Trial Outcomes & Findings for Post T-plant Infusion of Allogeneic Cytokine Induced Killer (CIK) Cells as Consolidative Therapy in Myelodysplastic Syndromes/Myeloproliferative Disorders (NCT NCT01392989)

NCT ID: NCT01392989

Last Updated: 2019-05-07

Results Overview

Proportion of patients achieving full donor T-cell chimerism (FDC) by on or before Day 90 post non-myeloablative allogeneic transplant with allogeneic cytokine-induced killer (CIK) cells will be determined. FDC is defined as the attainment of \>95% donor type CD3+ cells. The outcome will be reported as number of participants who achieved full donor chimerism, a number without dispersion.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

44 participants

Primary outcome timeframe

90 days

Results posted on

2019-05-07

Participant Flow

Participant milestones

Participant milestones
Measure
Allogeneic Cytokine Induced Killer Cells (CIK)
Target dose of ≥ 5 x 106 CD34+ cells/kg of recipient body weight plus an additional 2 x109 mononuclear cells. CIK cells: Standard of care Cyclosporine: 5 mg/kg, po Mycophenolate Mofetil: 15 mg/kg, oral Thymoglobulin: 7.5 mg/kg, IV
Total Lymphoid Irradiation (TLI)
STARTED
44
Total Lymphoid Irradiation (TLI)
COMPLETED
44
Total Lymphoid Irradiation (TLI)
NOT COMPLETED
0
CIK Cell Infusion
STARTED
31
CIK Cell Infusion
COMPLETED
31
CIK Cell Infusion
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Post T-plant Infusion of Allogeneic Cytokine Induced Killer (CIK) Cells as Consolidative Therapy in Myelodysplastic Syndromes/Myeloproliferative Disorders

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Allogeneic Cytokine Induced Killer Cells (CIK)
n=44 Participants
Target dose of ≥ 5 x 106 CD34+ cells/kg of recipient body weight plus an additional 2 x109 mononuclear cells. CIK cells: Standard of care Cyclosporine: 5 mg/kg, po Mycophenolate Mofetil: 15 mg/kg, oral Thymoglobulin: 7.5 mg/kg, IV
Age, Categorical
<=18 years
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
22 Participants
n=5 Participants
Age, Categorical
>=65 years
22 Participants
n=5 Participants
Age, Continuous
63.9 Years
STANDARD_DEVIATION 6.58 • n=5 Participants
Sex: Female, Male
Female
21 Participants
n=5 Participants
Sex: Female, Male
Male
23 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
41 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
1 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
Race (NIH/OMB)
White
39 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
4 Participants
n=5 Participants
Region of Enrollment
United States
44 participants
n=5 Participants

PRIMARY outcome

Timeframe: 90 days

Population: Cytokine-induced killer (CIK) cells were infused in a subset of participants.

Proportion of patients achieving full donor T-cell chimerism (FDC) by on or before Day 90 post non-myeloablative allogeneic transplant with allogeneic cytokine-induced killer (CIK) cells will be determined. FDC is defined as the attainment of \>95% donor type CD3+ cells. The outcome will be reported as number of participants who achieved full donor chimerism, a number without dispersion.

Outcome measures

Outcome measures
Measure
Allogeneic Cytokine Induced Killer Cells (CIK)
n=31 Participants
Target dose of ≥ 5 x 106 CD34+ cells/kg of recipient body weight plus an additional 2 x109 mononuclear cells. CIK cells: Standard of care Cyclosporine: 5 mg/kg, po Mycophenolate Mofetil: 15 mg/kg, oral Thymoglobulin: 7.5 mg/kg, IV
Full Donor Chimerism (FDC)
6 Participants

SECONDARY outcome

Timeframe: 2 years

Population: Cytokine-induced killer (CIK) cells were infused in a subset of participants. Participants that did not receive CIK cells were not included in this analysis.

Overall survival (OS) is an expression of the number of participants that remain alive 2 years after cytokine-induced killer (CIK) infusion. The outcome will be reported as the number of participants alive 2 years after CIK infusion, a number without dispersion.

Outcome measures

Outcome measures
Measure
Allogeneic Cytokine Induced Killer Cells (CIK)
n=31 Participants
Target dose of ≥ 5 x 106 CD34+ cells/kg of recipient body weight plus an additional 2 x109 mononuclear cells. CIK cells: Standard of care Cyclosporine: 5 mg/kg, po Mycophenolate Mofetil: 15 mg/kg, oral Thymoglobulin: 7.5 mg/kg, IV
Overall Survival (OS)
16 Participants

SECONDARY outcome

Timeframe: 2 years

Population: All participants are reported. Cytokine-induced killer (CIK) cells were infused in a subset of participants.

