Patient-donor Vaccination in the Context of Allogeneic Bone Marrow Transplant With Post-transplant Cyclophosphamide

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE2

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-04-30

Study Completion Date

2016-01-31

Brief Summary

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This research is being done to understand the effects of certain types of bone marrow transplant (BMT) on the immune system. Your doctors are planning a BMT, using one of your family members as the bone marrow donor, for your cancer. Part of that BMT involves a chemotherapy drug, called Cyclophosphamide (Cytoxan), given after the transplant. This research is being done to understand the effects of Cyclophosphamide on the immune system.

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Detailed Description

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The research will involve giving your donor a vaccine against a certain infection, before the bone marrow donation: either a vaccine against hepatitis (the hepatitis A vaccine), or a vaccine against pneumonia (Prevnar). You will then get both of these vaccines following your transplant. By studying how much these vaccines may improve your immune system, we hope to better understand the effects of the BMT with Cyclophosphamide on the immune cells.

Prevnar is a pneumococcal vaccine (pneumococcus is a bacteria that can cause pneumonia and other infections). It is approved by the Food and Drug Administration (FDA) for the prevention of infections in children. It is not usually given to adults. Hepatitis A vaccine is approved by the FDA for the prevention of hepatitis A (a liver infection) in children and adults.

The vaccines are not approved for bone marrow donors or for vaccinating adults after BMT (using these vaccines in this research is investigational). The FDA is allowing the use of these vaccines in this research study.

Certain people getting BMT followed by Cyclophosphamide may join, if their donors might also join. Your bone marrow donor must take part in this study, in order for you to continue on this study

Conditions

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Transplant-Related Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Only the study pharmacist was unblinded.

Study Groups

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Donor PCV13

Donors receive PCV13 prior to bone marrow donation.

Group Type ACTIVE_COMPARATOR

PCV13

Intervention Type BIOLOGICAL

0.5 mL IM

Donor Havrix

Donors receive Havrix prior to bone marrow donation.

Group Type ACTIVE_COMPARATOR

Havrix

Intervention Type BIOLOGICAL

1440 ELISA units, or 1 mL, IM

Recipient vaccine

Recipients receive Havrix and PCV13 post bone marrow transplant.

Group Type ACTIVE_COMPARATOR

Havrix

Intervention Type BIOLOGICAL

1440 ELISA units, or 1 mL, IM

PCV13

Intervention Type BIOLOGICAL

0.5 mL IM

Interventions

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Havrix

1440 ELISA units, or 1 mL, IM

Intervention Type BIOLOGICAL

PCV13

0.5 mL IM

Intervention Type BIOLOGICAL

Other Intervention Names

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Hepatitis A vaccine Prevnar-13

Eligibility Criteria

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Inclusion Criteria

Patients inclusion for study:

1. Patient age \> 18 years.
2. Plan to undergo one of the following types of transplant, using bone marrow from a related donor:

* Myeloablative, HLA matched or partially HLA-mismatched (haploidentical), related-donor bone marrow transplantation that includes high-dose posttransplantation Cy
* Nonmyeloablative, HLA matched or partially HLA-mismatched, related-donor bone marrow transplantation that includes high-dose posttransplantation Cy Note: Patients who receive posttransplantation rituximab are eligible.

Patients inclusion for vaccine:

1. Receipt of the type of myeloablative or nonmyeloablative BMT
2. The bone marrow donor has received the pre-bone marrow harvest vaccine (either Prevnar or hepatitis A vaccine) on this study.

Donors inclusion:

1\. Donor age \> 18 years.

Exclusion Criteria

Patients exclusion for study entry:

1. Hypersensitivity to either the components of hepatitis A vaccine (including neomycin) or the components of the PCV7 and PCV13 vaccines (including diphtheria toxin).
2. Severe latex allergy.

Patients exclusion for vaccine:

1. Graft failure.
2. Disease progression or relapse, or disease persistence requiring treatment.Note: Patients with asymptomatic or low-volume disease progression or relapse may be eligible, determined on a case-by-case basis by the PI.
3. Systemic immunosuppression for GVHD treatment or prophylaxis within 4 weeks (+/- 5 days) prior to vaccination.
4. Pregnant or breastfeeding

Donors exclusion:

1. Hypersensitivity to both the components of hepatitis A vaccine (including neomycin) and the components of the PCV7 and PCV13 vaccines (including diphtheria toxin).
2. Severe latex allergy.
3. Expected to be on systemic immunosuppressants between the time of vaccination and the bone marrow donation.
4. Pregnant or breastfeeding

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes