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The purpose of this study is to estimate the safety of ex vivo expanded haploidentical natural killer (NK) cells for patients with leukemia.
Immunotherapy with natural killer (NK) cells may improve the results of treatment for patients with cancer. However, for better efficiency high doses of NK cells are required. For this purpose, NK cells were expanded in the presence of feeder K562 cells gene-modified for expression 4-1BBL and membrane bound IL-21. In the result of expansion, large number of activated NK cells are obtained.
Protocol of immunotherapy includes conditioning (fludarabine + cyclophosphamide or any other protocol of chemotherapy) followed by expanded NK cells intravenous infusion. To sustain proliferation of donor NK cells in vivo patients receive 6 doses of Il-2 every second day. 10 patients will be enrolled in phase I to test different doses of NK cells: 20, 50, 70, 100 and >100 x 10^6/kg.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| NK cells + IL-2 | Experimental | After cycle of chemotherapy patient receive one intravenous infusion of expanded haploidentical NK cells on day 0. On alternate days, 6 doses of subcutaneous IL-2 is administered with start on day -1. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Expanded Haploidentical Natural Killer cells | Biological | One dose (from 20x to >100x 10^6 /kg) of expanded haploidentical NK cells |
|
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Treatment-Emergent Adverse Events | Adverse events will be graded according to the CTCAE v4.0 | 1 months |
| Measure | Description | Time Frame |
|---|---|---|
| Days of persistence of adoptively-transferred haploidentical NK cells | Analysis of donor chimerism at +2, 6, 10, 14, 21, 28 days after NK infusion. | 1 months |
| Occurrence of disease response | Analysis of blast cells content in bone marrow by cytomorphology or detection of MRD level by flow/PCR before and after immunotherapy. |
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Inclusion Criteria:
Patients:
Donor:
Exclusion Criteria:
Patients:
Donors:
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| Name | Affiliation | Role |
|---|---|---|
| Olga Aleinikova | Belarussian Research Center for Pediatric Oncology, Hematology and Immunology | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Belarussian Research Center for Pediatric Oncology, Hematology and Immunology | Minsk | Minsk Oblast | 223053 | Belarus |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36527513 | Derived | Shman TV, Vashkevich KP, Migas AA, Matveyenka MA, Lasiukov YA, Mukhametshyna NS, Horbach KI, Aleinikova OV. Phenotypic and functional characterisation of locally produced natural killer cells ex vivo expanded with the K562-41BBL-mbIL21 cell line. Clin Exp Med. 2023 Oct;23(6):2551-2560. doi: 10.1007/s10238-022-00974-2. Epub 2022 Dec 17. |
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| ID | Term |
|---|---|
| D015470 | Leukemia, Myeloid, Acute |
| D054198 | Precursor Cell Lymphoblastic Leukemia-Lymphoma |
| ID | Term |
|---|---|
| D007951 | Leukemia, Myeloid |
| D007938 | Leukemia |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D007376 | Interleukin-2 |
| ID | Term |
|---|---|
| D007378 | Interleukins |
| D016207 | Cytokines |
| D036341 | Intercellular Signaling Peptides and Proteins |
| D010455 | Peptides |
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| IL-2 | Drug | 6 doses of IL-2 (1 × 10^6 units/m2) from -1 day every other day. |
|
|
| 1 months post infusion |
| Median time to leukocytes and platelets recovery | Days of platelets (>50x10^9/L) and leukocytes (>1x10^9/L) recovery. | 2 months post infusion |
| Number of T, B, NK, activated T and NK cells after immunotherapy | Analysis of T, B, NK, activated T and NK cells numbers (cells/microL) at +2, 6, 10, 14, 21, 28 days after NK infusion. | 1 months post infusion |
| D006402 |
| Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007945 | Leukemia, Lymphoid |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D000602 |
| Amino Acids, Peptides, and Proteins |
| D008222 | Lymphokines |
| D011506 | Proteins |
| D001685 | Biological Factors |