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The purpose of this study is to estimate the efficacy of immunotherapy with ex vivo expanded haploidentical NK cells for children/young adults with primary high risk or refractory AML and relapsed AML.
Immunotherapy with NK cells may improve the treatment results in AML. For better efficiency high cell doses or several infusions of NK cells are required. For this purpose, donor NK cells are expanded in the presence of feeder K562-mbIL21-41BBL cell line.
For patients with high-risk primary AML a cycle of immunotherapy includes chemotherapy (HD-ARA-C+IDA) followed by three doses of NK cells infusion.
For patients with refractory/relapsed AML a cycle of immunotherapy includes chemotherapy (FLAG - fludarabine, cytarabine, G-CSF) followed by three doses of NK cells infusion.
A 2nd cycle of therapy may be administered if a recipient continues to meet the eligibility criteria.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| expanded haploidentical NK cell immunotherapy | Experimental | After a cycle of chemotherapy a patient receive three intravenous infusions of expanded haploidentical NK cells. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| NK cell infusions | Biological | Three doses of expanded haploidentical NK cells (30-100 x 10^6 cells /kg). |
|
| Measure | Description | Time Frame |
|---|---|---|
| Objective Response Rate (ORR) (PR+ MLFS+CRi +CR) | The proportion of patients with complete remission (CR), CR with incomplete hematologic recovery (CRi), morphologic leukemia-free state (MLFS), and partial remission (PR) as measured by response criteria definitions for acute myeloid leukemia. | 30 days after every a course of NK immunotherapy |
| Leukemia-free survival (LFS) | Time from achievement of CR/CRi/MLFS to the time of relapse, death in remission, or last follow-up. | 1 year |
| Overall survival (OS) | The proportion of patients with overall survival | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Duration of persistence of infused NK cells | Days of persistence of donor NK cells | 21 days after the first 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) after NK infusions. |
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Inclusion Criteria:
Patients:
Donors:
Exclusion Criteria:
Patients:
Donors:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Tatsiana Shman, PhD | Contact | +375296341853 | shman@oncology.by | |
| Mariya Naumovich, MD | Contact | +375293563846 | mariyanaumovich@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Olga Aleinikova, MD, Prof | 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 | Recruiting | Minsk | Minsk Oblast | 223053 | Belarus |
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| ID | Term |
|---|---|
| D015470 | Leukemia, Myeloid, Acute |
| ID | Term |
|---|---|
| D007951 | Leukemia, Myeloid |
| D007938 | Leukemia |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
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| 30 days after the first infusion |
| D006402 |
| Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |