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The study objectives are to evaluate the safety of a single intravenous (IV) infusion of autologous CD34+ cells enriched with placenta-derived allogeneic mitochondria in participant with primary mitochondrial disease associated with mitochondrial DNA mutations or deletions.
6 participants aged from 4 to 18 years old on the day of screening visit with primary mitochondrial disease associated with mitochondrial DNA mutations or deletions will be enrolled.
MNV-BM-PLC is a personalized cell therapy based on autologous patient-derived Hematopoietic stem/progenitor cells (HSPCs) enriched with mitochondria isolated from healthy placenta obtained from donors during C-section. Healthy mitochondria are employed, ex-vivo, to enrich the patient's CD34+ peripheral blood cells, followed by infusion of the mitochondrial enriched cells back to the patient. This therapeutic process of mitochondrial augmentation provides the patient with healthy mitochondria carrying non-mutated/deleted mtDNA that can supplement mitochondrial functionality in the patient's cells.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cohort 1 & Cohort 2 | Experimental | 3 patients will be administrated with Dose 1 (0.88 mitochondria unit (mU) citrate synthase (CS) activity per million cells). 3 patients will be administrated with Dose 2 (4.4mU mitochondria unit (mU) citrate synthase (CS) activity per million cells). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bone Marrow mobilization | Procedure | During four days before the apheresis, Neupogen (G-CSF) at a dose of 10 microgram per kilogram will be administered subcutaneously in the morning (days -6 to -3 of cell therapy). In addition, Mozobil (Plerixafor) at a dose of 0.24 milligram per kilogram will be administered subcutaneously approximately 4 hours before apheresis initiation. A fifth dose of Neupogen (G-CSF) will be administered just prior to the apheresis |
| Measure | Description | Time Frame |
|---|---|---|
| Number of participants with Treatment-related adverse events as assessed by CTCAE v5.0 following MNV-BM-PLC | Severity will graded according to CTCAE, Version 5.0 | 1 month |
| Measurement of hemoglobin level | Change from baseline in hematological parameter | 1 month |
| Measurement of absolute neutrophil count | Change from baseline in hematological parameter | 1 month |
| Measurement of platelet count | Change from baseline in hematological parameter | 1 month |
| Measure | Description | Time Frame |
|---|---|---|
| Number of participants with Treatment-related adverse events as assessed by CTCAE v5.0 following MNV-BM-PLC | Severity will graded according to CTCAE, Version 5.0 | 2 years |
| Measurement of hemoglobin level |
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Inclusion Criteria:
Exclusion Criteria
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sheba Medical Center - Tel Ashomer | Ramat Gan | Israel |
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The study will involve two sequential cohorts:
Cohort 1: 3 patients will be administrated with Dose 1 The dosing interval between patients will be at minimum 2 weeks. Two (2) weeks after the 3rd patient has received MNV-BM-PLC, the Data safety monitoring board (DSMB) will convene to review accumulated safety data. The DSMB will make a recommendation whether to proceed with the 4th patient administration.
Cohort 2: 3 patients will be administrated with Dose 2 The dosing interval between patients will be at minimum 2 weeks.
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| Apheresis | Procedure | Apheresis will be performed two days prior to MNV-BM-PLC infusion. During this procedure, patient's peripheral blood will be collected by apheresis |
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| MNV-BM-PLC infusion | Biological | The MNV-BM-PLC (autologous CD34+ cells enriched with placenta-derived allogeneic mitochondria) infusion will be performed by standard IV procedure. The dosing interval between patients will be at minimum 2 weeks. |
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Change from baseline in hematological parameter
| 2 years |
| Measurement of absolute neutrophil count | Change from baseline in hematological parameter | 2 years |
| Measurement of platelet count | Change from baseline in hematological parameter | 2 years |
| IPMDS (International Pediatric Mitochondrial Disease Scale) | To compare the change in International Pediatric Mitochondrial Disease Scale (IPMDS) score during a follow up period of 3, 6 12 and 24 months post treatment. IPMDS total score ranges from 0 to 243. The score is expressed as the percentage of items which were feasible to perform. The lower the score is, the higher the child's function | 2 years |
| Performance Score | Stabilization or improvement in performance score (Lansky score (for patients younger than 15 years) or Karnofsky (for patients older than 15) score relative to baseline | 2 years |
| PEDI: Pediatric Evaluation of Disability Inventory | Stabilization or improvement in PEDI score relative to baseline | 2 years |
| 6-minute walk test | Stabilization or improvement in 6-minute walk test relative to baseline | 2 years |
| 30 Second chair stand | Stabilization or improvement in 30 Second chair stand relative to baseline | 2 years |
| Hospitalization events | Reduction in number, cause and duration of hospitalization events relative to 12 months before IP treatment | 1 year |
| ID | Term |
|---|---|
| D001781 | Blood Component Removal |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
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