Reduced Immunosuppressive Therapy With or Without Donor White Blood Cells in Treating Patients With Lymphoproliferative Disease After Organ Transplantation

NCT ID: NCT00033475

Last Updated: 2013-12-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2001-03-31

Brief Summary

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RATIONALE: Some types of lymphoproliferative disease are associated with Epstein-Barr virus. Combining reduced immunosuppressive therapy with donor white blood cells that have been treated in the laboratory to kill cells infected with Epstein-Barr virus may be an effective treatment for lymphoproliferative disease.

PURPOSE: Randomized phase III trial to compare the effectiveness of reducing immunosuppressive therapy with or without donor white blood cells in treating patients who have Epstein-Barr virus-associated lymphoproliferative disease after organ transplantation.

Detailed Description

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OBJECTIVES:

* Determine the efficacy of treatment with partially HLA-matched allogeneic cytotoxic T cells and reduction of immunosuppression, in terms of survival rate and time to remission in patients with Epstein-Barr virus-associated B-cell lymphoproliferative disease after solid organ transplantation.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to transplanted organ type and transplant center. Patients are randomized to 1 of 2 treatment arms.

* Arm I: Patients undergo sliding-scale reduction of immunosuppressive drugs from 1 of 5 regimens at physician's discretion. Patients then receive partially HLA-matched allogeneic cytotoxic T cells IV over 5 minutes once weekly for a total of 4 weeks.
* Arm II: Patients undergo reduction of immunosuppression as in arm I alone. Patients are followed monthly for 6 months and then every 3 months for 2 years.

PROJECTED ACCRUAL: A total of 50 patients will be accrued for this study.

Conditions

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Lymphoproliferative Disorder

Keywords

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post-transplant lymphoproliferative disorder

Study Design

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Allocation Method

RANDOMIZED

Primary Study Purpose

TREATMENT

Interventions

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therapeutic allogeneic lymphocytes

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Diagnosis of post-transplant lymphoproliferative disease (PTLD) after solid organ (heart, heart/lung, liver, liver/gut, pancreas, or kidney) transplantation

* Epstein-Barr virus-positive tumor
* Newly diagnosed disease
* Measurable disease by clinical methods or radiography
* Must have partially matched donor cytotoxic T cells (CTL) available
* No known panel reactivity to any of the HLA types of CTL available for therapy

PATIENT CHARACTERISTICS:

Age:

* Any age

Performance status:

* Karnofsky 20-100%

Life expectancy:

* Not specified

Hematopoietic:

* Not specified

Hepatic:

* Not specified

Renal:

* Not specified

Other:

* Not pregnant

PRIOR CONCURRENT THERAPY:

Biologic therapy:

* Not specified

Chemotherapy:

* Not specified

Endocrine therapy:

* Not specified

Radiotherapy:

* Not specified

Surgery:

* Not specified

Other:

* No prior therapy for PTLD
* No concurrent antiviral drugs (e.g., acyclovir or ganciclovir) for PTLD
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Edinburgh

OTHER

Sponsor Role lead

Principal Investigators

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Dorothy H. Crawford, MD

Role: STUDY_CHAIR

University of Edinburgh

Locations

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Birmingham Children's Hospital

Birmingham, England, United Kingdom

Site Status

Papworth Hospital

Cambridge, England, United Kingdom

Site Status

Royal Free and University College Medical School

London, England, United Kingdom

Site Status

King's College Hospital

London, England, United Kingdom

Site Status

Wythenshawe Hospital

Manchester, England, United Kingdom

Site Status

Central Manchester and Manchester Children's University Hospitals NHS Trust

Manchester, England, United Kingdom

Site Status

Northern General Hospital

Sheffield, England, United Kingdom

Site Status

Institute of Cancer Research - UK

Sutton, England, United Kingdom

Site Status

Royal Infirmary of Edinburgh at Little France

Edinburgh, Scotland, United Kingdom

Site Status

University of Edinburgh

Edinburgh, Scotland, United Kingdom

Site Status

University of Edinburgh Laboratory for Clinical and Molecular Virology

Edinburgh, Scotland, United Kingdom

Site Status

Royal Infirmary - Castle

Glasgow, Scotland, United Kingdom

Site Status

Countries

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United Kingdom

Other Identifiers

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CRUK-EBV-CTL

Identifier Type: -

Identifier Source: secondary_id

LCMV-CTL

Identifier Type: -

Identifier Source: secondary_id

EU-20057

Identifier Type: -

Identifier Source: secondary_id

CDR0000069288

Identifier Type: -

Identifier Source: org_study_id