Event-free Survival (EFS) rate will be assessed on all enrolled participants and is defined as the duration of time after cytokine-induced killer (CIK) cell infusion that the participants remain alive with experiencing relapse, Grade 3 to 4 acute graft vs host disease (aGVHD), or death. The outcome will be reported as the number of participants, stratified by receipt of CIK cells, that did not experience a specified event, a number without dispersion.

Outcome measures

Outcome measures
Measure
Allogeneic Cytokine Induced Killer Cells (CIK)
n=44 Participants
Target dose of ≥ 5 x 106 CD34+ cells/kg of recipient body weight plus an additional 2 x109 mononuclear cells. CIK cells: Standard of care Cyclosporine: 5 mg/kg, po Mycophenolate Mofetil: 15 mg/kg, oral Thymoglobulin: 7.5 mg/kg, IV
Event-free Survival (EFS) Rate
CIK-infused participants
14 Participants
Event-free Survival (EFS) Rate
Non-CIK-infused participants
4 Participants

SECONDARY outcome

Timeframe: 1 year

Population: Cytokine-induced killer (CIK) cells were infused in a subset of participants. Results are reported for both subsets and collectively, at 2 time points.

Acute graft vs host disease (aGvHD) Grade 2 to 4 was staged \& graded using modified Keystone criteria, as below. The outcome is reported as the number of participants that experience Grade 2 to 4 aGvHD within 100 days and 1 year. * Stage 1: Skin: rash \< 25% of skin. Liver: bilirubin 2 to 3 mg/dL. Gut: diarrhea 500 to 1000 mL/day or persistent nausea with positive biopsy for GvHD * Stage 2: Skin: rash 25 to 50% of skin. Liver: bilirubin 3 to 6 mg/dL. Gut: diarrhea 1000 to 1500 mL/day. * Stage 3: Skin: rash \> 50% of skin. Liver: bilirubin 6 to 15 mg/dL. Gut: diarrhea \> 1500 mL/day. * Stage 4: Skin: generalized erythroderma with bulla formation. Liver: bilirubin \> 15 mg/dL. Gut: severe abdominal pain with or without ileus Grade of aGvHD was determined as follows. * Grade 1: Stage 1-2 Skin + No Liver stage + No Gut stage * Grade 2: Stage 3 Skin OR Stage 1 Liver or Stage 1 Gut * Grade 3: No Skin stage + Stage 2 to 3 Liver Stage 2 to 4 Gut * Grade 4: Stage 4 Skin + or Stage 2

Outcome measures

Outcome measures
Measure
Allogeneic Cytokine Induced Killer Cells (CIK)
n=44 Participants
Target dose of ≥ 5 x 106 CD34+ cells/kg of recipient body weight plus an additional 2 x109 mononuclear cells. CIK cells: Standard of care Cyclosporine: 5 mg/kg, po Mycophenolate Mofetil: 15 mg/kg, oral Thymoglobulin: 7.5 mg/kg, IV
Number of Participants That Experience Grade 2 to 4 aGvHD Within 100 Days and 1 Year
All participants within 100 days
9 Participants
Number of Participants That Experience Grade 2 to 4 aGvHD Within 100 Days and 1 Year
All participants within 1 year
11 Participants
Number of Participants That Experience Grade 2 to 4 aGvHD Within 100 Days and 1 Year
CIK-infused participants within 100 days
3 Participants
Number of Participants That Experience Grade 2 to 4 aGvHD Within 100 Days and 1 Year
CIK-infused participants within 1 year
5 Participants
Number of Participants That Experience Grade 2 to 4 aGvHD Within 100 Days and 1 Year
Non-CIK-infused participants within 100 days
6 Participants
Number of Participants That Experience Grade 2 to 4 aGvHD Within 100 Days and 1 Year
Non-CIK-infused participants within 1 year
6 Participants

SECONDARY outcome

Timeframe: Pre-transplant

Population: Insufficient tumor sample materials from the pre-transplant diagnostic bone marrow aspirate was available for the research analysis. No analysis was conducted.

Pre-transplant expression of natural-killer group 2, member D (NKG2D) ligands MIC A, MIC B, and the UL16 binding proteins (ULBPs) will be assessed in participants' bone marrow aspirates. The outcomes is expressed as the number of participants whose expression level for each ligand was elevated compared to background, represented by the known levels for individual without cancer.

