Haploidentical Stem Cell Transplantation for Children With Acquired Severe Aplastic Anemia

NCT ID: NCT01759732

Last Updated: 2013-01-03

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

PHASE2

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-09-30

Study Completion Date

2015-12-31

Brief Summary

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Rationale: Fludarabine, cyclophosphamide, anti-thymocyte globulin and low-dose total body irradiation (LD-TBI) may induce the engraftment cross the immunologic barrier in the setting of HLA-haploidentical allogeneic hematopoietic cell transplantation. In addition, depletion of CD3 cells may contribute to prevent developing severe acute graft versus host disease (GVHD) in haploidentical transplantation.

Purpose: Phase II trials to evaluate the efficacy of haploidentical stem cell transplantation with fixed dose of T cells after in vitro T cell depletion using CD3 monoclonal antibody for children with acquired severe aplastic anemia

Detailed Description

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Conditions

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Acquired Aplastic Anemia

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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HAPLO

Group Type EXPERIMENTAL

Fludarabine

Intervention Type DRUG

40mg/M2 once daily IV on days -7 to -4

Cyclophosphamide

Intervention Type DRUG

60 mg/kg IV on day-3 and -2

anti-thymocyte globulin

Intervention Type BIOLOGICAL

filgrastim

Intervention Type BIOLOGICAL

Total body irradiation

Intervention Type RADIATION

200 cGy per day on D-5 \& -4

CD3-depleted hematopoietic cell transplantation

Intervention Type PROCEDURE

Immunogenetic depletion on CliniMACS

Interventions

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Fludarabine

40mg/M2 once daily IV on days -7 to -4

Intervention Type DRUG

Cyclophosphamide

60 mg/kg IV on day-3 and -2

Intervention Type DRUG

anti-thymocyte globulin

Intervention Type BIOLOGICAL

filgrastim

Intervention Type BIOLOGICAL

Total body irradiation

200 cGy per day on D-5 \& -4

Intervention Type RADIATION

CD3-depleted hematopoietic cell transplantation

Immunogenetic depletion on CliniMACS

Intervention Type PROCEDURE

Other Intervention Names

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Beginning on day 4 and continuing until blood counts recover

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of life-threatening marrow failure (severe aplastic anemia) of nonmalignant etiology meeting 2 of the following criteria:

* Granulocyte count \< 500/mm3,
* Corrected reticulocyte count \< 1%,
* Platelet count \< 20,000/mm3
* No HLA-identical family member or closely matched (8 of 8 HLA-locus match) unrelated marrow donor available
* HLA-haploidentical related donor available

Exclusion Criteria

* Paroxysmal nocturnal hemoglobinuria or Fanconi anemia
* Clonal cytogenetic abnormalities or myelodysplastic syndromes
* Active fungal infections
* HIV positive
* Severe disease other than aplastic anemia that would severely limit the probability of survival during the graft procedure
* Pregnant or nursing
Maximum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Asan Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Ho Joon Im

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ho Joon Im, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Asan Medical Center

Locations

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Asan Medical Center

Seoul, , South Korea

Site Status RECRUITING

Countries

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South Korea

Central Contacts

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Ho Joon Im, MD, PhD

Role: CONTACT

82-2-3010-3371

Facility Contacts

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Ho Joon Im, MD, PhD

Role: primary

82-2-3010-3371

References

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Burroughs LM, Woolfrey AE, Storer BE, Deeg HJ, Flowers ME, Martin PJ, Carpenter PA, Doney K, Appelbaum FR, Sanders JE, Storb R. Success of allogeneic marrow transplantation for children with severe aplastic anaemia. Br J Haematol. 2012 Jul;158(1):120-8. doi: 10.1111/j.1365-2141.2012.09130.x. Epub 2012 Apr 26.

Reference Type BACKGROUND
PMID: 22533862 (View on PubMed)

Tolar J, Deeg HJ, Arai S, Horwitz M, Antin JH, McCarty JM, Adams RH, Ewell M, Leifer ES, Gersten ID, Carter SL, Horowitz MM, Nakamura R, Pulsipher MA, Difronzo NL, Confer DL, Eapen M, Anderlini P. Fludarabine-based conditioning for marrow transplantation from unrelated donors in severe aplastic anemia: early results of a cyclophosphamide dose deescalation study show life-threatening adverse events at predefined cyclophosphamide dose levels. Biol Blood Marrow Transplant. 2012 Jul;18(7):1007-11. doi: 10.1016/j.bbmt.2012.04.014. Epub 2012 Apr 27.

Reference Type BACKGROUND
PMID: 22546497 (View on PubMed)

Xu LP, Liu KY, Liu DH, Han W, Chen H, Chen YH, Zhang XH, Wang Y, Wang FR, Wang JZ, Huang XJ. A novel protocol for haploidentical hematopoietic SCT without in vitro T-cell depletion in the treatment of severe acquired aplastic anemia. Bone Marrow Transplant. 2012 Dec;47(12):1507-12. doi: 10.1038/bmt.2012.79. Epub 2012 May 28.

Reference Type BACKGROUND
PMID: 22635243 (View on PubMed)

Koh KN, Im HJ, Kim BE, Choi ES, Jang S, Kwon SW, Park CJ, Seo JJ. Haploidentical haematopoietic stem cell transplantation using CD3 or CD3/CD19 depletion and conditioning with fludarabine, cyclophosphamide and antithymocyte globulin for acquired severe aplastic anaemia. Br J Haematol. 2012 Apr;157(1):139-42. doi: 10.1111/j.1365-2141.2011.08924.x. Epub 2011 Nov 5. No abstract available.

Reference Type RESULT
PMID: 22055111 (View on PubMed)

Im HJ, Koh KN, Suh JK, Lee SW, Choi ES, Jang S, Kwon SW, Park CJ, Seo JJ. Refinement of treatment strategies in ex vivo T-cell-depleted haploidentical SCT for pediatric patients. Bone Marrow Transplant. 2015 Feb;50(2):225-31. doi: 10.1038/bmt.2014.232. Epub 2014 Oct 13.

Reference Type DERIVED
PMID: 25310303 (View on PubMed)

Related Links

Other Identifiers

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AMCPHO-SCT1202

Identifier Type: -

Identifier Source: org_study_id

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