Trial Outcomes & Findings for Methods to Enhance the Safety and Effectiveness of Stem Cell Transplants (NCT NCT00378534)

NCT ID: NCT00378534

Last Updated: 2021-06-16

Results Overview

Subjects with hematological malignancies receiving a myeloablative conditioning regimen of cyclophosphamide, fludarabine and total body irradiation followed by an infusion of stem cell product prepared using the Miltenyi CliniMacs system for CD34 selection and a delayed T cell depletion add back as donor lymphocyte infusion at day 90. The subjects receiving allogeneic stem cell transplantation will have stem cell product prepared using Miltenyi CliniMacs system to determine the overall survival and non-relapse mortality at day +200.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

116 participants

Primary outcome timeframe

Day 200

Results posted on

2021-06-16

Participant Flow

Participant milestones

Participant milestones
Measure
T Cell Depletion Transplant Participants
Participants with hematological malignancies received a myeloablative conditioning regimen of cyclophosphamide, fludarabine and total body irradiation followed by an infusion of stem cell product prepared using the Miltenyi CliniMacs system for CD34 selection and a delayed T cell depletion add back as donor lymphocyte infusion at day 90.
Stem Cell Donors
An HLA 6/6 identical family member will be co-enrolled into this study as a stem cell donor. The stem cell collection aspect of this protocol is not investigational.
Overall Study
STARTED
58
58
Overall Study
COMPLETED
55
58
Overall Study
NOT COMPLETED
3
0

Reasons for withdrawal

Reasons for withdrawal
Measure
T Cell Depletion Transplant Participants
Participants with hematological malignancies received a myeloablative conditioning regimen of cyclophosphamide, fludarabine and total body irradiation followed by an infusion of stem cell product prepared using the Miltenyi CliniMacs system for CD34 selection and a delayed T cell depletion add back as donor lymphocyte infusion at day 90.
Stem Cell Donors
An HLA 6/6 identical family member will be co-enrolled into this study as a stem cell donor. The stem cell collection aspect of this protocol is not investigational.
Overall Study
Participants did not receive transplant
3
0

Baseline Characteristics

Methods to Enhance the Safety and Effectiveness of Stem Cell Transplants

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
T Cell Depletion Transplant Participants
n=58 Participants
Participants with hematological malignancies received a myeloablative conditioning regimen of cyclophosphamide, fludarabine and total body irradiation followed by an infusion of stem cell product prepared using the Miltenyi CliniMacs system for CD34 selection and a delayed T cell depletion add back as donor lymphocyte infusion at day 90
Stem Cell Donors
n=58 Participants
An HLA 6/6 identical family member will be co-enrolled into this study as a stem cell donor. The stem cell collection aspect of this protocol is not investigational.
Total
n=116 Participants
Total of all reporting groups
Age, Categorical
<=18 years
4 Participants
n=5 Participants
4 Participants
n=7 Participants
8 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
52 Participants
n=5 Participants
51 Participants
n=7 Participants
103 Participants
n=5 Participants
Sex: Female, Male
Male
27 Participants
n=5 Participants
28 Participants
n=7 Participants
55 Participants
n=5 Participants
Age, Categorical
>=65 years
2 Participants
n=5 Participants
3 Participants
n=7 Participants
5 Participants
n=5 Participants
Sex: Female, Male
Female
31 Participants
n=5 Participants
30 Participants
n=7 Participants
61 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
30 Participants
n=5 Participants
31 Participants
n=7 Participants
61 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
27 Participants
n=5 Participants
26 Participants
n=7 Participants
53 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
5 Participants
n=5 Participants
6 Participants
n=7 Participants
11 Participants
n=5 Participants
Race (NIH/OMB)
White
22 Participants
n=5 Participants
20 Participants
n=7 Participants
42 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=5 Participants
2 Participants
n=7 Participants
3 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
28 Participants
n=5 Participants
28 Participants
n=7 Participants
56 Participants
n=5 Participants
Region of Enrollment
United States
58 participants
n=5 Participants
58 participants
n=7 Participants
116 participants
n=5 Participants

PRIMARY outcome

Timeframe: Day 200

Subjects with hematological malignancies receiving a myeloablative conditioning regimen of cyclophosphamide, fludarabine and total body irradiation followed by an infusion of stem cell product prepared using the Miltenyi CliniMacs system for CD34 selection and a delayed T cell depletion add back as donor lymphocyte infusion at day 90. The subjects receiving allogeneic stem cell transplantation will have stem cell product prepared using Miltenyi CliniMacs system to determine the overall survival and non-relapse mortality at day +200.

