Overview

Fucosylated T Cells for Graft Versus Host Disease (GVHD) Prevention

Status:
Completed

Trial end date:
2020-10-06

Target enrollment:
0

Participant gender:
All

Summary

Any time the words "you," "your," "I," or "me" appear, it is meant to apply to the potential participant. T-cells are white blood cells that are important to the immune system. The T cells for this study (called regulatory T-cells, or Tregs) will be from a donor who is not related to you. Before the Tregs are given to you, they may be changed in the laboratory to make use of sugar that is found in small amounts in blood cells through a process called fucosylation. They are then called fucosylated Tregs. Adding more sugars to the Tregs in the laboratory is designed to help the Tregs find their way faster to the bone marrow, which may help low blood counts to recover faster. The goal of this clinical research study is to learn if it is safe and practical to give fucosylated Tregs to patients who will receive a matched related donor (MRD), a matched unrelated donor (MUD), or cord blood transplant. Researchers also want to learn if these Tregs may prevent or reduce the effects of graft-versus host disease (GVHD). GVHD can result from a reaction of the transplanted cord blood cells against certain tissues in the body. This is an investigational study. Fucosylation of Tregs is not an FDA-approved process. It is currently being used for research purposes only. Fludarabine, melphalan, cyclophosphamide and rituximab are FDA approved and commercially available to be given to patients with leukemia or lymphoma having a cord blood transplant. Total body irradiation is delivered using FDA-approved and commercially available methods. Up to 47 patients will take part in this study. All will be enrolled at MD Anderson.

Phase:

Phase 1

Accepts Healthy Volunteers?

Details

Lead Sponsor:

M.D. Anderson Cancer Center

Collaborators:

Cancer Prevention Research Institute of Texas
National Cancer Institute (NCI)
Targazyme, Inc.

Treatments:

Cyclophosphamide
Everolimus
Fludarabine
Fludarabine phosphate
Lenograstim
Mycophenolate mofetil
Mycophenolic Acid
Rituximab
Sirolimus
Vidarabine

Criteria

Inclusion Criteria:

1. Patients with high risk hematologic malignancies, including those with induction
failure and in relapse.

2. Patients must have matched related or matched unrelated donor source OR CB unit(s)
available for the primary transplant which is/are matched with the patient at 4, 5, or
6/6 HLA class I (serological) and II (molecular) antigens. The cord(s) must contain at
least 3 x 107 total nucleated cells/Kg recipient body weight (pre-thaw).

3. Age Criteria: Age >/= 18 and be determined in conjunction with an MDACC pediatrician.

4. Bilirubin
5. Calculated creatinine clearance of >50 mL/min using the Cockcroft-Gault equation for
adult patients 18 to 70 years old based on ideal body weight.

6. Diffusing capacity for carbon monoxide (DLCO) >/= 45% predicted corrected for
hemoglobin. For children function test, an O2 saturation of >/= 92% on room air.

7. Left ventricular ejection fraction (LEF) >/= 40%.

8. Zubrod performance status /= 60%.

9. Twenty-one or more days must have elapsed since the patient's last radiation or
chemotherapy administration before beginning treatment for stem cell transplant.
Hydrea, Gleevec and other TKI inhibitors as well as intrathecal therapy are accepted
exceptions.

10. A back-up graft identified, in case of graft failure, from any of the following
sources: an available fraction of autologous marrow; or PBPCs harvested and
cryopreserved; or family member donor; or a third cord blood unit.

11. Able to stop all CYP3A4 inhibitors (voriconazole or posaconazole) at least 7 days
before admission.

Exclusion Criteria:

1. HIV seropositivity.

2. Uncontrolled infection, not responding to appropriate antimicrobial agents after seven
days of therapy. The PI is the final arbiter of eligibility.

3. Positive beta HCG in female of child-bearing potential defined as not post-menopausal
for 12 months or no previous surgical sterilization or lactating females.

4. Unable to sign informed consent.