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| ID | Type | Description | Link |
|---|---|---|---|
| R01CA195563 | U.S. NIH Grant/Contract | View source | |
| OCR15852 | Other Identifier | Universiy of Florida |
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due to lack of accrual/feasibility to complete accrual due to competing trials
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| Name | Class |
|---|---|
| National Pediatric Cancer Foundation | OTHER |
| National Cancer Institute (NCI) | NIH |
| Moffitt Clinical Research Network (MCRN) | UNKNOWN |
| National Institutes of Health (NIH) |
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It is believed that the body's immune system protects the body by attacking and killing tumor cells. T-lymphocytes (T-cells) are part of the immune system and can attack when they recognize special proteins on the surface of tumors. In most patients with advanced cancer, T-cells are not stimulated enough to kill the tumor. In this research study, we will use a patient's tumor to make a vaccine which we hope will stimulate T-cells to kill tumor cells and leave normal cells alone.
High grade gliomas (HGGs) are very aggressive and difficult for the body's immune system to attack. Before T-cells can become active against tumor cells, they require strong stimulation by special "stimulator" cells in the body called Dendritic Cells (DCs) which are also part of the immune system. DCs can recognize the cancer cells and then activate the T lymphocytes, and create this strong stimulation.
The purpose of this research study is to learn whether anti-tumor T-cells and anti-tumor DC vaccines can be given safely. Most importantly, this study is also to determine whether the T-cells and DC vaccines can stimulate a person's immune system to fight off the tumor cells in the brain.
It is believed that the body's immune system protects the body by attacking and killing tumor cells. T-lymphocytes (T-cells) are part of the immune system and can attack when they recognize special proteins on the surface of tumors. But in most patients with advanced cancer, T-cells are not stimulated enough to kill the tumor. In this research study, we will use your tumor to make a vaccine which we hope will stimulate your T-cells to kill tumor cells and leave your normal cells alone.
High grade gliomas (HGGs) are very aggressive and difficult for the body's immune system to attack. Before T-cells can become active against tumor cells, they require strong stimulation by special "stimulator" cells in the body called Dendritic Cells (DCs) which are also part of the immune system. DCs can recognize the cancer cells and then activate the T lymphocytes, and create this strong stimulation.
The purpose of this research study is to learn whether anti-tumor T-cells and anti-tumor DC vaccines can be given safely. Most importantly, this study is also to determine whether the T-cells and DC vaccines can stimulate your immune system to fight off the tumor cells in your brain. When the vaccine for this study is made, dendritic cells will be loaded with genetic material called RNA (ribonucleic acid) from your tumor to stimulate the dendritic cells. The vaccine has two components given at different times after chemoradiation and throughout chemotherapy cycles. The first part, the DC vaccine, involves RNA loaded dendritic cells that are given under the skin at several time points in the study and the second part, xALT vaccine, is a single infusion of tumor-specific T cells delivered through one of two peripheral IV catheters that are placed prior to infusion. This vaccine is investigational which means that it is not approved by the US Food and Drug Administration (FDA) and is being tested in research studies.
