Stem Cell Transplant for Blood Cancer

Not currently recruiting at 2 trial locations
RT
Miguel-Angel Perales, MD profile photo
Overseen ByMiguel-Angel Perales, MD
Age: 18+
Sex: Any
Trial Phase: Phase 1
Sponsor: Memorial Sloan Kettering Cancer Center
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 4 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new combination of chemotherapy and low-dose radiation to determine its safety and effectiveness for treating certain blood cancers. The aim is to develop a less intense treatment that still effectively targets cancer cells. It specifically examines a stem cell transplant method called Allogeneic Hematopoietic Stem Cell Transplantation (AlloHCT), which the FDA has not yet approved for this purpose. This trial may suit individuals with certain blood cancers, such as acute myeloid leukemia or severe aplastic anemia, who have already tried other treatments. As a Phase 1 trial, the research focuses on understanding how the treatment works in people, offering participants a chance to be among the first to receive this new therapy.

Do I need to stop my current medications for the trial?

The trial information does not specify if you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that the CliniMACS device is safe for T cell depletion?

Research has shown that allogeneic hematopoietic stem cell transplantation, like the one in this study, is generally well-tolerated by patients with blood disorders. In a study of patients with sickle cell disease, the overall survival rate reached 94%, which is very promising. This study also reported low rates of acute and chronic graft-versus-host disease, where donor cells attack the patient's body.

However, up to 30% of patients might experience a relapse after the transplant, and 2% to 5% could develop new cancers from the donor cells. While these outcomes highlight potential risks, they also indicate that many patients handle the treatment well.

As this is a Phase 1 study, the main goal is to determine safety. This phase usually involves fewer participants and aims to assess if the treatment is safe for humans. Past research suggests that while there are risks, the treatment has a manageable safety profile.12345

Why are researchers excited about this trial's treatment?

Researchers are excited about this treatment because it uses allogeneic hematopoietic stem cell transplantation in a novel way, particularly for patients with myeloid malignancies and aplastic anemia. Unlike standard treatments that often involve chemotherapy or autologous stem cell transplants, this method incorporates a unique conditioning regimen with ATG, fludarabine, and total body irradiation (TBI), followed by post-transplant cyclophosphamide to help reduce complications like graft-versus-host disease. Additionally, a dose of Rituxan is included to lower the risk of viral infections, and donor stem cells are sourced from peripheral blood, aiming for a high target cell infusion to enhance recovery and improve outcomes. Researchers are hopeful that these innovations will lead to better immune function and disease control, potentially setting a new standard in treatment for these challenging conditions.

What evidence suggests that this trial's treatments could be effective for blood cancer?

Research has shown that using healthy donor stem cells to replace damaged bone marrow, as in the allogeneic hematopoietic stem cell transplantation studied in this trial, can effectively treat severe aplastic anemia and some blood cancers. One study found that 55 patients who received this treatment had a 3-year survival rate of 71.8%, meaning about 72 out of every 100 people were still alive three years after the transplant. Another study found that early transplantation for severe aplastic anemia improved survival chances. Although risks exist, these studies suggest that this treatment can potentially cure certain blood cancers and severe bone marrow diseases.16789

Who Is on the Research Team?

Roni Tamari, MD - MSK Bone Marrow ...

Roni Tamari, MD

Principal Investigator

Memorial Sloan Kettering Cancer Center

Are You a Good Fit for This Trial?

This trial is for adults with certain high-risk blood cancers or severe aplastic anemia who haven't had a previous stem cell transplant. They should be responding to current therapy, have adequate organ function, and not be pregnant or HIV positive. A detailed consent form must be signed indicating willingness to participate.

Inclusion Criteria

I am able to care for myself and am up more than 50% of my waking hours.
Patients must be willing to participate as a research participant and sign an informed consent form
My heart, liver, kidneys, and lungs are all working well.
See 1 more

Exclusion Criteria

I have had a stem cell transplant from a donor.
I am HIV positive.
I have tested positive for HTLV-1.
See 9 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Conditioning

Participants undergo transplant conditioning with ATG, fludarabine, and TBI, followed by high dose cyclophosphamide post stem cell infusion

8 days
Inpatient stay

Transplantation

Stem cell infusion and administration of Rituxan to reduce EBV viremia risk

1 day
Inpatient stay

Post-Transplant Monitoring

Participants receive G-CSF and undergo chimerism studies and immune function assessments

24 months
Regular follow-up visits at 30 days, 100 days, 6, 12, 18, and 24 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

6 months

What Are the Treatments Tested in This Trial?

Interventions

  • Allogeneic Hematopoietic Stem Cell Transplantation
Trial Overview The study tests a new low-intensity combination of chemotherapy with low-dose radiation before a T cell depleted allogeneic hematopoietic stem cell transplantation. The goal is to determine safety and effectiveness in curing bone marrow cancer.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Patients with Myeloid Malignancies & Aplastic AnemiaExperimental Treatment6 Interventions

Allogeneic Hematopoietic Stem Cell Transplantation is already approved in European Union, United States, Canada, Japan for the following indications:

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Approved in European Union as Allogeneic Hematopoietic Stem Cell Transplantation for:
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Approved in United States as Allogeneic Hematopoietic Stem Cell Transplantation for:
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Approved in Canada as Allogeneic Hematopoietic Stem Cell Transplantation for:
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Approved in Japan as Allogeneic Hematopoietic Stem Cell Transplantation for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Memorial Sloan Kettering Cancer Center

Lead Sponsor

Trials
1,998
Recruited
602,000+

Citations

The outcome of allogeneic hematopoietic stem cell ...In this study, 55 patients undergoing allogeneic HSCT had HID, and their transplants resulted in a 3-year overall survival of 71.8%. Previously, the efficacy of ...
Evidence-Based Guidelines From the American Society for ...Allogeneic hematopoietic cell transplantation (HCT) is a potentially curative treatment for severe aplastic anemia (SAA).
OUTCOMES OF ALLOGENEIC STEM CELL ...This study presents data on allogeneic HSCT procedures performed in our transplant center for AML patients.
Allogeneic Hematopoietic Stem Cell Transplantation in ...Our study found that patients who received early allogeneic transplantation for SAA had better outcomes. Pre-engraftment failure was the major cause of ...
NCA - Allogeneic Hematopoietic Stem Cell Transplantation ...CMS has determined that the evidence does not demonstrate that the use of allogeneic hematopoietic stem cell transplantation (HSCT) improves health outcomes ...
Recent advances and current challenges in allogeneic ...This review article summarizes recent advances in allogeneic SCT for patients with acquired SAA, with the exception of CB transplantation.
Efficacy and Safety of Allogeneic Hematopoietic Stem Cell ...Allo-HSCT in SCD has OS, EFS, and mortality rates of 94%, 86% and 6%, respectively. •. NMA conditioning has the lowest aGVHD, cGVHD, and ...
Risks of Patient and Donor Genetics in Allogeneic ...Up to 30% of patients relapse after allo-HSCT, of which up to 2% to 5% are donor-derived malignancies (DDMs). DDMs can arise from a germline genetic ...
Allogeneic hematopoietic cell transplantation: the state of ...The estimated 5-year overall survival was 33%, with 5-year relapse and nonrelapse mortalities of 42 and 26%, respectively. Of note, patients in first and second ...
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