Stem Cell Transplant for Sickle Cell Disease

(HaploSCD Trial)

Not currently recruiting at 6 trial locations
Age: < 65
Sex: Any
Trial Phase: Phase 2
Sponsor: New York Medical College
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new treatment for sickle cell disease using a stem cell transplant called CD34 selected T-cell depleted allogeneic SCT. The goal is to determine if high-dose chemotherapy followed by a transplant of immune cells from a family member can safely control sickle cell disease long-term. The trial seeks participants with sickle cell disease who experience serious complications such as strokes, repeated chest problems, or frequent pain episodes. Participants must have a family member who can donate cells and does not have severe sickle cell disease. As a Phase 2 trial, this research focuses on measuring the treatment's effectiveness in an initial, smaller group, offering participants a chance to contribute to advancing treatment options for sickle cell disease.

Will I have to stop taking my current medications?

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

Is there any evidence suggesting that this treatment is likely to be safe for humans?

Research has shown that using CD34 selected T-cell depleted stem cells can be promising for people with sickle cell disease. In past studies, about 5.4% of patients experienced graft failure, meaning the transplanted cells didn't grow. Graft rejection, where the body attacks the transplanted cells, occurred in about 7.5% of patients.

One study found that a year after treatment, 83% of patients were still alive, although two individuals died from infections. These findings suggest that while risks exist, many patients respond well to this treatment.

Other reports indicate that the safety of this type of stem cell transplant has improved over time. It is considered a potential cure for sickle cell disease, but discussing possible risks with a doctor is important.12345

Why do researchers think this study treatment might be promising for sickle cell disease?

Unlike the standard treatments for sickle cell disease, such as hydroxyurea or blood transfusions, the stem cell transplant under study offers a potentially curative approach. This treatment utilizes CD34 selected T-cell depleted allogeneic stem cell transplantation, which involves replacing the patient’s defective blood-forming cells with healthy ones from a donor. Researchers are excited about this method because it specifically targets the root cause of the disease, offering the potential to eliminate sickle cell symptoms entirely, rather than just managing them. This approach is groundbreaking as it aims to provide long-term solutions rather than short-term relief.

What evidence suggests that this stem cell transplant is effective for sickle cell disease?

Research has shown that a specific type of stem cell transplant, which involves removing certain T-cells, can effectively treat severe sickle cell disease. In this trial, participants will receive the CD34-selected T-cell depleted allogeneic stem cell transplant. Studies have found that recipients of this transplant have a high survival rate of 90% to 100%. The risk of transplant failure is about 10%. The chance of developing acute graft-versus-host disease (GVHD), where donor cells attack the body, ranges from 0% to 10%. Chronic GVHD, a longer-lasting form, occurs in about 20% of cases. These findings suggest that this treatment could help control the disease over the long term.12367

Who Is on the Research Team?

Mitchell S. Cairo, M.D. | New York ...

Mitchell S Cairo, MD

Principal Investigator

New York Medical College

Are You a Good Fit for This Trial?

This trial is for high-risk sickle cell disease patients who've had multiple painful events, adequate organ function, and specific complications like stroke or acute chest syndrome. They need a partially matched family donor and can't be pregnant, breastfeeding, non-compliant with medical care, have significant liver fibrosis/cirrhosis or previous stem cell transplants.

Inclusion Criteria

I have had a stroke or brain injury related to my sickle cell disease.
I have had at least 3 painful episodes in the last 2 years.
My kidney, liver, heart, and lungs are working well.
See 7 more

Exclusion Criteria

Demonstrated lack of compliance with medical care.
I have severe liver scarring.
I am not pregnant or breastfeeding.
See 4 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Chemotherapy

Participants receive a high-dose chemotherapy regimen as part of the conditioning process

4-6 weeks

Stem Cell Transplantation

Infusion of CD34 selected T-cell depleted allogeneic stem cells from a haploidentical donor

1 week

Follow-up

Participants are monitored for safety, effectiveness, and long-term outcomes such as donor chimerism and organ function

4 years

What Are the Treatments Tested in This Trial?