It is hoped that by injecting the DC vaccine into your skin and infusing the T-cells into your blood, your immune system will be activated against the tumor. Once it is activated against the tumor, your immune system may recognize and attack the tumor cells in your brain and not attack normal cells. Use of a vaccine that stimulates your immune system is called immunotherapy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group A | Experimental | Dose-intensified TMZ with TTRNA-DC vaccines with GM-CSF and TTRNA-xALT plus Td vaccine without Autologous Hematopoietic Stem cells (HSCs) |
|
| Group B | Experimental | Dose-intensified TMZ with TTRNA-DC vaccines with GM-CSF and TTRNA-xALT plus Td vaccine with Autologous Hematopoietic Stem cells (HSCs) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TTRNA-DC vaccines with GM-CSF | Biological | After chemoradiation subjects will receive the first cycle of dose-intensified TMZ followed by three biweekly TTRNA-DC vaccines with GM-CSF. Monthly DC vaccines will be given during TMZ Cycles 2-5 for Groups A and B and 48-96 hours after completion of TMZ Cycle 6 Day 21 for Group A and 12-36 hours after HSCs for Group B. All subjects will receive an additional two bi-weekly vaccines during Cycle 6 for a total of 10 DC vaccines. All DC vaccines will be embedded with GM-CSF (150 µg per injection) and given intradermal. |
| Measure | Description | Time Frame |
|---|---|---|
| Evaluate Safety of TTRNA-DCs and TTRNA-xALT | Percentage of subjects with grade 3 or greater adverse events. Adverse events (AEs) were summarized in the safety population (N = 5) at the participant level. For each AE term, a participant was counted once using the maximum observed CTCAE grade. Recurrent occurrences of the same AE in a participant were not counted multiple times. | From first DC Vaccine through 30 days after administration of the last dose of trial drug or subject death, whichever occurs first, up to 10 months |
| Measure | Description | Time Frame |
|---|---|---|
| Determine Feasibility of Completing Treatment | Number of subjects completing treatment. Completion defined as receipt of ≥3 DC vaccinations. | Up to 10 months |
| Change in CD4:CD8 T-cell Ratio | Change in CD4:CD8 T-cell ratio from baseline to post-treatment immune assessment measured in peripheral blood samples. |
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Screening Eligibility:
Post-Surgical Resection Eligibility
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Elias Sayour, MD, PhD | University of Florida | Principal Investigator |
| Duane Mitchell, MD, PhD | University of Florida | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Children's of Alabama at UAB | Birmingham | Alabama | 35233 | United States | ||
| Children's National Hospital |
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Twelve participants were ineligible due to histology and one was withdrawn at direction of physician.
From 08/27/2018 (first enrollment date) to 03/10/2023 (last enrollment date), 18 patients were accrued to Arm A. Arm B never enrolled participants - study was terminated.
Enrollment date is date of consent.
Of these, 13 patients were not eligible. Five patients were eligible and evaluable for efficacy and toxicity analyses.
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| ID | Title | Description |
|---|---|---|
| FG000 | Group A | Dose-intensified TMZ with TTRNA-DC vaccines with GM-CSF and TTRNA-xALT plus Td vaccine without Autologous Hematopoietic Stem cells (HSCs) TTRNA-DC vaccines with GM-CSF: After chemoradiation subjects will receive the first cycle of dose-intensified TMZ followed by three biweekly TTRNA-DC vaccines with GM-CSF. Monthly DC vaccines will be given during TMZ Cycles 2-5 for Groups A and B and 48-96 hours after completion of TMZ Cycle 6 Day 21 for Group A and 12-36 hours after HSCs for Group B. All subjects will receive an additional two bi-weekly vaccines during Cycle 6 for a total of 10 DC vaccines. All DC vaccines will be embedded with GM-CSF (150 µg per injection) and given intradermal. Dose-intensified TMZ: After chemoradiation, subjects will receive the first cycle of dose-intensified TMZ followed by three biweekly TTRNA-DC vaccines with GM-CSF. All subjects will have an additional five cycles of dose-intensified TMZ (for a total of 6 Cycles) with concurrent monthly DC vaccinations. TTRNA-xALT: During TMZ Cycle 6 and with DC vaccine #8, an infusion of T-cells will be administered to all subjects. Td vaccine: A full Td booster vaccine will be administered IM at Vaccine #1 to all subjects, and vaccine site pretreatment will be administered to all subjects prior to Vaccine#3, #6, and #8. |
