Acute Myeloid Leukemia Clinical Trial

Cytokine Induced Memory-like NK Cell Adoptive Therapy for Relapsed AML After Allogeneic Hematopoietic Cell Transplant

Summary

Donor Lymphocyte Infusion (DLI) following salvage chemotherapy is the one of the most widely used treatment approaches in patients who relapse after allogeneic hematopoietic cell transplant (allo-HCT). However, the complete remission (CR) rates and long term survival remain very poor in these patients and, therefore, there is an unmet need to develop more effective treatment approaches in patients who relapse after allo-HCT.

Based on the initial promising results with our ongoing cytokine-induced memory-like (CIML) natural killer (NK) cell trial, the investigators hypothesize that combining the CIML NK cells with DLI approach will significantly enhance the graft versus leukemia and therefore potentially provide potentially curative therapy for these patients with otherwise extremely poor prognosis. Combining CIML NK cells with the DLI platform will also potentially allow these adoptively transferred cells to persist for longer duration as they should not be rejected by donor T cells as the CIML NK cells are derived from the same donor. The use of CIML NK cells is unlikely to lead to excessive graft versus host disease (GVHD) as previous studies have not been associated with excessive GVHD rates.

View Eligibility Criteria

Eligibility Criteria

Recipient Inclusion Criteria:

Relapsed AML after HLA-matched related or unrelated allogeneic hematopoietic cell transplant
For pilot pediatric/young adult patient cohort ≥1 and <18 years of age
For phase 2 adult patient cohort ≥18 years of age
Available original donor (same donor as used for the initial stem cell transplant) that is willing and eligible for non-mobilized collection
Patients with known central nervous system (CNS) involvement with AML are eligible provided that they have been treated and cerebrospinal fluid (CSF) is clear for at least 2 weeks prior to enrollment into the study. CNS therapy (chemotherapy or radiation) should continue as medically indicated during the study treatment.
Karnofsky performance status > 60 %

Adequate organ function as defined below:

Total bilirubin < 2 mg/dL
AST(SGOT)/ALT(SGPT) < 3.0 x IULN
Creatinine within normal institutional limits OR creatinine clearance > 60 mL/min/1.73 m2 by Cockcroft-Gault Formula
Oxygen saturation ≥90% on room air
Not currently requiring systemic corticosteroid therapy (10 mg or less of prednisone or equivalent doses of other systemic steroids are allowed) or any other immune suppressive medications
Women of childbearing potential must have a negative pregnancy test within 28 days prior to study registration. Female and male patients (along with their female partners) must agree to use two forms of acceptable contraception, including one barrier method, during participation in the study including throughout the initial evaluation period (100 days after CIML NK cell infusion).
Ability to understand and willingness to sign an IRB approved written informed consent document (or that of legally authorized representative, if applicable).

Recipient Exclusion Criteria:

Acute or chronic GvHD with ongoing active systemic treatment.
Circulating blast count >10,000/uL by morphology or flow cytometry (cyto-reductive therapies, including salvage chemotherapy, is encouraged prior to study enrollment)
Uncontrolled bacterial or viral infections, or known HIV, Hepatitis B, or Hepatitis C infection.
Uncontrolled angina, severe uncontrolled ventricular arrhythmias, or EKG suggestive of acute ischemia or active conduction system abnormalities.
New or progressive pulmonary infiltrates concerning for new or uncontrolled infectious process.
Known hypersensitivity to one or more of the study agents
Received any investigational drugs within the 14 days prior to CIML NK cell infusion date
Pregnant and/or breastfeeding

Donor Inclusion Criteria:

At least 18 years of age
Same donor as used for the allo-HCT
In general good health, and medically able to tolerate leukapheresis
Ability to understand and willingness to sign an IRB approved written informed consent document

Donor Exclusion Criteria:

Active hepatitis, positive for HTLV, or HIV on donor viral screen
Pregnant

Study is for people with:

Acute Myeloid Leukemia

Phase:

Phase 1

Estimated Enrollment:

110

Study ID:

NCT03068819

Recruitment Status:

Recruiting

Sponsor:

Washington University School of Medicine

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There is 1 Location for this study

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Washington University School of Medicine
Saint Louis Missouri, 63110, United States More Info
Amanda Cashen, M.D.
Contact
314-454-8323
[email protected]
Amanda Cashen, M.D.
Principal Investigator
Jeffrey Bednarski, M.D., Ph.D.
Sub-Investigator
Todd Fehniger, M.D., Ph.D.
Sub-Investigator
Shalini Shenoy, M.D.
Sub-Investigator
Robert Hayashi, M.D.
Sub-Investigator
Andrew Cluster, M.D.
Sub-Investigator
Peter Westervelt, M.D., Ph.D.
Sub-Investigator
Geoffrey Uy, M.D.
Sub-Investigator
Ravi Vij, M.D.
Sub-Investigator
Camille Abboud, M.D.
Sub-Investigator
Rizwan Romee, M.D.
Sub-Investigator
Meagan Jacoby, M.D., Ph.D.
Sub-Investigator
Iskra Pusic, M.D.
Sub-Investigator
Armin Ghobadi, M.D.
Sub-Investigator
Mark Schroeder, M.D.
Sub-Investigator
Keith Stockerl-Goldstein, M.D.
Sub-Investigator

How clear is this clinincal trial information?

Study is for people with:

Acute Myeloid Leukemia

Phase:

Phase 1

Estimated Enrollment:

110

Study ID:

NCT03068819

Recruitment Status:

Recruiting

Sponsor:


Washington University School of Medicine

How clear is this clinincal trial information?

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