Administration of Virus Specific CTLs for the Prophylaxis and Treatment of EBV/CMV Infections After HSCT in China

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

PHASE1

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-05-31

Study Completion Date

2016-08-31

Brief Summary

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Cytomegalovirus (CMV) and Epstein Barr Virus (EBV) cause significant morbidity and mortality in hematopoietic stem cell transplantation (HSCT) patients in China. Antiviral drugs given either prophylactically or as early therapy for patients with detectable viral loads appear to be an effective strategy for reducing viral infections. However, long-term treatment with these drugs is associated with significant toxicity, expense and the appearance of drug resistant virus isolates ultimately resulting in treatment failure. CMV and EBV specific T cells infusion to immunocompromised patients following HSCT is able to induce a successful anti-viral response. The primary purpose of this study is to determine the safety and efficacy of the infusion of CMV and EBV specific cytotoxic T cells (CTLs) for patients with CMV and EBV reactivation or infection.

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Detailed Description

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To generate CMV/EBV specific CTLs, G-CSF mobilized hemopoietic progenitor cell (G-HPC) products or nonmobilized peripheral blood apheresis collectings were stimulated with CMV/EBV specific peptides covering most HLA alleles among Chinese populations. Once the investigators made sufficient numbers of T cells, they tested their ex vivo properties.Then a fraction of CTLs were separated for immediate infusion and the others were frozen for further infusion.

If the donor was available, the donor derived CTLs were started to produce when CMV reactivation was detected by qPCR in recipients peripheral blood. Otherwise, autologous CTLs were used. For patients at high risk of developing CMV/EBV infections after stem cell transplantation, a small part of G-HPC products was extracted for CTLs generation.

Conditions

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Viral Infection

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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Infusion of CMV/EBV specific CTLs

Repetitive CTLs infusion to treat CMV/EBV activation and infection

Group Type EXPERIMENTAL

CMV/EBV specific CTLs

Intervention Type BIOLOGICAL

Patients will receive approximately 1x10e6 CTLs/kg as a single infusion via IV injection and may receive 1 to 8 additional infusions at intervals of one week.

Interventions

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CMV/EBV specific CTLs

Patients will receive approximately 1x10e6 CTLs/kg as a single infusion via IV injection and may receive 1 to 8 additional infusions at intervals of one week.

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

* Patients with any type of allogeneic HSCT
* CMV, adenovirus or EBV activation or infection which is defined as below. EBV/CMV reactivation is defined as CMV/EBV DNA levels \> 1000 IU/ml for a single test or \> 500 IU/ml for two consecutive tests. EBV/CMV related disease were defined as the demonstration of CMV/EBV biopsy specimen or clinical diagnosis through symptoms, signs or radiography.
* Written informed consent and/or signed assent line from patient, parent or guardian
* Positive CMV or EBV serology of the donor
* Absence of severe renal disease (Creatinine \> 3x upper limit normal)
* Absence of severe hepatic disease (Bilirubin \> 3x upper limit normal, AST \> 3x upper limit normal)
* Life expectancy \> 30 days

Exclusion Criteria

* Active acute GVHD grades II-IV
* Received donor lymphocytes infusion(DLI) within 30 days
* Received ATG or other immunosuppressive monoclonal antibodies within 30 days
* Uncontrolled acute infections
* Active and relapse of malignancy
* Received steroids treatment more than 0.5 mg/kg/day prednisone

Eligible Sex

ALL

Accepts Healthy Volunteers

No