| FG001 | Group B | Dose-intensified TMZ with TTRNA-DC vaccines with GM-CSF and TTRNA-xALT plus Td vaccine with Autologous Hematopoietic Stem cells (HSCs) After chemoradiation subjects will receive the first cycle of dose-intensified TMZ followed by three biweekly TTRNA-DC vaccines with embedded GM-CSF. Monthly DC vaccines will be given during TMZ Cycles 2-5 for Groups A and B and 48-96 hours after completion of TMZ Cycle 6 Day 21 for Group A and 12-36 hours after HSCs for Group B. All subjects will receive an additional two bi-weekly vaccines during Cycle 6 for a total of 10 DC vaccines. All DC vaccines are given intradermal. After chemoradiation, subjects will receive the first cycle of dose-intensified TMZ followed by three biweekly TTRNA-DC vaccines with GM-CSF. All subjects will have an additional five cycles of dose-intensified TMZ (for a total of 6 Cycles) with concurrent monthly DC vaccinations. Prior to chemoradiation, enrolled subjects will undergo a mobilized leukapheresis for collection of PBSCs and PBMCs for generation of DCs. One group will receive recommended dose of > 2 x 106 CD34+ HSCs/kg. Subjects enrolled in Group B will receive HSCs during TMZ Cycle 6 before receiving DC vaccine and T-cell infusion. During TMZ Cycle 6 and with DC vaccine #8, an infusion of T-cells will be administered to all subjects. A full Td booster will be administered IM at Vaccine #1 and vaccine site pretreatment will be administered to all subjects prior to Vaccine#3, #6, and #8. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
The study was terminated prior to commencement in Arm B.
Not provided
| ID | Title | Description |
|---|---|---|
| BG000 | Group A | Dose-intensified TMZ with TTRNA-DC vaccines with GM-CSF and TTRNA-xALT plus Td vaccine without Autologous Hematopoietic Stem cells (HSCs) TTRNA-DC vaccines with GM-CSF: After chemoradiation subjects will receive the first cycle of dose-intensified TMZ followed by three biweekly TTRNA-DC vaccines with GM-CSF. Monthly DC vaccines will be given during TMZ Cycles 2-5 for Groups A and B and 48-96 hours after completion of TMZ Cycle 6 Day 21 for Group A and 12-36 hours after HSCs for Group B. All subjects will receive an additional two bi-weekly vaccines during Cycle 6 for a total of 10 DC vaccines. All DC vaccines will be embedded with GM-CSF (150 µg per injection) and given intradermal. Dose-intensified TMZ: After chemoradiation, subjects will receive the first cycle of dose-intensified TMZ followed by three biweekly TTRNA-DC vaccines with GM-CSF. All subjects will have an additional five cycles of dose-intensified TMZ (for a total of 6 Cycles) with concurrent monthly DC vaccinations. TTRNA-xALT: During TMZ Cycle 6 and with DC vaccine #8, an infusion of T-cells will be administered to all subjects. Td vaccine: A full Td booster vaccine will be administered IM at Vaccine #1 to all subjects, and vaccine site pretreatment will be administered to all subjects prior to Vaccine#3, #6, and #8. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median |
| 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 | Evaluate Safety of TTRNA-DCs and TTRNA-xALT | Percentage of subjects with grade 3 or greater adverse events. Adverse events (AEs) were summarized in the safety population (N = 5) at the participant level. For each AE term, a participant was counted once using the maximum observed CTCAE grade. Recurrent occurrences of the same AE in a participant were not counted multiple times. | The study was terminated prior to commencement in Arm B. Single-arm analysis; no comparison group. | Posted | Count of Participants | Participants | From first DC Vaccine through 30 days after administration of the last dose of trial drug or subject death, whichever occurs first, up to 10 months |
|
From start of leukapheresis to 24 hours after completion of procedure and from first administration of DC vaccine through 30 days after the last dose of trial drug or death, whichever occurs first (up to approximately 3 years)
Adverse events were collected for participants enrolled in Arm A. Arm B did not enroll participants because the study was terminated early. Serious and non-serious adverse events were summarized descriptively.
