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This study will evaluate pediatric patients with malignant or non-malignant blood cell disorders who are having a blood stem cell transplant depleted of T cell receptor (TCR) alfa and beta cells that comes from a partially matched family donor. The study will assess whether immune cells, called T cells, from the family donor, that are specially grown in the laboratory and given back to the patient along with the stem cell transplant can help the immune system recover faster after transplant. As a safety measure these T cells have been programmed with a self-destruct switch so that they can be destroyed if they start to react against tissues (graft versus host disease).
This is a Phase 1/2 study evaluating the safety and feasibility of BPX-501 T cells infused after partially mismatched, related, TCR alpha beta T cell depleted hematopoietic stem cell transplant (HSCT) in pediatric patients. The purpose of this clinical trial is to determine whether BPX-501 infusion can enhance immune reconstitution in those patients with hematologic disorders, with the potential for reducing the severity and duration severe acute graft versus host disease (GvHD).
The trial will also evaluate the treatment of GvHD by the infusion of dimerizer drug (AP1903/rimiducid) in those subjects who present with GVHD that does not adequately respond to standard of care therapy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| BPX-501 T cells and Rimiducid | Experimental | TCR alpha beta depleted graft infusion with addback of BPX-501 T cells. Rimiducid: Dimerizer drug administered to subjects who present with Grade I-IV acute GVHD with inadequate response to steroids within 48 hours of treatment or mild to severe chronic GVHD with inadequate response to steroids within 7 days of treatment. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| BPX-501 T cells | Biological | T cells transduced with CaspaCIDe® safety switch |
|
| Measure | Description | Time Frame |
|---|---|---|
| Adverse Event | Demonstrate safety of BPX-501 MTD | Month 24 |
| TRM/NRM | Assess the cumulative incidence of non-relapse/transplant related mortality | Day 180, Month 12 |
| Measure | Description | Time Frame |
|---|---|---|
| Disease-free survival | Disease-free survival rates after transplantation | Month 24 |
| Relapse | Cumulative incidence of relapse | Month 12 |
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Inclusion Criteria:
Age > 1 month and < 26 years
Life expectancy > 10 weeks
Subjects deemed eligible for allogeneic stem cell transplantation.
Subjects with life-threatening hematological malignancies (high-risk ALL in 1st CR, ALL in 2nd or subsequent CR, AML in 1st CR, AML in 2nd or subsequent CR, myelodysplastic syndromes, non-Hodgkin lymphomas in 2nd or subsequent CR, other hematologic malignancies eligible for stem cell transplantation per institutional standard);
Non-malignant disorders amenable to cure by an allograft:
Lack of suitable conventional donor (HLA identical sibling or HLA phenotypically identical relative or 10/10 unrelated donor evaluated using high resolution molecular typing) or presence of rapidly progressive disease not permitting time to identify an unrelated donor
A minimum genotypic identical match of 5/ 10 is required.
The donor and recipient must be identical, as determined by high resolution typing, at least one allele of each of the following genetic loci: HLA-A, HLA-B, HLA-Cw, HLA- DRB1 and HLA-DQB1.
Lansky/Karnofsky score > 50
Signed written informed consent
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Bellicum Pharmaceuticals | Bellicum Pharmaceuticals, Inc. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Children's Hospital Los Angeles | Los Angeles | California | 90027 | United States | ||
| Stanford University - Division of Pediatric Stem Cell Transplant & Regenerative Medicine |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Jun 22, 2023 | |
| Reset | Jul 13, 2023 | |
| Release | Sep 12, 2023 |
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| Rimiducid | Drug | administered to inactivate BPX-501 cells in the event of GVHD |
|
|
| Engraftment | Cumulative incidence of neutrophil and platelet engraftment, primary & secondary graft failure | Month 24 |
| GvHD | Cumulative incidence and severity of acute and chronic GvHD | Month 24 |
| Rimiducid Efficacy | Time to resolution of acute or chronic GvHD after administration of rimiducid | Month 24 |
| Infection | Rate of infectious complications | Month 24 |
| Hospitalizations | Duration of hospitalization and rehospitalization | Month 24 |
| Palo Alto |
| California |
| 94304 |
| United States |
| Children's National Medical Center | Washington D.C. | District of Columbia | 20010 | United States |
| Children's Healthcare of Atlanta | Atlanta | Georgia | 30322 | United States |
| Dana-Farber Boston Children's Cancer and Blood Disorders Center | Boston | Massachusetts | 02215 | United States |
| Children's Hospital at Montefiore | The Bronx | New York | 10467 | United States |
| Oregon Health Sciences University - Doernbecher Children's Hospital | Portland | Oregon | 97239 | United States |
| University of Texas Southwestern-Children's Medical Center | Dallas | Texas | 77390 | United States |
| Baylor College of Medicine/ Texas Children's Hospital | Houston | Texas | 77030 | United States |
| Fred Hutchinson Cancer Research Center | Seattle | Washington | 98109 | United States |
| Reset | Oct 4, 2023 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Jun 22, 2023 | Jul 13, 2023 | |||
| Sep 12, 2023 | Oct 4, 2023 |
| ID | Term |
|---|---|
| D054198 | Precursor Cell Lymphoblastic Leukemia-Lymphoma |
| D007938 | Leukemia |
| D015470 | Leukemia, Myeloid, Acute |
| D008228 | Lymphoma, Non-Hodgkin |
| D009190 | Myelodysplastic Syndromes |
| D000081207 | Primary Immunodeficiency Diseases |
| D010022 | Osteopetrosis |
| D000095542 | Cytopenia |
| D000741 | Anemia, Aplastic |
| D019337 | Hematologic Neoplasms |
| ID | Term |
|---|---|
| D007945 | Leukemia, Lymphoid |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D007951 | Leukemia, Myeloid |
| D008223 | Lymphoma |
| D001855 | Bone Marrow Diseases |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D007153 | Immunologic Deficiency Syndromes |
| D010026 | Osteosclerosis |
| D010009 | Osteochondrodysplasias |
| D001848 | Bone Diseases, Developmental |
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
| D000740 | Anemia |
| D000080983 | Bone Marrow Failure Disorders |
| D009371 | Neoplasms by Site |
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| ID | Term |
|---|---|
| C423866 | AP 1903 reagent |
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