Status:

TERMINATED

A Phase I Study of WT1 Peptides to Induce Anti-Leukemia Immune Responses Following Transplantation

Lead Sponsor:

Michael Morse, MD

Conditions:

Acute Myelogenous Leukemia (AML)

Chronic Myelogenous Leukemia (CML)

Eligibility:

All Genders

18+ years

Phase:

PHASE1

Brief Summary

The purpose of this study is to determine the safety and effectiveness of administering Wilms tumor gene 1 (WT1) cancer peptides. Cancer peptides are short pieces of protein that are made in a laborat...

Detailed Description

Two subgroups with 2 dose cohorts of up to 6 patients each will be enrolled in this exploratory study in order to attempt to obtain immunologic and clinical data on patients with a variety of hematolo...

Eligibility Criteria

Inclusion

  • There are two subgroups of patients: Those undergoing autologous stem cell transplantation and those undergoing allogeneic stem cell transplantation.
  • Autologous transplant subgroup:
  • Patients with the following hematologic malignancies (AML, CML, ALL, B cell malignancies, and myelodysplastic syndrome) who will be undergoing autologous stem cell transplantation.
  • Allogeneic transplantation subgroup:
  • Patients with the following hematologic malignancies (AML, CML, ALL, B cell malignancies, and myelodysplastic syndrome) who have undergone allogeneic stem cell transplantation. There is no limitation on whether myeloablative or non-myeloablative chemotherapy is administered. A 3/6 or greater match is required for patients who have had an allogeneic stem cell transplant.
  • Both subgroups:
  • Subject must be one of the following HLA types: HLA A2, A24, DR15 or DRw53 (includes HLA-DR4, -DR7, and DRw9)
  • Karnofsky performance status must be greater than or equal to 70%.
  • Age ≥ 18 years.
  • Ability to understand and provide signed informed consent that fulfills Institutional Review Board guidelines.
  • Patient must agree to use adequate contraception defined as: for women, one of the following (1) surgical sterilization, (2) approved hormonal contraceptives (such as birth control pills, Depo-Provera, or Lupron Depot), (3) barrier methods (such as a condom or diaphragm) used with a spermicide, or (4) an intrauterine device (IUD); for men, one of the following: (1) surgical sterilization, or (2) a condom used with a spermicide.
  • In order to receive their immunizations, subjects should be:
  • For autologous transplants:
  • At least 2 weeks from prior chemotherapy.
  • Injections 1 and 2 must be completed prior to administration of any growth factor mobilization
  • Injections 3, 4, 5, and 6, to resume 2 or more weeks from the time of their stem cell infusion if there has been no Grade 3 or 4 non-hematologic, major organ toxicity within the preceding 1 week. Non-major organ toxicities must have resolved to grade 2 or less.
  • For allogeneic transplants,
  • At least 2 weeks from the time of their stem cell infusion.
  • Without Grade 3 or 4 non-hematologic major organ toxicity within the preceding 1 week; non major organ toxicities must have resolved to grade 2 or less.
  • We will require demonstration of \>50% donor myeloid hematopoiesis, based on microsatellite polymorphisms, prior to enrolling the patients with MDS on the study.
  • Adequate laboratory data as follows:
  • Hematologic function: WBC ≥ 3000/microliter, hemoglobin ≥ 9 g/dL (may transfuse or use erythropoietin to achieve this level), platelets ≥ 50,000/microliter ((may transfuse).
  • Renal and hepatic function: serum creatinine \< 1.5 mg/dL, bilirubin \< 1.5 mg/dL (except a bilirubin of \<2.0 will be permitted for patents with Gilbert's syndrome), SGOT/SGPT \< 2 x upper limit of normal.
  • Subjects must have a CD4+ count is \> 200/mm. There is no specified requirement for CD8+ T cell count.
  • Urine protein/creatinine ratio (UPC) must be less than 1.

Exclusion

  • Corticosteroid (greater than 10mg per day of prednisone or an equipotent dose of another corticosteroid) or other immunosuppressive therapy within the prior 1 week.
  • Pregnant women and nursing mothers.
  • Current or prior history of brain metastases.
  • More than 12 months since their stem cell transplant.
  • HIV +, hepatitis BsAg +, Hepatitis C Ab+.

Key Trial Info

Start Date :

June 1 2007

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

October 1 2013

Estimated Enrollment :

8 Patients enrolled

Trial Details

Trial ID

NCT00672152

Start Date

June 1 2007

End Date

October 1 2013

Last Update

December 10 2013

Active Locations (1)

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Duke Comprehensive Cancer Center

Durham, North Carolina, United States, 27710