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| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2014-01990 | Registry Identifier | CTRP (Clinical Trial Reporting Program) | |
| 2013-0657 | Other Identifier | M D Anderson Cancer Center |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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This phase II trial studies how well donor cytomegalovirus-specific cytotoxic T-lymphocytes work in treating patients with a cytomegalovirus infection that has come back or has not gotten better despite standard therapy. White blood cells from donors who have been exposed to cytomegalovirus may be effective in treating patients with a cytomegalovirus infection.
PRIMARY OBJECTIVE:
I. To assess the efficacy, feasibility and safety of administering most closely human leukocyte antigen (HLA)-matched cytomegalovirus (CMV) specific cytotoxic T-lymphocytes (HMC-CTLs) generated by "gamma-catch" to mediate antiviral activity in hematopoietic stem cell transplantation (HSCT) recipients with CMV infections.
SECONDARY OBJECTIVE:
I. To assess the persistency of the administered HMC-CTLs generated by "gamma-catch" and their contribution immune reconstitution.
OUTLINE:
Patients receive allogeneic cytomegalovirus-specific cytotoxic T-lymphocytes intravenously (IV). Patients with partial response, stable disease, or progressive disease may receive an additional dose of allogeneic cytomegalovirus-specific cytotoxic T-lymphocytes at a minimum of 2 weeks from the first infusion.
After completion of study treatment, patients are followed up periodically for 12 months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment (allogeneic CMV-specific cytotoxic T-lymphocytes) | Experimental | Patients receive allogeneic cytomegalovirus-specific cytotoxic T-lymphocytes IV. Patients with partial response, stable disease, or progressive disease may receive an additional dose of allogeneic cytomegalovirus-specific cytotoxic T-lymphocytes at a minimum of 2 weeks from the first infusion. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Allogeneic Cytomegalovirus-Specific Cytotoxic T lymphocytes | Biological | Given IV |
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| Measure | Description | Time Frame |
|---|---|---|
| Success, defined as R1 and R2 without treatment failure | The best outcome is defined as R1 = in complete response (CR) for 4 consecutive weeks, starting at week 2, without the need for a second cytotoxic T-lymphocyte (CTL) infusion. The second best outcome is defined as R2 = not in CR at week 2, 3, or 4, but in CR or partial response (PR) 4 weeks after the second CTL infusion. | Up to 4 weeks after second CTL infusion |
| Measure | Description | Time Frame |
|---|---|---|
| Overall survival time | Will be analyzed as a function of patient covariates using standard statistical methods, including Bayesian survival regression analysis and ordinal regression. Unadjusted event time distributions will be estimated using the Kaplan-Meier method. | Up to 12 months |
| Disease-free survival time |
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Inclusion criteria:
Patients with or without a malignancy; and/or any type of autologous or allogeneic HSCT; and/or patients who are immunocompromised with CMV infection will be included.
Persistent CMV infection despite optimum anti-viral therapy
Patients with CMV disease: defined as the demonstration of CMV by biopsy specimen from visceral sites (by culture or histology) or the detection of CMV by culture or direct fluorescent antibody stain in bronchoalveolar lavage fluid in the presence of new or changing pulmonary infiltrates OR
Failure of antiviral therapy: defined as the continued presence of DNAemia (defined as >/= 137 copies/ml by PCR) for at least 2 weeks of CMV antiviral therapy OR
Patients who cannot tolerate standard anti-viral therapy and cannot continue anti-viral treatment due to side effect profile will be eligible independent of anti-viral therapy duration.
Clinical status at enrollment to allow tapering of steroids equal to or less than 0.5 mg/kg/day of prednisone.
Patients with chronic GVHD if on prednisone equal to or less than 0.5 mg/kg and not receiving second-line GVHD treatments like Pentostatin, Infliximab, Etanercept, etc.
Written informed consent and/or signed assent line from patient, parent or guardian.
Written informed consent from patient or legally authorized representative (LAR). Patients with cognitive impairment are eligible.
Exclusion criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Betul Oran | M.D. Anderson Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| M D Anderson Cancer Center | Houston | Texas | 77030 | United States |
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| Label | URL |
|---|---|
| MD Anderson Cancer Center | View source |
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Will be analyzed as a function of patient covariates using standard statistical methods, including Bayesian survival regression analysis and ordinal regression. Unadjusted event time distributions will be estimated using the Kaplan-Meier method. |
| Up to 12 months |
| Graft-versus-host disease | Will be analyzed as a function of patient covariates using standard statistical methods, including Bayesian survival regression analysis and ordinal regression. | Up to 12 months |
| Secondary graft failure | Will be analyzed as a function of patient covariates using standard statistical methods, including Bayesian survival regression analysis and ordinal regression. | Up to 12 months |
| ID | Term |
|---|---|
| D003586 | Cytomegalovirus Infections |
| D019337 | Hematologic Neoplasms |
| ID | Term |
|---|---|
| D006566 | Herpesviridae Infections |
| D004266 | DNA Virus Infections |
| D014777 | Virus Diseases |
| D007239 | Infections |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
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