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In this trial, investigators will infuse donor bone marrow mesenchymal stromal cells intravenously, as a treatment for pediatric Crohn's disease or ulcerative colitis that has not responded to conventional therapies. The goals of this study are to test the safety and tolerability of donor mesenchymal stromal cells in children with Inflammatory Bowel Disease.
Mesenchymal stromal cells support the development of blood cells within the bone marrow. When isolated from a donor and infused into an animal or human, they have been demonstrated to travel to areas of inflammation, to alter immune responses, to decrease pro-inflammatory cytokines, and to promote tissue repair. Infusion of these cells does not lead to rejection. These properties lead investigators to hypothesize that that these may be they may be beneficial in treating inflammatory bowel disease.
In this trial, investigators will infuse donor bone marrow mesenchymal stromal cells intravenously, as a treatment for pediatric Crohn's disease or ulcerative colitis that has not responded to conventional therapies. Mesenchymal stromal cells support the development of blood cells within the bone marrow. They have also been demonstrated to travel to areas of inflammation, to alter immune responses, to decrease pro-inflammatory cytokines, and to promote tissue repair. Infusion of these cells does not lead to rejection. These properties lead investigators to hypothesize that that these may be they may be beneficial in treating inflammatory bowel disease.
Investigators will culture donated bone marrow mesenchymal stromal cells in a unique automated system, and infuse the cells in a fresh, replicating stage of growth. This study is to test the safety and tolerability of donor mesenchymal stromal cells in children with Inflammatory Bowel Disease.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Mesenchymal Stromal Cells (MSCs) | Experimental | A fixed dose of Mesenchymal Stromal Cells (MSCs) will be studied: 1 x 106 cells/kg administered intravenously (IV) weekly for 4 consecutive weeks, with the option of an additional 4 weeks of treatment, at the discretion of the principal investigator. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Allogeneic bone marrow-derived mesenchymal stromal cells | Biological | This study is a pilot phase 1 study of patients with moderately to severely active Crohn Disease (CD) and ulcerative colitis (UC) (≥ 18 years, Mayo score: ≥6 or CDAI: ˃ 220; <18 years, Pediatric Crohn's Disease Activity Index (PCDAI) :> 30) or Pediatric Ulcerative Colitis Activity Index (PUCAI) : >34). A fixed dose will be studied: 1 x 106 cells/kg administered intravenously (IV) weekly for 4 consecutive weeks, with the option of an additional 4 weeks of treatment, at the discretion of the principal investigator. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Subjects Who Experience Serious Adverse Events, Adverse Events, and/or Early Treatment Discontinuations. | Safety and tolerability of the administration of human allogeneic bone marrow-derived stromal cells to children and young adults with IBD, measured by the frequency of any SAEs, AEs and/or early treatment discontinuations. Weekly infusions for 8 weeks, post-treatment assessment 45 days after last infusion, three additional follow-up visits over 2 years. | 45 days after the last infusion |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of Patients With Clinical Response | Proportion of subjects that achieve a clinical response by 45 days after last infusion, as defined by a decrease in PCDAI from baseline by greater than or equal to 12.5 points (for CD) or a decrease in PUCAI of greater than or equal to 20 points (for UC). | 45 days after last infusion |
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Inclusion Criteria:
Exclusion Criteria:
• Patients < 12 years of age or >22 years of age
Pregnant or breastfeeding. Serum pregnancy test must be negative at screening for female subjects of childbearing potential. Urine pregnancy test must remain negative at each of 4 infusion visits.
Patients with toxic mega-colon or intestinal perforation
Evidence of autoimmune chronic active hepatitis or sclerosing cholangitis.
Patients with fever > 39° C or clinically significant active infection within 1 week (i.e. chronic infections including Hepatitis B/C or HIV or acute infections, including urinary tract infection and respiratory tract infection)
Received an agent not approved by the FDA for marketed use in any indication or any small molecule inhibitors (i.e. naltrexone) within 60 days of enrollment.
Subjects who are taking greater than 20 mg (or if body weight <40 kg, 0.5 mg/kg) of prednisone daily.
Clinically significant abnormal biochemical and hematological parameters, including:
Has active infection with enteric pathogens as evidenced by positive microbiological culture of stool or C.difficile toxin PCR.
Had bowel surgery other than perianal procedures (fistulotomy, seton placement, abscess drainage) within 3 months of enrollment.
Has uveitis
Has known pulmonary disease, excluding mild intermittent asthma
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| Name | Affiliation | Role |
|---|---|---|
| Laurie S. Conklin, M.D. | Children's National Research Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Children's National Medical Center | Washington D.C. | District of Columbia | 20010 | United States |
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STOMP001 was enrolled in the study on 6/7/2018 at CNH outpatient clinic. Only one patient was enrolled in this study.
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| ID | Title | Description |
|---|---|---|
| FG000 | Mesenchymal Stromal Cells (MSCs) | A fixed dose of Mesenchymal Stromal Cells (MSCs) will be studied: 1 x 106 cells/kg administered intravenously (IV) weekly for 4 consecutive weeks, with the option of an additional 4 weeks of treatment, at the discretion of the principal investigator. Allogeneic bone marrow-derived mesenchymal stromal cells: This study is a pilot phase 1 study of patients with moderately to severely active Crohn Disease (CD) and ulcerative colitis (UC) (≥ 18 years, Mayo score: ≥6 or CDAI: ˃ 220; <18 years, Pediatric Crohn's Disease Activity Index (PCDAI) :> 30) or Pediatric Ulcerative Colitis Activity Index (PUCAI) : >34). A fixed dose will be studied: 1 x 106 cells/kg administered intravenously (IV) weekly for 4 consecutive weeks, with the option of an additional 4 weeks of treatment, at the discretion of the principal investigator. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
STOMP001 was enrolled in the study on 6/7/2018 and was withdrawn from the study 09/05/2018 due to refusal to continue the follow-up visits for the study.