Outcome measures

Outcome data not reported

Adverse Events

Allogeneic Cytokine Induced Killer Cells (CIK)

Serious events: 27 serious events
Other events: 44 other events
Deaths: 24 deaths

Serious adverse events

Serious adverse events
Measure
Allogeneic Cytokine Induced Killer Cells (CIK)
n=44 participants at risk
Target dose of ≥ 5 x 106 CD34+ cells/kg of recipient body weight plus an additional 2 x109 mononuclear cells. CIK cells: Standard of care Cyclosporine: 5 mg/kg, po Mycophenolate Mofetil: 15 mg/kg, oral Thymoglobulin: 7.5 mg/kg, IV
General disorders
Fever
2.3%
1/44 • Number of events 1 • 2 years
Infections and infestations
Infections and infestations -Other, bacteremia
2.3%
1/44 • Number of events 1 • 2 years
General disorders
Death NOS
2.3%
1/44 • Number of events 1 • 2 years
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Neoplasms benign, malignant and unspecified (incl cysts and polyps) - Other, progressive disease
40.9%
18/44 • Number of events 18 • 2 years
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Neoplasms benign, malignant and unspecified (incl cysts and polyps) - Other, GvHD
6.8%
3/44 • Number of events 3 • 2 years
Respiratory, thoracic and mediastinal disorders
Aspiration (Pneumonia)
2.3%
1/44 • Number of events 1 • 2 years
Infections and infestations
Sepsis
2.3%
1/44 • Number of events 1 • 2 years
Respiratory, thoracic and mediastinal disorders
Respiratory failure
2.3%
1/44 • Number of events 1 • 2 years
Renal and urinary disorders
Renal and urinary disorders -Other, Renal failure
2.3%
1/44 • Number of events 1 • 2 years
Investigations
Lymphocyte count increased
2.3%
1/44 • Number of events 1 • 2 years

