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This study seeks to examine the efficacy and safety of the administration of autologous T cells that have been modified through the introduction of a chimeric antigen receptor (CAR) targeting the B cell surface antigen CD19 following administration of chemotherapy lymphodepletion regimen in children with relapsed or refractory acute lymphoblastic leukemia (ALL) or lymphoma. The overall goal of this study is to validate the safety profile of administration CD19-CAR T cells and describe the response rate in children with relapsed/refractory ALL or lymphoma.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CAR-T cell therapy | Experimental | CAR-T cell infusion intravenously once |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CAR-T | Biological | CAR-T cell (CHXCART01) infusion intravenously once at a dose of 0.2-2 million cells/kg recipient body weight |
|
| Measure | Description | Time Frame |
|---|---|---|
| Complete response rate (CRR) for ALL and Overall response rate (ORR) for lymphoma | Complete response for ALL was defined as leukemic cells <5% in bone marrow. Overall response for lymphoma was defined as complete response plus partial response defined by Lugano criteria. | 1 month for subjects with ALL, and 3 months for subjects with lymphoma |
| Incidence and severity of adverse events | Severity of adverse events are graded according to CTCAEv5.0. | through study completion, an average of 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Frequency of minimal residual disease for ALL | Measurable residual disease in bone marrow by flow cytometry or PCR methods. | 1 month |
| Overall survival | survival as estimated by Kaplan-Meier method. Death from any cause is considered as event for analysis. |
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Inclusion Criteria:
Subjects must have relapsed or refractory ALL or lymphoma treated with at least two lines of therapy. Disease must have either progressed after the last regimen or presented failure to achieve partial or complete remission with the last regimen.
The patient's disease must be CD19 positive, either by immunohistochemistry or flow cytometry analysis on the last biopsy available.
Age 1-17 years.
Performance status: Subjects > 10 years of age: Karnofsky ≥ 50%; Subjects ≤ 10 years of age: Lansky scale ≥ 50%.
Normal organ function.
Prior therapy wash-out. At least 2 weeks or 5 half lives, whichever is shorter, must have elapsed since any prior systemic therapy at the time the subject is planned for leukapheresis.
Subjects' parent or legal guardian must have the ability to understand and the willingness to sign a written informed consent document.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Daniel Cheuk, MBBS | Contact | 852-35136049 | cheukkld@ha.org.hk |
| Name | Affiliation | Role |
|---|---|---|
| Pamela Lee, MD | The University of Hong Kong | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hong Kong Children's Hospital | Recruiting | Hong Kong | Hong Kong |
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| ID | Term |
|---|---|
| D016393 | Lymphoma, B-Cell |
| D054198 | Precursor Cell Lymphoblastic Leukemia-Lymphoma |
| ID | Term |
|---|---|
| D008228 | Lymphoma, Non-Hodgkin |
| D008223 | Lymphoma |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
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| 1 year |
| Event-free survival | Event-free survival as estimated by Kaplan-Meier method. Events are death from any cause, or relapse or progression of underlying disease. | 1 year |
| Proportion of products successfully manufactured | Success defined as meeting product release criteria with at least 0.2 million cells/kg recipient body weight | at the time of CAR-T cell infusion |
| D008232 |
| Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D007945 | Leukemia, Lymphoid |
| D007938 | Leukemia |
| D006402 | Hematologic Diseases |