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| ID | Title | Description |
|---|---|---|
| BG000 | Mesenchymal Stromal Cells (MSCs) | A fixed dose of Mesenchymal Stromal Cells (MSCs) will be studied: 1 x 106 cells/kg administered intravenously (IV) weekly for 4 consecutive weeks, with the option of an additional 4 weeks of treatment, at the discretion of the principal investigator. Allogeneic bone marrow-derived mesenchymal stromal cells: This study is a pilot phase 1 study of patients with moderately to severely active Crohn Disease (CD) and ulcerative colitis (UC) (≥ 18 years, Mayo score: ≥6 or CDAI: ˃ 220; <18 years, Pediatric Crohn's Disease Activity Index (PCDAI) :> 30) or Pediatric Ulcerative Colitis Activity Index (PUCAI) : >34). A fixed dose will be studied: 1 x 106 cells/kg administered intravenously (IV) weekly for 4 consecutive weeks, with the option of an additional 4 weeks of treatment, at the discretion of the principal investigator. |
| 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 | Number of Subjects Who Experience Serious Adverse Events, Adverse Events, and/or Early Treatment Discontinuations. | Safety and tolerability of the administration of human allogeneic bone marrow-derived stromal cells to children and young adults with IBD, measured by the frequency of any SAEs, AEs and/or early treatment discontinuations. Weekly infusions for 8 weeks, post-treatment assessment 45 days after last infusion, three additional follow-up visits over 2 years. | STOMP001 was enrolled in the study on 6/7/2018 and was withdrawn from the study 09/05/2018 due to refusal to continue the follow-up visits for the study. Due to patient's refusal to continue the study, there were no relative data to be analyzed. | Posted | Count of Participants | Participants | 45 days after the last infusion |
|
3 months
Participant was withdrawn from the study after 3 months due to refusal to continue all study related follow-up visits.
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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 | Mesenchymal Stromal Cells (MSCs) | A fixed dose of Mesenchymal Stromal Cells (MSCs) will be studied: 1 x 106 cells/kg administered intravenously (IV) weekly for 4 consecutive weeks, with the option of an additional 4 weeks of treatment, at the discretion of the principal investigator. Allogeneic bone marrow-derived mesenchymal stromal cells: This study is a pilot phase 1 study of patients with moderately to severely active Crohn Disease (CD) and ulcerative colitis (UC) (≥ 18 years, Mayo score: ≥6 or CDAI: ˃ 220; <18 years, Pediatric Crohn's Disease Activity Index (PCDAI) :> 30) or Pediatric Ulcerative Colitis Activity Index (PUCAI) : >34). A fixed dose will be studied: 1 x 106 cells/kg administered intravenously (IV) weekly for 4 consecutive weeks, with the option of an additional 4 weeks of treatment, at the discretion of the principal investigator. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Worsening Crohn's disease | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment | On 6/26/2018, patient went to the ER for vomiting and dehydration. Patient was then hospitalized at CNMC on 6/29/18 for conditions consistent with worsening Crohn's disease. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Fainting | Cardiac disorders | CTCAE (4.0) | Systematic Assessment | On 6/11/2018, patient fainted at work and per PI's recommendation, patient went to the ER for labs, EKG and IV fluids |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Catherine Bollard, MD | Children's National Hospital | 202-476-4776 | cbollard@childrensnational.org |
| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Jan 22, 2018 | May 25, 2021 | Prot_000.pdf |
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| ID | Term |
|---|---|
| D015212 | Inflammatory Bowel Diseases |
| D003424 | Crohn Disease |
| D003093 | Colitis, Ulcerative |
| ID | Term |
|---|---|
| D005759 | Gastroenteritis |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
| D007410 | Intestinal Diseases |
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|
| Number of Subjects Demonstrating an Improvement of Laboratory Tests Reflecting Systemic Inflammation. |
Improvement in laboratory parameters (i.e. C-reactive protein, fecal calprotectin, anti-HLA antibodies, and viral specific T-cell activity) |
| 45 days after last infusion |
| Participants |
|
| Age, Customized | Number | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
|
|
| Secondary | Proportion of Patients With Clinical Response | Proportion of subjects that achieve a clinical response by 45 days after last infusion, as defined by a decrease in PCDAI from baseline by greater than or equal to 12.5 points (for CD) or a decrease in PUCAI of greater than or equal to 20 points (for UC). | STOMP001 was enrolled in the study on 6/7/2018 and was withdrawn from the study 09/05/2018 due to refusal to continue the follow-up visits for the study. Due to patient's refusal to continue the study, there were no relative data to be analyzed. | Posted | 45 days after last infusion |
|
|
| Secondary | Number of Subjects Demonstrating an Improvement of Laboratory Tests Reflecting Systemic Inflammation. | Improvement in laboratory parameters (i.e. C-reactive protein, fecal calprotectin, anti-HLA antibodies, and viral specific T-cell activity) | STOMP001 was enrolled in the study on 6/7/2018 and was withdrawn from the study 09/05/2018 due to refusal to continue the follow-up visits for the study. Due to patient's refusal to continue the study, there were no relative data to be analyzed. | Posted | 45 days after last infusion |
|
|
| 0 |
| 1 |
| 1 |
| 1 |
| 1 |
| 1 |
|
|
| Superior mesenteric artery syndrome (Partial Obstruction of Duodenum) | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment | On 6/30/2018, patient developed Superior mesenteric artery syndrome (Partial Obstruction of Duodenum). The event ended on 9/5/2018 |
|
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| D003092 | Colitis |
| D003108 | Colonic Diseases |