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This study is to evaluate the safety and efficacy of a single dose of Cellgram™ delivered via hepatic artery in patients with decompensated alcoholic liver cirrhosis.
After providing written informed consent, subjects will return to the study center for further evaluation and to have their Bone marrow harvested by an experienced hematologist or interventional radiologist.
Within approximately 1 month (30 ± 7 days) after Bone marrow aspiration, study participants will be admitted to the study center on Day 1.
At the study center, the participant will undergo hepatic artery catheterization by an interventional radiologist who will inject a single dose of Cellgram™. Participants will remain as in-patients and be observed for 24 hours post-infusion. Following discharge, participants will periodically return to the study center for study assessment visits over a period of 1 year.
When a suitable candidate is identified by the Investigator, the Investigator or designated healthcare professional will ask the patient about his/her willingness to be included in the clinical study. Following this, patients will be allowed sufficient time, in their own opinion, to consider study entry, and will be offered the opportunity to ask any further questions prior to signing the informed consent form.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cellgram™ (Bone marrow-derived MSCs) | Experimental | Infusion Cellgram™(Bone marrow-derived MSCs). Single dose administration of approximately 5 x 10^7 cells/10 mL (range: 4.5 x 10^7 to 5.5 x 10^7 cells/10 mL) via the hepatic artery. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cellgram™ (Bone marrow-derived MSCs) | Biological | Approximately 15 to 30 mL of bone marrow is aspirated from the posterior iliac crest of patients under local anesthesia. Approximately 30 days (±7 days) after BM aspiration, the participant will return to the study center for admission and for the infusion Cellgram™ (Bone marrow-derived MSCs). |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Serious Adverse Events | An SAE suggests a significant hazard, contraindication, side-effect, or precaution. With respect to human clinical experience, this includes any event that:
| 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Number of patients with Hepatocellular carcinoma (primary liver cancer) development | assessed via ultrasonography and alpha fetoprotein [AFP] analysis | 12 months |
| Incidence of Adverse Events |
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Inclusion Criteria:
Exclusion Criteria:
Current diagnosis of malignant hematologic disease (e.g., acute myeloid leukemia, acute lymphoblastic leukemia, non-Hodgkin's lymphoma, Hodgkin's lymphoma, multiple myeloma).
Etiology other than alcohol for underlying liver cirrhosis.
Baseline creatinine >1.7 mg/dL and/or estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2
Clinical history of a solid cancer within 5 years prior to screening or current diagnosis of a solid cancer (including hepatocellular carcinoma assessed by ultrasonography and elevated AFP level) and currently receiving cancer treatment.
Continuous use of a clinically relevant amount of steroids or antibiotics within 1 month prior to screening. Clinical relevance will be determined by the Investigator.
Model for End-Stage Liver Disease score >20.
International normalized ratio >3.0 and/or platelet counts <30,000/mm3
Major operation within 3 months prior to screening.
Presence of extrahepatic biliary stricture.
Participant has undergone transjugular intrahepatic portosystemic shunt.
Active hepatic artery or portal vein thrombosis.
Presence of advanced hepatic encephalopathy Stages 3-4 (West Haven criteria) at the time of screening.
Active variceal bleeding during the last 6 months before screening.
Severe cardiac, renal, or respiratory failure.
Positive serological test results for human immunodeficiency virus (HIV), HCV, hepatitis B surface antigen (HBsAg) and/or syphilis.
Patient is pregnant or breast feeding, or planning to become pregnant while enrolled in the study, up to the EOS visit.
Positive urine pregnancy test at Screening.
Drug abuse within the past 2 years (as confirmed by patient disclosure or a urine drug screen conducted at Screening).
Participation in an interventional clinical study within 30 days prior to screening.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| JIYEOUN JEONG, CCRP, Bachelor | Contact | 82-02-3496-0134 | jyjeong@pharmicell.com |
| Name | Affiliation | Role |
|---|---|---|
| Juan Gallegos-Orozco, Ph.D | University of Utah | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Utah | Recruiting | Salt Lake City | Utah | 84132 | United States |
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| ID | Term |
|---|---|
| D008104 | Liver Cirrhosis, Alcoholic |
| D005355 | Fibrosis |
| D008107 | Liver Diseases |
| ID | Term |
|---|---|
| D008103 | Liver Cirrhosis |
| D004066 | Digestive System Diseases |
| D008108 | Liver Diseases, Alcoholic |
| D010335 | Pathologic Processes |
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A single-dose injection of autologous bone marrow-derived mesenchymal stem cells (Cellgram™) will be administered to the patient by an experienced interventional radiologist.
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|
Incidence of Adverse Events as assessed by vital signs, physical examination, safety laboratory tests, and patient reporting
| 12 months |
| Liver stiffness measurement | with transient elastography (i.e., FibroScan®) | 12 months |
| How well the Liver is functioning | by tests including: serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin, albumin, gamma glutamyl transpeptidase (GGT) and creatinine. Units of Measure: AST will be report in U/L. ALT will be report in U/L. GGT will be report in U/L. Bilirubin will be report in mg/dL. creatinine will be report in mg/dL. Albumin will be report in g/dL | 12 months |
| Chronic liver disease as assessed by the Child-Pugh score | The Child-Pugh Score will be used to determine the prognosis, required strength of treatment and the necessity of liver transplantation. The score employs 5 clinical measures of liver disease (total bilirubin, serum albumin, INR, ascites and hepatic encephalopathy). Each parameter is scored 1 to 3, with 3 indicating the most severe derangement. | 12 months |
| Model for End-Stage Liver Disease (MELD) Score | MELD uses the patient's values for serum bilirubin, serum creatinine, and the INR for PT to predict survival. It is calculated according to the following formula defined by Kamath et al (2001): MELD = 3.78×ln[serum bilirubin (mg/dL)] + 11.2×ln[INR] + 9.57×ln[serum creatinine (mg/dL)] + 6.43 | 12 months |
| Overall survival | defined as the time from infusion until death from any cause during the study period. | 12 months |
| Quality of life as assessed by 36-Item Short Form Survey (SF-36) Questionnaire | The Short Form-36 Quality Of Life questionnaire will be recorded for each patient. The 8 subscales of the SF-36 (Physical Functioning, Role Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role Emotional, Mental Health) and 2 summary component measures (Physical Component Summary, Mental Component Summary) will be calculated and summarized. | 12 months |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D020751 | Alcohol-Induced Disorders |
| D019973 | Alcohol-Related Disorders |
| D019966 | Substance-Related Disorders |
| D064419 | Chemically-Induced Disorders |