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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 | Group A | Dose-intensified TMZ with TTRNA-DC vaccines with GM-CSF and TTRNA-xALT plus Td vaccine without Autologous Hematopoietic Stem cells (HSCs) TTRNA-DC vaccines with GM-CSF: After chemoradiation subjects will receive the first cycle of dose-intensified TMZ followed by three biweekly TTRNA-DC vaccines with GM-CSF. Monthly DC vaccines will be given during TMZ Cycles 2-5 for Groups A and B and 48-96 hours after completion of TMZ Cycle 6 Day 21 for Group A and 12-36 hours after HSCs for Group B. All subjects will receive an additional two bi-weekly vaccines during Cycle 6 for a total of 10 DC vaccines. All DC vaccines will be embedded with GM-CSF (150 µg per injection) and given intradermal. Dose-intensified TMZ: After chemoradiation, subjects will receive the first cycle of dose-intensified TMZ followed by three biweekly TTRNA-DC vaccines with GM-CSF. All subjects will have an additional five cycles of dose-intensified TMZ (for a total of 6 Cycles) with concurrent monthly DC vaccinations. TTRNA-xALT: During TMZ Cycle 6 and with DC vaccine #8, an infusion of T-cells will be administered to all subjects. Td vaccine: A full Td booster vaccine will be administered IM at Vaccine #1 to all subjects, and vaccine site pretreatment will be administered to all subjects prior to Vaccine#3, #6, and #8. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Muscle weakness | General disorders | Non-systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Fatigue | General disorders | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Duane Mitchell, MD, PhD | University of Florida | 352-273-9000 | duane.mitchell@neurosurgery.ufl.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Apr 25, 2025 | Feb 10, 2026 | Prot_SAP_001.pdf |
| ICF | No | No | Yes | Informed Consent Form | Feb 1, 2023 | Mar 24, 2025 | ICF_000.pdf |
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| ID | Term |
|---|---|
| D005910 | Glioma |
| ID | Term |
|---|---|
| D018302 | Neoplasms, Neuroepithelial |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
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Not provided
| ID | Term |
|---|---|
| D016178 | Granulocyte-Macrophage Colony-Stimulating Factor |
| D022422 | Diphtheria-Tetanus Vaccine |
| ID | Term |
|---|---|
| D003115 | Colony-Stimulating Factors |
| D006023 | Glycoproteins |
| D006001 | Glycoconjugates |
| D002241 | Carbohydrates |
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| NIH |
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|
| Dose-intensified TMZ | Drug | After chemoradiation, subjects will receive the first cycle of dose-intensified TMZ followed by three biweekly TTRNA-DC vaccines with GM-CSF. All subjects will have an additional five cycles of dose-intensified TMZ (for a total of 6 Cycles) with concurrent monthly DC vaccinations. |
|
| Autologous Hematopoietic Stem cells (HSCs) | Biological | Prior to chemoradiation, enrolled subjects will undergo a mobilized leukapheresis for collection of PBSCs and PBMCs for generation of DCs. One group will receive recommended dose of > 2 x 106 CD34+ HSCs/kg. Subjects enrolled in Group B will receive HSCs during TMZ Cycle 6 before receiving DC vaccine and T-cell infusion. |
|
| TTRNA-xALT | Biological | During TMZ Cycle 6 and with DC vaccine #8, an infusion of T-cells will be administered to all subjects. |
|
| Td vaccine | Drug | A full Td booster vaccine will be administered IM at Vaccine #1 to all subjects, and vaccine site pretreatment will be administered to all subjects prior to Vaccine#3, #6, and #8. |
|
| baseline to up to 10 months after initiation of treatment |
| Progression-free Survival (PFS) | Median time to progression | From date of first treatment until documented disease progression or death, assessed during study follow-up (up to approximately 3 years) |
| Overall Survival (OS) | Median time to death | From date of first treatment until death from any cause, assessed during study follow-up (up to approximately 3 years) |
| Washington D.C. |
| District of Columbia |
| 20010 |
| United States |
| UF Health Shands Children's Hospital | Gainesville | Florida | 32608 | United States |
| Disease Progression |
|
| BG001 | Group B | Dose-intensified TMZ with TTRNA-DC vaccines with GM-CSF and TTRNA-xALT plus Td vaccine with Autologous Hematopoietic Stem cells (HSCs) After chemoradiation subjects will receive the first cycle of dose-intensified TMZ followed by three biweekly TTRNA-DC vaccines with embedded GM-CSF. Monthly DC vaccines will be given during TMZ Cycles 2-5 for Groups A and B and 48-96 hours after completion of TMZ Cycle 6 Day 21 for Group A and 12-36 hours after HSCs for Group B. All subjects will receive an additional two bi-weekly vaccines during Cycle 6 for a total of 10 DC vaccines. All DC vaccines are given intradermal. After chemoradiation, subjects will receive the first cycle of dose-intensified TMZ followed by three biweekly TTRNA-DC vaccines with GM-CSF. All subjects will have an additional five cycles of dose-intensified TMZ (for a total of 6 Cycles) with concurrent monthly DC vaccinations. Prior to chemoradiation, enrolled subjects will undergo a mobilized leukapheresis for collection of PBSCs and PBMCs for generation of DCs. One group will receive recommended dose of > 2 x 106 CD34+ HSCs/kg. Subjects enrolled in Group B will receive HSCs during TMZ Cycle 6 before receiving DC vaccine and T-cell infusion. During TMZ Cycle 6 and with DC vaccine #8, an infusion of T-cells will be administered to all subjects. A full Td booster will be administered IM at Vaccine #1 and vaccine site pretreatment will be administered to all subjects prior to Vaccine#3, #6, and #8. |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| OG001 | Group B | Dose-intensified TMZ with TTRNA-DC vaccines with GM-CSF and TTRNA-xALT plus Td vaccine with Autologous Hematopoietic Stem cells (HSCs) After chemoradiation subjects will receive the first cycle of dose-intensified TMZ followed by three biweekly TTRNA-DC vaccines with embedded GM-CSF. Monthly DC vaccines will be given during TMZ Cycles 2-5 for Groups A and B and 48-96 hours after completion of TMZ Cycle 6 Day 21 for Group A and 12-36 hours after HSCs for Group B. All subjects will receive an additional two bi-weekly vaccines during Cycle 6 for a total of 10 DC vaccines. All DC vaccines are given intradermal. After chemoradiation, subjects will receive the first cycle of dose-intensified TMZ followed by three biweekly TTRNA-DC vaccines with GM-CSF. All subjects will have an additional five cycles of dose-intensified TMZ (for a total of 6 Cycles) with concurrent monthly DC vaccinations. Prior to chemoradiation, enrolled subjects will undergo a mobilized leukapheresis for collection of PBSCs and PBMCs for generation of DCs. One group will receive recommended dose of > 2 x 106 CD34+ HSCs/kg. Subjects enrolled in Group B will receive HSCs during TMZ Cycle 6 before receiving DC vaccine and T-cell infusion. During TMZ Cycle 6 and with DC vaccine #8, an infusion of T-cells will be administered to all subjects. A full Td booster will be administered IM at Vaccine #1 and vaccine site pretreatment will be administered to all subjects prior to Vaccine#3, #6, and #8. |
|
|
| Secondary | Determine Feasibility of Completing Treatment | Number of subjects completing treatment. Completion defined as receipt of ≥3 DC vaccinations. | The trial was terminated prior to commencement in Arm B. Single-arm analysis; no comparison group. | Posted | Number | participants | Up to 10 months |
|
|
|
| Secondary | Change in CD4:CD8 T-cell Ratio | Change in CD4:CD8 T-cell ratio from baseline to post-treatment immune assessment measured in peripheral blood samples. | Group A Single-arm analysis; no comparison group. | Posted | Mean | Standard Deviation | Change in CD4:CD8 ratio | baseline to up to 10 months after initiation of treatment |
