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This is an open label, interventional, non-randomized, phase II trial of TCR alpha/beta and CD19-depeleted allogeneic HCT in pediatric patients with hematologic disease.
This is a single-site, open label, interventional, non-randomized, phase II trial of TCRαβ/CD19 deplete allogeneic HCT as donor source and sole GVHD prophylaxis in pediatric patients with either malignant or non-malignant hematologic disease who are eligable for allogeneic HCT, but lack a HLA-matched sibling donor.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pediatric patients with malignant or non-malignant hematologic condition | Experimental | The infusion of the final TCRαβ/CD19 depleted product will be given through the recipient's central venous catheter and will be administered fresh, without cryopreservation whenever possible. If the product must be cryopreserved and then thawed, this will be done according to institutional standards. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CliniMACS Plus Instrument | Device | Miltenyi Biotec's CliniMACS Plus Instrument is to be used to TCRαβ CD19 deplete products utilized in this protocol. The CliniMACS Plus is an automated cell separation platform which is functionally closed, maintaining a sterile system for cell depletion and enrichment utilizing a magnetic separation column. Reagents and supplies are to be used for research only but are manufactured and tested under a quality system certified to ISO 13485. Should CD34 selection be required to augment stem cell dose, Miltenyi Biotec's CliniMACS® Plus CD34 Reagent System is FDA approved as a Humanitarian Use Device (HUD). The approved indication was the treatment of patients with acute myeloid leukemia (AML) undergoing myeloablative transplant from matched related allogeneic donors. The CliniMACS® Plus reagent system was approved to obtain an enriched CD34+ cell population for hematopoietic reconstitution without the need for GVHD prophylaxis. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of severe (grade III-IV) acute graft-versus-host disease (GVHD) at day 100 after infusion of a TCRαβ+/CD19+ negative, peripheral blood stem cell (PBSC) product without additional GVHD prophylaxis. | Grade to be determined using Acute GVHD Staging Scale | 5 years |
| Measure | Description | Time Frame |
|---|---|---|
| Number of patients with non-engraftment | Defined as the lack of donor-derived neutrophil engraftment | 100 days |
| Number of patients with relapse | Interval from transplant to relapse/recurrence of disease |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Alisa B Lee Sherick | University of Colorado, Denver | Principal Investigator |
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| ID | Term |
|---|---|
| D019337 | Hematologic Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
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Eligible Patients with a hematologic disease who could benefit from HCT with an eligible mismatched related or unrelated donor per donor selection criteria. Patient/recipient admitted of HCT/start of preparative regimen and stem cell infusion
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| 1 year |
| Number of treatment-related mortality (TRM) | Defined as death due to regimen-related toxicity or GVD. | 1 year |
| Disease-free Survival (DFS) measured in days | Defined as the minimum time interval from transplant to relapse/recurrence of disease, death or last follow-up. | 1 year |
| Overall Survival (OS) measured in days | Determined at 1 year post-HCT | 1 year |
| Immune Reconstitution | Incidence of absolute CD4+ T-cell count >400 cells at 1 year post-HCT | 1 year |
| Post-HCT infections | Incidence of bacterial, fungal, and viral infections at day +100 | 100 days |