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Immuno-Augmentation With GM-CSF in Patients Receiving Pneumococcal Vaccine While Undergoing Treatment for Advanced Chronic Lymphocytic Leukemia (CLL)

Phase 2
Not Enrolling

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Trial Information

Immuno-Augmentation With GM-CSF in Patients Receiving Pneumococcal Vaccine While Undergoing Treatment for Advanced Chronic Lymphocytic Leukemia (CLL)

Sargramostim (also commonly called granulocyte macrophage colony stimulating factor -
GM-CSF) is a medication used to stimulate the bone marrow production of white blood cells
before a stem cell transplant, after chemotherapy or after a bone marrow transplant.
Pneumococcal vaccine is a medication used to prevent infections caused by a bacteria called
Streptococcus pneumoniae.

If you have not had a gammaglobulins test (a test to measure immunity against certain
infectious diseases) measured within three months before the study begins, then this blood
test will be done before you receive any study medications.

Women who are able to have children must have a negative urine pregnancy test before
starting treatment.

After consenting to this study, you will be randomly assigned (as in the toss of a coin) to
receive treatment with sargramostim in addition to the pneumococcal vaccine or to receive
pneumococcal vaccine alone (Prevnar).

- If you are randomized to vaccine plus sargramostim group, you will receive an injection
of sargramostim at the same time you receive the pneumococcal vaccine.

- If you are randomized to the vaccine alone group, you will receive the pneumococcal
vaccine on the first day.

Blood tests will be performed on the day of the pneumococcal vaccination, and 4 weeks, 12
weeks and 24 weeks after vaccination. Each of the blood tests will require about 4
teaspoons of blood. These blood tests will measure your immunity to pneumococcal infection.

If after 6 months of your first vaccination your body is not able to show immunity to
pneumococcal infection, you will receive a second dose either pneumococcal vaccine plus
sargramostim or pneumococcal vaccine alone. Your immunity will be checked again at 4 weeks,
12 weeks, and 24 weeks after this second dose. Only 4 teaspoon of blood will be required for
the tests.

You may be removed from the study if you have a severe allergic reaction to the sargramostim
and/or pneumococcal vaccine. The total maximum time you will be on this is study is 24

This is an investigational study. Both of the medications used in this study are approved
by the FDA. Up to 50 patients may be treated on this study. All will be enrolled at M.D.

Inclusion Criteria:

1) Patients in complete / partial remission or those with active Chronic lymphocytic
leukemia (CLL) with Rai stage 0 to 4.

Exclusion Criteria:

1. Patients will not be entered while neutropenic (PMNs < 500 cells/mm3) or having
received Rituximab within 6 months.

2. Patients will not be entered while febrile (Temperature > 38 degrees C) within 1

3. Active infection.

4. Patients with known Human immunodeficiency virus (HIV) infection.

5. Known history of allergy to Granulocyte/ macrophage colony stimulating factor
(GM-CSF) or pneumococcal vaccine.

6. Chemotherapy other than Campath, fludarabine, cyclophosphamide, in 4 weeks.

7. Patients who have previously received pneumococcal vaccine within the preceding 12

8. Absolute lymphocyte count less than 500 cells/mm3.

Type of Study:


Study Design:

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Number of Participants (With Increase) Immune Response to GM-CSF With a Pneumococcal Vaccine

Outcome Description:

Response defined as 2-fold rise in anticapsular immunoglobulin G (IgG) when prevaccination titer is compared with levels post vaccination and with a final level of >0.5 ug/mL. Anti-pneumococcal immunoglobulin titers measured at baseline and 1 month after vaccine. Response determined by measuring serum IgG to capsular polysaccharides from 6 of the most common infecting serotypes of Streptococcus pneumoniae.

Outcome Time Frame:

Baseline and at 1 month after vaccine.

Safety Issue:


Principal Investigator

Amar Safdar, MD

Investigator Role:

Principal Investigator

Investigator Affiliation:

M.D. Anderson Cancer Center


United States: Institutional Review Board

Study ID:




Start Date:

June 2004

Completion Date:

May 2011

Related Keywords:

  • Leukemia
  • Chronic Lymphocytic Leukemia
  • Leukemia
  • Sargramostim
  • Pneumococcal Pneumonia
  • Pneumococcal Vaccine
  • Prevnar
  • GM-CSF
  • CLL
  • Leukemia
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Leukemia, Lymphoid



UT MD Anderson Cancer CenterHouston, Texas  77030