |
| D017690 | Cell Transplantation |
| D064987 | Cell- and Tissue-Based Therapy |
| D001691 | Biological Therapy |
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| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
|
|
| Secondary | Survival | Data are reporting the number of participants who survived three years after the transplant Survival of 21 participants was evaluated at three years after the transplant | Posted | Number | participants | three years |
|
|
|
| 0 |
| 21 |
| 7 |
| 21 |
|
| Blood culture with coagulase-negative staphylococcus | Infections and infestations | Systematic Assessment | One patient had a blood culture with coagulase-negative staphylococcus; this was isolated in one specimen of four sent concurrently, which suggests a probable contaminant. |
|
| Dermatomal zoster | Infections and infestations | Systematic Assessment | Two patients developed dermatomal zoster at 20 and 22 months post-transplantation and both resolved with oral antiviral therapy. |
|
| Diarrhoea due to Clostridium difficile | Gastrointestinal disorders | Systematic Assessment | One month after hospital discharge after the transplantation, one patient developed diarrhoea due to Clostridium difficile that resolved with oral metronidazole. |
|
| Grade IV thrombocytopenia | Blood and lymphatic system disorders | Systematic Assessment | Two patients treated with alemtuzumab developed grade IV thrombocytopenia 7 and 14 months after transplantation. The thrombocytopenia presented as easy bruising and petechiae, resolved with intravenous immunoglobulin, prednisone and rituximab |
|
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| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D013812 | Therapeutics |
| D014180 | Transplantation |
| D013514 | Surgical Procedures, Operative |