Not provided
| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2013-01728 | Registry Identifier | CTRP (Clinical Trial Reporting Program) | |
| 13282 | Other Identifier | City of Hope Medical Center |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
This pilot clinical trial studies gene therapy after frontline chemotherapy in treating patients with acquired immune deficiency syndrome (AIDS)-related non-Hodgkin lymphoma (NHL). Placing genes for anti-human immunodeficiency virus (HIV) ribonucleic acid (RNA) into stem/progenitor cells may make the body build an immune response to AIDS. Giving the chemotherapy drug busulfan before gene therapy can help gene-modified cells engraft and work better.
PRIMARY OBJECTIVES:
I. To evaluate the safety and feasibility of recombinant (r)HIV7-short hairpin RNA targeted to the HIV-1 tat/rev (shI)-trans-active response element (TAR)-chemokine cysteine-cysteine receptor 5 ribozyme (CCR5RZ)-treated hematopoietic stem progenitor cells (HSPC) (lentivirus vector rHIV7-shI-TAR-CCR5RZ-transduced hematopoietic progenitor cells) infusion in AIDS patients completing treatment for NHL and non-myeloablative conditioning with busulfan.
II. To demonstrate the engraftment of gene-modified progeny cells following such treatment.
III. To determine if selection of these gene-modified progeny cells occurs during analytical treatment interruption (ATI) of combination anti-retroviral therapy (cART).
SECONDARY OBJECTIVES:
I. To evaluate the pharmacokinetics of busulfan in patients with AIDS-related lymphoma (ARL).
II. To determine the effects of HIV-1 infection on the presence of gene-marked peripheral blood mononuclear cells (PBMC) as measured by woodchuck post-transcriptional regulatory element (WPRE) deoxyribonucleic acid (DNA) polymerase chain reaction (PCR) performed before, during, and after ATI.
OUTLINE: Patients receive busulfan intravenously (IV) over 3 hours on day -2 followed by lentivirus vector rHIV7-shI-TAR-CCR5RZ-transduced hematopoietic progenitor cells IV on day 0.
After completion of study treatment, patients are followed up at 1, 7, 14, and 21 days and 1, 2, 3, 6, 9, 12, 18, and 24 months and then annually for 3 years.
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment (gene therapy) | Experimental | Patients receive busulfan IV over 3 hours on day -2 followed by lentivirus vector rHIV7-shI-TAR-CCR5RZ-transduced hematopoietic progenitor cells IV on day 0. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| busulfan | Drug | Given IV |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Procedure related toxicity as determined by adverse events (AE) grading scale using the Common Terminology Criteria for Adverse Events (CTCAE) version v4.03 | Tables will be created to summarize these toxicities and side effects by dose | Up to 5 years |
| Time to Absolute Neutrophil Count (ANC) >= 500/uL | First 28 days | |
| Time to platelet recovery to >= 50,000/uL | First 90 days |
| Measure | Description | Time Frame |
|---|---|---|
| Evidence for and duration of vector-marked PBMC/marrow cells assessed by PCR | PCR-based assay on PBMC | Up to 5 years |
| Expression of the RNA transgenes in lineage-specific progeny of the transduced cells assessed by PCR |
Not provided
Inclusion Criteria:
SECONDARY ELIGIBILITY CRITERIA FOR GENE-MODIFIED HSPC INFUSION:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Amrita Krishnan | City of Hope Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| City of Hope Medical Center | Duarte | California | 91010 | United States |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| lentivirus vector rHIV7-shI-TAR-CCR5RZ-transduced hematopoietic progenitor cells | Biological | Given IV |
|
|
| pharmacological study | Other | Correlative studies |
|
| laboratory biomarker analysis | Other | Correlative studies |
|
PCR-based assay on FACS-sorted cells
| Up to 2 years |
| Effect of ATI on HIV markers and CD4 count | HIV proviral DNA, HIV RNA single copy, and 2-LTR circle DNA from PBMCs | Up to 5 years |
| Pharmacokinetic parameters of busulfan | Cmax, CLsys, Vd, t1/2's, AUC | Day -2 at 0 hours (pre-infusion); 3 hours (just before end of infusion); and at 4, 5, and 6 hours and day -1 at 24 hours |
| Ability to obtain suitable numbers of transduced HSPC for engraftment assessed by FACS | The number and type of cells will be determined by fluorescence activated cell sorting (FACS) analysis of the final cell product. The minimum target number of CD34+ cells for collection is 7.5 x 10e6 cells/kg and, in the final transduced cell product, the number of CD34+ cells must be >= 2.0 x 10e6 CD34+ cells/kg with total viability >= 70%. | Up to day -2 (Pre-infusion of the investigational drug) |
| Feasibility of product manufacturing as evidenced by product release assessed by release assays | Release assays | Up to day -2 (Pre-infusion of the investigational drug) |
| ID | Term |
|---|---|
| D015658 | HIV Infections |
| ID | Term |
|---|---|
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
| D015229 | Sexually Transmitted Diseases, Viral |
| D012749 | Sexually Transmitted Diseases |
| D016180 | Lentivirus Infections |
| D012192 | Retroviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D007153 | Immunologic Deficiency Syndromes |
| D007154 | Immune System Diseases |
Not provided
Not provided
| ID | Term |
|---|---|
| D002066 | Busulfan |
| ID | Term |
|---|---|
| D002072 | Butylene Glycols |
| D006018 | Glycols |
| D000438 | Alcohols |
| D009930 | Organic Chemicals |
| D008698 | Mesylates |
| D000476 | Alkanesulfonates |
| D017738 | Alkanesulfonic Acids |
| D000473 | Alkanes |
| D006839 | Hydrocarbons, Acyclic |
| D006838 | Hydrocarbons |
| D013451 | Sulfonic Acids |
| D013456 | Sulfur Acids |
| D013457 | Sulfur Compounds |
Not provided
Not provided