The goal of this clinical trial is to learn if HY001N cell injection safety and tolerability in adult patients with autoimmune hemolytic anemia after failure of 3 or more lines of therapy. It will also learn about the efficacy of HY001N cell injection to treat adult patients with autoimmune hemolytic anemia. The main questions it aims to answer are:
Proportion of participants attaining a CR (defined as normalization of hemoglobin not attributed to transfusion effect and the normalization of hemolytic markers) or CRi (defined as normalization of hemoglobin not attributed to transfusion effect without normalization of hemolytic markers) after HY001N infusion? Proportion of participants attaining a PR (defined as hemoglobin ≥ 100 g/L or at least ≥ 20 g/L increase from baseline not attributed to transfusion effect) after HY001N infusion.
• What medical problems do participants have when taking HY001N cell injection?
Researchers will see if HY001N cell injection works to treat autoimmune hemolytic anemia.
Participants will:
Inclusion Criteria:
Participant and/or participant's legal representative fully understand and voluntarily sign informed consent forms;
Aged 18 to 75 years, regardless of gender;
Participants with autoimmune hemolytic anemia or Evans syndrome after Failure ≥3 lines of therapy. The Failure of ≥3 lines of therapy meet all the following conditions: Hemoglobin less than 10g/dL and symptoms of anemia;
For participants diagnosed warm AIHA, or mixed AIHA, or Evans syndrome:
Failure of first-line corticosteroid therapy; Failure of second-line rituximab therapy; Failure of any one or more of the third-line treatments (splenectomy, cyclosporine, cyclophosphamide, azathioprine, mycophenolate mofetil, fludarabine, bortezomib, etc.)
For participants diagnosed cold AIHA (cold agglutinin disease):
Failure of first-line rituximab therapy; Failure of second-line rituximab ± Bendamostine/fludalabine; Failure of third-line therapy (bortezomib, Sutimlimab, Pegcetacoplan, Eculizumab, etc.)
Women of childbearing age must have a negative blood pregnancy test within 7 days prior to the initiation of conditioning. Any male or female subject of reproductive potential must agree to use effective contraception throughout the study period and for at least 2 year following the infusion of CAR T-cells. In the judgment of the investigator, a subject of reproductive potential refers to having the biological capacity to conceive or father a living child and being sexually active. Women who considered infertile (i.e., meeting at least one of the following criteria): Has undergone a hysterectomy or bilateral oophorectomy, or Medically confirmed ovarian failure, or is medically confirmed as postmenopausal (defined as at least 12 consecutive months of amenorrhea without pathological or physiological causes).
Laboratory tests of adequate organ function: Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤3×ULN; Coagulation profile: INR ≤ 1.5×ULN and aPTT ≤ 1.5×ULN; Serum creatinine ≤1.5×ULN or CCr ≥ 60mL/min; and have a minimum level of pulmonary reserve defined as the blood oxygen saturation in a non-oxygenated state is > 91%.
Eastern Cooperative Oncology Group (ECOG) performance status 0~2.
Exclusion Criteria:
History of lymphoproliferative neoplasms
Secondary AIHA caused by drugs or infection
Pregnancy or lactation
Previously received organ or hematopoietic stem cell transplantation
History of new thrombotic event or organ infarction in the past 6 months
Diagnosis of the active stage of connective tissue disease
Had other inherited or acquired hemolytic diseases
Have active infections, such as sepsis, bacteremia, fungemia, uncontrolled pulmonary infection and active tuberculosis, etc.
Positive hepatitis B surface antigen (HBs-Ag) or hepatitis B e antigen (HBe-Ag); positive hepatitis B e antibody (HBe-Ab) or hepatitis B core antibody (HBc-Ab), and the HBV-DNA copy number is above the lower limit of the measurable capacity; positive hepatitis C (HCV) antibody; positive human immunodeficiency virus (HIV) antibody; positive syphilis test; EBV-DNA or CMV-DNA copy number is above the lower limit of the measurable capacity;
Received major surgery within 4 weeks before screening that was assessed by the researcher as unsuitable for enrollment
Have malignant tumors within 5 years before enrollment, except tumors with negligible risk of metastasis or death and curable tumors, such as adequately treated cervical carcinoma in situ, cutaneous basal cell carcinoma, etc.
Have any of the following cardiovascular diseases: a. Left ventricular ejection fraction (LVEF) ≤45%, b. presence of active heart disease or congestive heart failure (New York Heart Association [NYHA] Class III or IV)), c. severe arrhythmias requiring treatment (except atrial fibrillation, paroxysmal supraventricular tachycardia), d. QTcB interval
≥450ms for male and ≥470ms for female, e. have myocardial infarction, bypass surgery, or stent placement within the 6 months before the trial, f. other heart diseases judged by the researcher to be unsuitable for enrollment
Have a history of live attenuated vaccines within 6 weeks before enrollment
Participate in other experimental studies within 30 days prior to apheresis or within 5 half-lives of the trial drug, whichever is longer. (Note: Parallel enrollment in studies is allowed)
Have a history of epilepsy or other active central nervous system diseases
Active bleeding
Have an allergy to the ingredients of the medicine used in this trial
Previously received CAR T-cell therapy
Participants considered to be ineligible for the study by the investigator for reasons other than the above.
panxiaofeng@juventas.cn
A conditioning chemotherapy regimen of fludarabine and cyclophosphamide will be administered followed by investigational treatment, HY001N Cell Injection.
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