Status:

COMPLETED

Cord Blood Fucosylation to Enhance Homing and Engraftment in Patients With Hematologic Malignancies

Lead Sponsor:

M.D. Anderson Cancer Center

Collaborating Sponsors:

American Stem Cell, Inc.

National Cancer Institute (NCI)

Conditions:

Blood And Marrow Transplantation

Leukemia

Eligibility:

All Genders

1-80 years

Phase:

PHASE1

Brief Summary

The goal of this clinical research study is to learn if it is safe and feasible to transplant changed cord blood for patients with leukemia or lymphoma. Researchers also want to learn if this can help...

Detailed Description

Central Venous Catheter Placement: You will first have a central venous catheter (CVC) placed. A CVC is a sterile flexible tube that will be placed into a large vein while you are under local anesthe...

Eligibility Criteria

Inclusion

  • Patients must have one of the following hematologic malignancies: Acute Myelogenous Leukemia (AML), induction failure, high-risk for relapse first remission (with intermediate-risk or high-risk cytogenetics, flt3 mutation positive and/or evidence of minimal residual disease by flow cytometry), secondary leukemia from prior chemotherapy and/or arising from MDS, Langerhan's cell histiocytosis, any disease beyond first remission; or,
  • Myelodysplastic Syndrome (MDS): Primary or therapy related; or,
  • Acute Lymphoblastic Leukemia (ALL): induction failure, primary refractory to treatment (do not achieve complete remission after first course of therapy) or are beyond first remission including second or greater remission or active disease. Patients in first remission are eligible if they are considered high risk, defined as any of the following detected at any time: with translocations 9;22 or 4;11, hypodiploidy, complex karyotype, secondary leukemia developing after cytotoxic drug exposure, and/or evidence of minimal residual disease, or acute biphenotypic leukemia, or double hit non-Hodgkin's lymphoma; or,
  • Non-Hodgkin's Lymphoma (NHL) in primary induction failure, second or third complete remission, refractory disease, or relapse (including relapse post autologous hematopoietic stem cell transplant). Double hit lymphomas in first remission or more advanced disease; or,
  • Small Lymphocytic Lymphoma (SLL), or Chronic Lymphocytic Leukemia (CLL) with progressive disease following standard therapy; or,
  • CML second chronic phase or accelerated phase; or,
  • Hodgkin's Disease (HD): Induction failures, second or third complete remission, or relapse (including relapse post autologous hematopoietic stem cell transplant).
  • Patients Age Criteria: Age \>/= 1 and \</= 80 years old. Eligibility for pediatric patients will be determined in conjunction with an MDACC pediatrician.
  • Performance score of at least 80% by Karnofsky or PS \< 3 (ECOG) (age \>/= 12 years), or Lansky Play-Performance Scale of at least 60% or greater (age \<12 years).
  • Adequate major organ system function as demonstrated by: a. Left ventricular ejection fraction of at least 40-45% b. Pulmonary function test (PFT) demonstrating a diffusion capacity of least 50% predicted. For children \</= 7 years of age who are unable to perform PFT, oxygen saturation \>/= 92% on room air by pulse oximetry. c. Creatinine \< 1.6 mg/dL. d. SGPT/bilirubin \</= to 2.0 x normal.
  • Negative Beta HCG test in a woman with child bearing potential defined as not post-menopausal for 12 months or no previous surgical sterilization and willing to use an effective contraceptive measure while on study.
  • Patients must have two CB units available which are matched with the patient at 4, 5, or 6/6 HLA class I (serological) and II (molecular) antigens. Each cord must contain at least 1.5 x 10\^7 total nucleated cells/Kg recipient body weight (pre-thaw).
  • Have identified a back-up cell source in case of engraftment failure. The source can be autologous, related or unrelated.

Exclusion

  • Patients with known history of HIV/AIDS.
  • Active CNS disease in patient with history of CNS malignancy.
  • Patients with chronic active hepatitis or cirrhosis. If positive hepatitis serology, the Study Chair may deem the patient eligible based on the results of liver biopsy.
  • Patients with uncontrolled serious medical condition such as persistent septicemia despite adequate antibiotic therapy, decompensated congestive heart failure despite cardiac medications or pulmonary insufficiency requiring intubation (excluding primary disease for which CB transplantation is proposed), or psychiatric condition that would limit informed consent.
  • Positive beta HCG in female of child-bearing potential defined as not post-menopausal for 12 months or no previous surgical sterilization or breast-feeding.

Key Trial Info

Start Date :

July 13 2012

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

April 25 2017

Estimated Enrollment :

33 Patients enrolled

Trial Details

Trial ID

NCT01471067

Start Date

July 13 2012

End Date

April 25 2017

Last Update

April 28 2017

Active Locations (1)

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1

University of Texas MD Anderson Cancer Center

Houston, Texas, United States, 77030