Interventions

  • CD34 selected T-cell depleted allogeneic SCT
Trial Overview The study tests the safety and effectiveness of high-dose chemotherapy followed by an infusion of immune cells from a family member to manage sickle cell disease. It aims to see if this approach offers long-term control over the condition.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Haplo Stem Cell TransplantationExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

New York Medical College

Lead Sponsor

Trials
73
Recruited
8,700+

Miltenyi Biomedicine GmbH

Industry Sponsor

Trials
38
Recruited
1,700+

Ann & Robert H Lurie Children's Hospital of Chicago

Collaborator

Trials
275
Recruited
5,182,000+

Washington University School of Medicine

Collaborator

Trials
2,027
Recruited
2,353,000+

UCSF Benioff Children's Hospital Oakland

Collaborator

Trials
80
Recruited
19,100+

Medical College of Wisconsin

Collaborator

Trials
645
Recruited
1,180,000+

Tufts Medical Center

Collaborator

Trials
264
Recruited
264,000+

University of California, Los Angeles

Collaborator

Trials
1,594
Recruited
10,430,000+

University of California, San Francisco

Collaborator

Trials
2,636
Recruited
19,080,000+

Published Research Related to This Trial

In a study of 29 sickle cell disease patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT), T-cell neogenesis was initially normal but declined post-transplant, fully restoring to healthy levels by one year, while B-cell neogenesis remained elevated throughout follow-up.
The presence of increased IL-10-producing B-regulatory cells after transplantation suggests a potential improvement in immune regulation and homeostasis, which may be beneficial for patient outcomes.
Allogeneic haematopoietic stem cell transplantation resets T- and B-cell compartments in sickle cell disease patients.Jarduli-Maciel, LR., de Azevedo, JTC., Clave, E., et al.[2022]
Myeloablative allogeneic hematopoietic stem cell transplantation (allo-HSCT) has shown to be curative for children with sickle cell disease (SCD), but recent advancements in nonmyeloablative allo-HSCT have made it a viable option for adults, leading to stable mixed hematopoietic chimerism and normalization of blood counts.
The potential for immunologic tolerance in adults receiving nonmyeloablative allo-HSCT suggests that this approach could safely expand treatment options for SCD patients, including the use of alternative donor sources, thereby increasing the accessibility of curative therapies.
Allogeneic hematopoietic stem cell transplantation for sickle cell disease: the time is now.Hsieh, MM., Fitzhugh, CD., Tisdale, JF.[2021]
In a study of 36 patients with sickle cell disease undergoing nonmyeloablative HLA-matched stem cell transplantation, 28% had pre-existing HLA class I antibodies, which led to increased platelet transfusion requirements post-transplant.
Patients with RBC alloantibodies required more red blood cell transfusions and showed significantly lower donor T cell chimerism at one year, indicating that pre-existing RBC alloimmunization may negatively impact long-term engraftment outcomes.
The impact of pre-existing HLA and red blood cell antibodies on transfusion support and engraftment in sickle cell disease after nonmyeloablative hematopoietic stem cell transplantation from HLA-matched sibling donors: A prospective, single-center, observational study.Nickel, RS., Flegel, WA., Adams, SD., et al.[2022]

Citations

Alternative donor hematopoietic stem cell transplantation for ...These trials have reported approximate overall survival of 90% to 100%, graft failure 10%, acute GVHD 0% to 10%, and chronic GVHD 0% to 20%. A recent study of ...
Outcomes with CD34-Selected Stem Cell Boost for Poor ...Highlights · CD34-selected stem cell boost improves outcomes for poor graft function after allogeneic hematopoietic stem cell transplantation.
NCT01461837 | Haplo T-Cell Depleted Transplantation in ...This study is being done to determine the safety and outcome (long-term control) of a high-dose chemotherapy regimen followed by an infusion of CD34 selected ( ...
Allogeneic hematopoietic stem cell transplantation to cure ...Disease-free survival at 5 years among those who received MUD-HSCT was 83%, comparatively lower than those who received MSD-HSCT (96%). However, ...
Clinical Outcomes Among Patients With Sickle Cell ...Graft failure was reported in 5.4% (1.1%–80.0%, 21 studies) of patients, graft rejection in 7.5% (0.5%–42.9%, 50 studies) of patients, acute ...
Alternative donor hematopoietic stem cell transplantation for ...A CD34-selected, T-cell–depleted alternative donor graft after a reduced conditioning regimen resulted in engraftment in patients with ...
Haploidentical Allogeneic Stem Cell Transplantation in ...We conclude that the safety of haploidentical SCT in SCD patients has improved significantly, and that this should be considered as a curative option in ...
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