Study of Immune Responses to Influenza Vaccination With or Without Imiquimod Application in Untreated CLL Patients

NCT ID: NCT00596336

Last Updated: 2017-04-12

Basic Information

• Recruitment Status: TERMINATED
• Clinical Phase: PHASE2
• Total Enrollment: 24 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2007-10-31
• Study Completion Date: 2017-03-15

Brief Summary

The purpose of the study is to determine whether it is possible to improve the immune response rate to 'flu vaccination in patients with chronic lymphocytic leukaemia (CLL).

Annual flu vaccination is recommended for all patients with CLL because they are known to be susceptible to infections and particularly to chest infections that may occur as a complication of influenza. Protection against 'flu depends on patients having a high level of antibodies against the 'flu virus. Vaccination works by stimulating the immune system and thus boosting the levels of these protective antibodies.

CLL patients have weakened immune systems due to the leukaemia itself but also following chemotherapy. The exact cause of these immune defects is not known. However, CLL patients typically have low antibody levels and their immune cells may not work normally.

Unfortunately, studies have shown that patients with CLL are not very good at making antibodies to 'flu vaccination and as a result protection against flu is not very reliable. Recent studies have shown that only 15-20 % of CLL patients will achieve a protective antibody level.

Recently a new type of medical cream has been introduced to treat certain skin conditions. Its name is Imiquimod and it is licensed to treat viral warts in the genital area and a type of skin cancer called basal cell carcinoma. It works by increasing the immune response in the skin. Animal studies have shown that as well as increasing immunity against viruses and cancers, it increases responses to vaccination when applied at the site of vaccination.

In this study we propose to test whether this new medicine can improve the response to the 'flu jab.

Detailed Description

Trial Summary

68 patients with stage A CLL who have not been treated, and 34 healthy age and sex matched volunteers who fulfil the entry requirements will be identified and invited to take part in this study.

Blood samples will be taken for baseline studies [FBC, U&E, LFT, Immunoglobulins (Igs), haemagglutinin titres] (20 mls) and T cells studies (50 mls to be frozen).If CLL prognostic factors have not already been determined a further 20ml will be taken for these.

Patients will be randomized to either:

Group A Vaccination with current trispecific influenza vaccine Day 1

or

Group B Vaccination with current trispecific influenza vaccine Day 1, together with the application of Imiquimod cream to the vaccination site on day 2 to 6.

Blood samples will be taken on day 0 for haemagglutinin studies (20 ml) and T cells (50ml to be frozen), then on day 7, 14 for T-cell studies (50 ml) and day 28 for haemagglutinin studies (20 ml). During the 28 days that subjects participate in the trial approximately 190 ml will be taken in total.

Antibody and T-cell responses to influenza virus will be assessed and compared between the two patient arms of the study and the control group.

Conditions

Chronic Lymphocytic Leukemia

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: FACTORIAL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: NONE

Study Groups

Group A CLL patients

Vaccination with current trispecific influenza vaccine Day 1

Group Type: ACTIVE_COMPARATOR

influenza vaccine

Intervention Type: DRUG

trispecific influenza vaccine 0.5 ml subcutaneously

Group B CLL patients

Vaccination with current trispecific influenza vaccine Day 1, together with the application of Imiquimod cream to the vaccination site on day 2 to 6.

Group Type: EXPERIMENTAL

Imiquimod cream

Intervention Type: DRUG

Imiquimod (aldara) 0.5 % cream to site of vaccination on day 2 to 6

influenza vaccine

Intervention Type: DRUG

trispecific influenza vaccine 0.5 ml subcutaneously

Group C volunteers

Vaccination with current trispecific influenza vaccine Day 1

Group Type: ACTIVE_COMPARATOR

influenza vaccine

Intervention Type: DRUG

trispecific influenza vaccine 0.5 ml subcutaneously

Interventions

Imiquimod cream

Imiquimod (aldara) 0.5 % cream to site of vaccination on day 2 to 6

Intervention Type: DRUG

influenza vaccine

trispecific influenza vaccine 0.5 ml subcutaneously

Intervention Type: DRUG

Other Intervention Names

Aldara cream; influvac sub-unit

Eligibility Criteria

Inclusion Criteria

• Untreated stage A CLL patients
• Healthy volunteers

Exclusion Criteria

• Patients with other malignancies
• Patients receiving corticosteroids or other immunosuppressive drugs
• Patients who have received vaccination against influenza in the past 6 months
• Patients who have had an allergic reaction to a flu shot in the past, or have an allergy to eggs or who previously developed Guillain-Barré syndrome within 6 weeks of getting a flu shot
• Patients failing to give informed consent.
• Patients using homeopathic remedies such as echniaea cream.

• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

CLL Topics, Inc.

OTHER

Sponsor Role: collaborator

The Royal Bournemouth Hospital

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Helen McCarthy, MBBS PhD

Role: PRINCIPAL_INVESTIGATOR

Royal Bournemouth Hospital

Locations

Royal Bournemouth hospital

Bournemouth, Dorset, United Kingdom

Countries

United Kingdom

Other Identifiers

LREC number: 06/Q2201/143

Identifier Type: -

Identifier Source: secondary_id

Eudract number: 2006-004902-16

Identifier Type: -

Identifier Source: org_study_id