Outcome measures

Outcome measures
Measure
T Cell Depletion Transplant Participants
n=55 Participants
Participants with hematological malignancies received a myeloablative conditioning regimen of cyclophosphamide, fludarabine and total body irradiation followed by an infusion of stem cell product prepared using the Miltenyi CliniMacs system for CD34 selection and a delayed T cell depletion add back as donor lymphocyte infusion at day 90.
Survival and Non-relapse Mortality at Day +200 Using the Miltenyi Reagent System
Survival at day 200
43 participants
Survival and Non-relapse Mortality at Day +200 Using the Miltenyi Reagent System
Non-relapse mortality
4 participants

SECONDARY outcome

Timeframe: Day 200

Number of participants with relapse of disease by day 200

Outcome measures

Outcome measures
Measure
T Cell Depletion Transplant Participants
n=55 Participants
Participants with hematological malignancies received a myeloablative conditioning regimen of cyclophosphamide, fludarabine and total body irradiation followed by an infusion of stem cell product prepared using the Miltenyi CliniMacs system for CD34 selection and a delayed T cell depletion add back as donor lymphocyte infusion at day 90.
Number of Participants With Relapse of Disease
17 Participants

SECONDARY outcome

Timeframe: 100 days

Number of participants who developed Acute Graft vs Host Disease (GVHD) Grades I, II, III, IV as defined by CIMBTR criteria for Organ Stages of Acute GVHD. Grades are defined as: Grade I: Skin = Maculopapular rash\< 25% of body surface area (BSA); Liver = Total Bilirubin 2-3 mg/dL; Lower GI = stool output/day is 500-999 mL/day. Grade II: Skin = rash on 25-50 percent body surface area; Liver = Total Bilirubin 3.1-6.0 mg/dL; Lower GI = Diarrhea 1001-1500 mL/day. Grade III: Skin = Rash on \>50% of body surface; Liver = Total Bilirubin 6.1 - 15.0 mg/dL; Lower GI = Diarrhea \> 1500 mL/day. Grade IV: Skin = Generalized erythroderma plus bullous formation; Liver = Total Bilirubin \>15 mg/dL; Lower GI = Severe abdominal pain with or without ileus. Grade I GVHD is characterized as mild disease, grade II GVHD as moderate, grade III as severe, and grade IV life-threatening.

Outcome measures

Outcome measures
Measure
T Cell Depletion Transplant Participants
n=55 Participants
Participants with hematological malignancies received a myeloablative conditioning regimen of cyclophosphamide, fludarabine and total body irradiation followed by an infusion of stem cell product prepared using the Miltenyi CliniMacs system for CD34 selection and a delayed T cell depletion add back as donor lymphocyte infusion at day 90.
Number of Participants Who Developed Acute GVHD Grades I, II, III, IV
Acute GVHD, Grade I
14 Participants
Number of Participants Who Developed Acute GVHD Grades I, II, III, IV
Acute GVHD, Grade II
16 Participants
Number of Participants Who Developed Acute GVHD Grades I, II, III, IV
Acute GVHD, Grade III
9 Participants
Number of Participants Who Developed Acute GVHD Grades I, II, III, IV
Acute GVHD, Grade IV
1 Participants

SECONDARY outcome

Timeframe: 36 months

Number of incidences of participants who developed Limited Chronic Graft vs Host Disease (GVHD). Limited disease is characterized by localized skin involvement and/or evidence of hepatic dysfunction. Limited disease is associated with a favorable outcome without systemic therapy, while extensive disease patients have an unfavorable outcome.

