A Study of Safety, Tolerability, and Pk of rhMBL in Pediatric Hematology/Oncology Pts With Fever and Neutropenia

A Multi-Center Study of the Safety, Tolerability, Pharmacokinetics, and Dose Escalation of Intravenous Recombinant Human Mannose-Binding-Lectin (rhMBL) in MBL Deficient Pediatric Hematology/Oncology Patients With Fever and Neutropenia

The goal of this clinical research study is to find the dose of EZN-2232 that can be given to MBL deficient pediatric cancer patients undergoing chemotherapy. The pharmacokinetics, pharmacodynamics, and safety of the study drug will also be studied.

MBL deficient patients will be randomized in a ratio of 1:1 to receive a single dose of either 0.5 mg/kg or 1.0 mg/kg of intravenous rhMBL. A total of 24 patients will be treated in each of the rhMBL arms, (12 in the 0.5 mg/kg and 12 in the 1.0 mg/kg. All patients are to receive anti-infectious prophylactic supportive therapy as per institutional standards

Inclusion Criteria: Patients must meet all of the following criteria to be eligible for enrollment into the study:

• Children ages 2 to 17 receiving chemotherapy for hematological/oncological diseases.
• Patients must have documented MBL levels <300 ng/mL in serum as evaluated in the screening protocol.
• Fever defined as an oral temperature equivalent of >100.4°F (38°C).
• Neutropenia defined as an absolute neutrophil count ≤1,000/mm3 with the anticipation that the counts will fall below 500/mm3.
• Receiving broad spectrum antibiotics for fever and neutropenia.
• Patients with age-adjusted normal serum creatinine OR a creatinine clearance >60 mL/min/1.73m2.
• Informed consent of the patient, parent or legally authorized representative obtained prior to entry.
• Reliable and willing to make themselves available for the duration of the study and to abide by the study restrictions.

Exclusion Criteria: Patients meeting any of the following exclusion criteria will not be eligible for enrollment.

• Patients receiving the preparative regimen for a bone marrow or hematopoietic stem cell transplantation.
• Concurrent serious illness in the opinion of the principal investigator that could potentially interfere with protocol compliance.
• Patient is pregnant, breast feeding or planning a pregnancy during the course of the study.
• Sexually active male and female patients not using an acceptable barrier method of contraception or practicing abstinence throughout the study and for at least 30 days after receiving their last treatment unless the patient is surgically or medically sterile.
• Patients with moderate or severe liver disease, as defined by:

AST or ALT >5 times upper limit of normal (ULN) OR Total bilirubin >2.5 times ULN.

• Patients with poor venous access that would preclude intravenous drug delivery or multiple blood draws.
• Current participation in another clinical study with an investigational agent and/or use of an investigational drug (not including investigational use of an FDA approved drug) in the 30 days before scheduled administration of rhMBL.
• Known allergic reactions to MBL or other human plasma products.
• Patients on hemodialysis unable to tolerate the volume of IV fluid on non-dialysis days.