|
|
|
| Secondary | Progression-free Survival (PFS) | Median time to progression | The trial was terminated prior to commencement in Arm B. Single-arm analysis; no comparison group. | Posted | Median | 95% Confidence Interval | days | From date of first treatment until documented disease progression or death, assessed during study follow-up (up to approximately 3 years) |
|
|
|
|
| Secondary | Overall Survival (OS) | Median time to death | The trial was terminated prior to the commencement of Arm B. Single-arm analysis; no comparison group. | Posted | Median | 95% Confidence Interval | days | From date of first treatment until death from any cause, assessed during study follow-up (up to approximately 3 years) |
|
|
|
|
| 3 |
| 5 |
| 1 |
| 5 |
| 1 |
| 5 |
| EG001 | Group B | Dose-intensified TMZ with TTRNA-DC vaccines with GM-CSF and TTRNA-xALT plus Td vaccine with Autologous Hematopoietic Stem cells (HSCs) After chemoradiation subjects will receive the first cycle of dose-intensified TMZ followed by three biweekly TTRNA-DC vaccines with embedded GM-CSF. Monthly DC vaccines will be given during TMZ Cycles 2-5 for Groups A and B and 48-96 hours after completion of TMZ Cycle 6 Day 21 for Group A and 12-36 hours after HSCs for Group B. All subjects will receive an additional two bi-weekly vaccines during Cycle 6 for a total of 10 DC vaccines. All DC vaccines are given intradermal. After chemoradiation, subjects will receive the first cycle of dose-intensified TMZ followed by three biweekly TTRNA-DC vaccines with GM-CSF. All subjects will have an additional five cycles of dose-intensified TMZ (for a total of 6 Cycles) with concurrent monthly DC vaccinations. Prior to chemoradiation, enrolled subjects will undergo a mobilized leukapheresis for collection of PBSCs and PBMCs for generation of DCs. One group will receive recommended dose of > 2 x 106 CD34+ HSCs/kg. Subjects enrolled in Group B will receive HSCs during TMZ Cycle 6 before receiving DC vaccine and T-cell infusion. During TMZ Cycle 6 and with DC vaccine #8, an infusion of T-cells will be administered to all subjects. A full Td booster will be administered IM at Vaccine #1 and vaccine site pretreatment will be administered to all subjects prior to Vaccine#3, #6, and #8. | 0 | 0 | 0 | 0 | 0 | 0 |
| Dysphasia | Nervous system disorders | Non-systematic Assessment |
|
| Ischemia cerebrovascular | Nervous system disorders | Non-systematic Assessment |
|
| Stroke | Nervous system disorders | Non-systematic Assessment |
|
| Vestibular disorder | Ear and labyrinth disorders | Non-systematic Assessment |
|
| Hypersomnia | General disorders | Non-systematic Assessment |
|
| CD4 lymphocytes decreased | Blood and lymphatic system disorders | Non-systematic Assessment |
|
| Lymphocyte count decreased | Blood and lymphatic system disorders | Non-systematic Assessment |
|
| Hypocalemia | Investigations | Non-systematic Assessment |
|
| Hypokalemia | Investigations | Non-systematic Assessment |
|
| Rash maculo-papular | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
|
| Urticaria | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
|
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| D009369 | Neoplasms |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009380 | Neoplasms, Nerve Tissue |
| D016298 |
| Hematopoietic Cell Growth Factors |
| D016207 | Cytokines |
| D036341 | Intercellular Signaling Peptides and Proteins |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D011506 | Proteins |
| D001685 | Biological Factors |
| D001428 | Bacterial Vaccines |
| D014612 | Vaccines |
| D001688 | Biological Products |
| D045424 | Complex Mixtures |
| D004168 | Diphtheria Toxoid |
| D014121 | Toxoids |
| D013745 | Tetanus Toxoid |
| D017778 | Vaccines, Combined |