TK008 Randomized Phase III Trial of Haploidentical HCT With or Without an Add Back Strategy of HSV-Tk Donor Lymphocytes in Patients With High Risk Acute Leukemia
Delayed immune-reconstitution remains one of the main limitation of haploidentical stem cell
transplantation. The risk of severe infections remains high for several months and CD4+
reconstitution could take more than 10 months. The low number of lymphocytes infused with
the graft, the degree of HLA disparity, and a reduced thymic function in adults and
differences in host/donor antigen presenting cells are contributing causes.
The infusions of HSV-TK engineered lymphocytes may represent a significant therapeutic
improvement in haploidentical HCT, because it remarkably may enhance both GvL activity, thus
reducing the occurrence of disease relapse, and post-transplant immune reconstitution in the
absence of chronic immune suppression, thus decreasing the rate of both post-transplant
opportunistic infections and transplant-related mortality. Furthermore, the efficient
control of GvHD achieved via the suicide mechanism allows also the multiple infusion of
HSV-TK-treated donor lymphocytes, when needed, that might further improve post-transplant
host immune reconstitution, and survival in patients receiving haplo-HCT. Finally, this
therapeutic approach can become a valuable option for all candidates, including patients
with advanced disease and older age.
The proposed clinical trial represents an innovative therapeutic treatment for patients
affected by high risk acute leukemia, who have undergone haploidentical stem cell
transplantation.
Interventional
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Disease-free survival (DFS)
From the randomization date to relapse date or death
Yes
Fabio Ciceri, MD
Principal Investigator
Fondazione San Raffaele
Italy: The Italian Medicines Agency
TK008
NCT00914628
February 2010
June 2016
Name | Location |
---|---|
Northwestern University Feinberg School of Medicine | Chicago, Illinois 60611 |
Washington University Medical School | St. Louis, Missouri 63110 |