Other adverse events

Other adverse events
Measure
Allogeneic Cytokine Induced Killer Cells (CIK)
n=44 participants at risk
Target dose of ≥ 5 x 106 CD34+ cells/kg of recipient body weight plus an additional 2 x109 mononuclear cells. CIK cells: Standard of care Cyclosporine: 5 mg/kg, po Mycophenolate Mofetil: 15 mg/kg, oral Thymoglobulin: 7.5 mg/kg, IV
Immune system disorders
Serum sickness
29.5%
13/44 • Number of events 16 • 2 years
Blood and lymphatic system disorders
Hemolysis
2.3%
1/44 • Number of events 1 • 2 years
Cardiac disorders
Cardiac disorders - Other, cardiac bigeminy
2.3%
1/44 • Number of events 1 • 2 years
Musculoskeletal and connective tissue disorders
Myalgia
6.8%
3/44 • Number of events 3 • 2 years
Musculoskeletal and connective tissue disorders
Back pain
6.8%
3/44 • Number of events 3 • 2 years
Musculoskeletal and connective tissue disorders
Buttock Pain
2.3%
1/44 • Number of events 1 • 2 years
Musculoskeletal and connective tissue disorders
Neck Pain
2.3%
1/44 • Number of events 1 • 2 years
Musculoskeletal and connective tissue disorders
Pain in extremity
4.5%
2/44 • Number of events 2 • 2 years
Nervous system disorders
Headache
9.1%
4/44 • Number of events 6 • 2 years
Nervous system disorders
Dizziness
2.3%
1/44 • Number of events 1 • 2 years
Eye disorders
Blurred vision
2.3%
1/44 • Number of events 1 • 2 years
General disorders
Chills
2.3%
1/44 • Number of events 1 • 2 years
General disorders
Localized Edema
2.3%
1/44 • Number of events 1 • 2 years
General disorders
Pain
2.3%
1/44 • Number of events 2 • 2 years
General disorders
Fever
20.5%
9/44 • Number of events 11 • 2 years
General disorders
Non-cardiac chest pain
2.3%
1/44 • Number of events 1 • 2 years
General disorders
General Disorders Other - Peripheral Edema
6.8%
3/44 • Number of events 3 • 2 years
Gastrointestinal disorders
Abdominal pain
4.5%
2/44 • Number of events 2 • 2 years
Gastrointestinal disorders
Dyspepsia
2.3%
1/44 • Number of events 1 • 2 years
Gastrointestinal disorders
Dysphagia
2.3%
1/44 • Number of events 1 • 2 years
Gastrointestinal disorders
Gastric ulcer
2.3%
1/44 • Number of events 1 • 2 years
Gastrointestinal disorders
Mucositis oral
2.3%
1/44 • Number of events 1 • 2 years
Gastrointestinal disorders
Gastrointestinal disorders -Other, Diverticulitis
2.3%
1/44 • Number of events 1 • 2 years
Gastrointestinal disorders
Constipation
2.3%
1/44 • Number of events 1 • 2 years
Gastrointestinal disorders
Diarrhea
9.1%
4/44 • Number of events 4 • 2 years
Hepatobiliary disorders
Portal vein thrombosis
2.3%
1/44 • Number of events 1 • 2 years
Infections and infestations
Otitis externa
2.3%
1/44 • Number of events 1 • 2 years
Infections and infestations
Lung infection
2.3%
1/44 • Number of events 1 • 2 years
Infections and infestations
Upper respiratory infection
2.3%
1/44 • Number of events 1 • 2 years
Infections and infestations
Bladder infection
2.3%
1/44 • Number of events 1 • 2 years
Infections and infestations
Urinary tract infection
2.3%
1/44 • Number of events 1 • 2 years
Infections and infestations
Infections and infestations - Other , Catheter Infection
2.3%
1/44 • Number of events 1 • 2 years
Infections and infestations
Infections and infestations - Other, Viremia
4.5%
2/44 • Number of events 2 • 2 years
Infections and infestations
Infections and infestations - Other, Coronavirus
2.3%
1/44 • Number of events 1 • 2 years
Investigations
Platelet Count decreased
2.3%
1/44 • Number of events 1 • 2 years
Investigations
Blood bilirubin increased
20.5%
9/44 • Number of events 9 • 2 years
Investigations
Aspartate aminotransferase increased
4.5%
2/44 • Number of events 3 • 2 years
Investigations
Alanine aminotransferase increased
4.5%
2/44 • Number of events 2 • 2 years
Investigations
Weight Gain
2.3%
1/44 • Number of events 1 • 2 years
Metabolism and nutrition disorders
Hyponatremia
6.8%
3/44 • Number of events 3 • 2 years
Metabolism and nutrition disorders
Hyperglycemia
2.3%
1/44 • Number of events 1 • 2 years
Renal and urinary disorders
Acute kidney injury
2.3%
1/44 • Number of events 1 • 2 years
Renal and urinary disorders
Urinary frequency
2.3%
1/44 • Number of events 1 • 2 years
Renal and urinary disorders
Renal and urinary disorders -Other, Dysuria
4.5%
2/44 • Number of events 2 • 2 years
Respiratory, thoracic and mediastinal disorders
Dyspnea
2.3%
1/44 • Number of events 1 • 2 years
Respiratory, thoracic and mediastinal disorders
Laryngeal inflammation
4.5%
2/44 • Number of events 2 • 2 years
Respiratory, thoracic and mediastinal disorders
Pneumothorax
2.3%
1/44 • Number of events 1 • 2 years
Respiratory, thoracic and mediastinal disorders
Pulmonary edema
4.5%
2/44 • Number of events 2 • 2 years
Respiratory, thoracic and mediastinal disorders
Pulmonary hypertension
2.3%
1/44 • Number of events 1 • 2 years
Reproductive system and breast disorders
Vaginal pain
2.3%
1/44 • Number of events 1 • 2 years
Skin and subcutaneous tissue disorders
Rash maculo-papular
6.8%
3/44 • Number of events 3 • 2 years
Skin and subcutaneous tissue disorders
Urticaria
4.5%
2/44 • Number of events 2 • 2 years
Skin and subcutaneous tissue disorders
Skin and subcutaneous tissue disorders Other, cutaneous eruptions
2.3%
1/44 • Number of events 1 • 2 years
Skin and subcutaneous tissue disorders
Skin and subcutaneous tissue disorders Other, Rash
11.4%
5/44 • Number of events 8 • 2 years
Vascular disorders
Hypertension
2.3%
1/44 • Number of events 1 • 2 years
Vascular disorders
Hematoma
2.3%
1/44 • Number of events 1 • 2 years
Vascular disorders
Thromboembolic event
2.3%
1/44 • Number of events 1 • 2 years
Vascular disorders
Vascular disorders - Other, DVT
2.3%
1/44 • Number of events 1 • 2 years
Psychiatric disorders
Psychiatric disorders - Other, altered mental status
2.3%
1/44 • Number of events 1 • 2 years

Additional Information

Everett Meyer, Assistant Professor of Medicine (Blood and Marrow Transplantation)

Stanford University

Phone: 650) 725-5816

Results disclosure agreements

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