Outcome measures

Outcome measures
Measure
T Cell Depletion Transplant Participants
n=55 Participants
Participants with hematological malignancies received a myeloablative conditioning regimen of cyclophosphamide, fludarabine and total body irradiation followed by an infusion of stem cell product prepared using the Miltenyi CliniMacs system for CD34 selection and a delayed T cell depletion add back as donor lymphocyte infusion at day 90.
Number of Participants Who Developed Limited Chronic GVHD
8 Participants

SECONDARY outcome

Timeframe: 36 months

Number of participants with extensive, Chronic Graft vs Host Disease (GVHD). Extensive chronic GVHD is defined as GVHD occurring after day 100 that did not meet the definition of limited chronic GVHD. Extensive disease presents either with generalized skin involvement, or with localized skin involvement or hepatic dysfunction plus at least one of the following: * Liver histology showing chronic progressive hepatitis, bridging necrosis, or cirrhosis * Involvement of the eye (Schirmer's test with less than 5 mm wetting) (see "Diagnosis and classification of Sjögren's syndrome") * Involvement of minor salivary glands or oral mucosa (as demonstrated on labial or mucosal biopsy specimen) * Involvement of any other target organ

Outcome measures

Outcome measures
Measure
T Cell Depletion Transplant Participants
n=55 Participants
Participants with hematological malignancies received a myeloablative conditioning regimen of cyclophosphamide, fludarabine and total body irradiation followed by an infusion of stem cell product prepared using the Miltenyi CliniMacs system for CD34 selection and a delayed T cell depletion add back as donor lymphocyte infusion at day 90.
Number of Participants Who Develop Extensive GVHD
18 Participants

Adverse Events

T Cell Depletion Transplant Participants

Serious events: 14 serious events
Other events: 0 other events
Deaths: 14 deaths

Stem Cell Donors

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
T Cell Depletion Transplant Participants
n=58 participants at risk
Participants with hematological malignancies received a myeloablative conditioning regimen of cyclophosphamide, fludarabine and total body irradiation followed by an infusion of stem cell product prepared using the Miltenyi CliniMacs system for CD34 selection and a delayed T cell depletion add back as donor lymphocyte infusion at day 90.
Stem Cell Donors
n=58 participants at risk
An HLA 6/6 identical family member will be co-enrolled into this study as a stem cell donor. The stem cell collection aspect of this protocol is not investigational.
Blood and lymphatic system disorders
Graft failure
5.2%
3/58 • Number of events 3 • 36 months
0.00%
0/58 • 36 months
Infections and infestations
Infection
12.1%
7/58 • Number of events 7 • 36 months
0.00%
0/58 • 36 months
Immune system disorders
GVHD
6.9%
4/58 • Number of events 4 • 36 months
0.00%
0/58 • 36 months
Immune system disorders
Posterior reversible encephalopathy syndrome
1.7%
1/58 • Number of events 1 • 36 months
0.00%
0/58 • 36 months
Musculoskeletal and connective tissue disorders
Hip fracture
1.7%
1/58 • Number of events 1 • 36 months
0.00%
0/58 • 36 months
Vascular disorders
Deep vein thrombosis
1.7%
1/58 • Number of events 1 • 36 months
0.00%
0/58 • 36 months
Cardiac disorders
Arrythmia
1.7%
1/58 • Number of events 1 • 36 months
0.00%
0/58 • 36 months
Blood and lymphatic system disorders
Hemorrhage
1.7%
1/58 • Number of events 1 • 36 months
0.00%
0/58 • 36 months
Blood and lymphatic system disorders
Microangiopathy Anemia
1.7%
1/58 • Number of events 1 • 36 months
0.00%
0/58 • 36 months
Respiratory, thoracic and mediastinal disorders
Pulmonary emboli
1.7%
1/58 • Number of events 1 • 36 months
0.00%
0/58 • 36 months

Other adverse events

Adverse event data not reported

Additional Information

Sara Hauffe, RN Protocol Liaison

NIH NHLBI OCD DIR ORIC

Phone: 301-827-2720

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place