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A Phase II Study Evaluating the Safety and Efficacy of Intravenous AMD3100 for the Mobilization and Transplantation of HLA-Matched Sibling Donor Hematopoietic Stem Cells in Patients With Advanced Hematological Malignancies


Phase 2
18 Years
65 Years
Not Enrolling
Both
Hematologic Neoplasms

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Trial Information

A Phase II Study Evaluating the Safety and Efficacy of Intravenous AMD3100 for the Mobilization and Transplantation of HLA-Matched Sibling Donor Hematopoietic Stem Cells in Patients With Advanced Hematological Malignancies


- To reduce the number of donors treated with IV AMD3100 who require a second collection
to obtain the minimum CD34/kg (2 X 106) necessary for allogeneic stem cell
transplantation when compared to our historic group who received 240ug SC AMD3100 from
33% (8 in 24) to 11% (3 in 27).

- To estimate with 95% confidence intervals the proportion of HLA-identical sibling
donors who experience grade 3-4 infusional toxicity and the proportion from whom ≥ 2.0
x 10e6 CD34+ cells/kg recipient weight are safely mobilized following one or two
intravenous infusions.

- To determine the kinetics of stem cell and lymphocyte mobilization using IV AMD3100 and
to determine if peripheral blood stem cell products collected after mobilization with
IV AMD3100 can be used safely for hematopoietic cell transplantation in HLA-matched
recipients as measured by neutrophil engraftment by day +21.

- To determine the pharmacokinetics and pharmacodynamics of IV AMD3100 on stem cell and
T-cell phenotyping and on immune reconstitution after transplantation.

- To determine the rate of acute GVHD and chronic GVHD in patients who receive IV AMD3100
mobilized peripheral blood stem cells.


Inclusion Criteria:



Donor Eligibility

- Donor is 18 to 70 years of age inclusive.

- If female and of child-bearing age: must be non-pregnant, not breast feeding and
agree to use adequate contraception.

- Donor is a 6/6 HLA-matched sibling willing to donate PBSC for transplant.

- Donor must be willing to provide written informed consent.

- Adequate cardiac function with no history of congestive heart failure and no history
of atrial fibrillation or ventricular tachyarrhythmia.

- Adequate renal function as defined by a calculated serum creatinine clearance of ≥75%
of normal (Cockcroft-Gault equation).

- Adequate hepatic function as defined by a total bilirubin <2x normal or absence of
hepatic fibrosis/cirrhosis.

- Adequate neurologic function as defined by NO evidence of a severe central or
peripheral neurologic abnormality. No history of cerebrovascular accident or seizure
disorder requiring anticonvulsant medication.

- Donor must be HIV-1&2 antibody and HTLV-I&II antibody sero-negative, by FDA licensed
test.

- Donor must have an ECOG performance status of 0 or 1.

- Donor must demonstrate ability to be compliant with study regimen.

- Donor must not have an active infection at the time of study entry.

- Donor does not have active alcohol or substance abuse within 6 months of study entry.

- Donor is not currently enrolled on another investigational agent study.

- Donor does not have any medical condition, which, in the opinion of the clinical
investigator, would interfere with his/her evaluation.

Recipient Eligibility

- Recipient must have available the successful collection of an AMD3100 mobilized
product. When an adequate collection cannot be obtained using G-CSF, some recipients
may need to receive a combined product of mobilized cells with AMD3100 and G-CSF.
Recipients who receive less than 2.0 X 106 CD34+ cells/kg/actual recipient weight
after two days of IV AMD3100 will not be considered "eligible" but followed per
protocol for safety purposes only.

- Patient is 18 to 65 years of age inclusive.

- Patient is willing and has a 6/6 HLA-matched sibling willing to donate PBSC for
transplant.

- Patient must provide signed informed consent.

- If female and of child-bearing age: must be non-pregnant, not breast feeding, and
uses adequate contraception.

- Patient must have one of the following diagnoses:

- Acute myelogenous leukemia (AML) in 1st or subsequent remission or in relapse,

- Acute lymphoblastic leukemia (ALL) in 1st or subsequent remission or in relapse,

- Myelodysplastic syndrome either intermediate 1 or 2, or high risk by the
International Prognostic Scoring System,

- Chronic myelogenous leukemia (CML) in accelerated or second chronic phase,

- Non-Hodgkin's lymphoma (NHL) or Hodgkin's disease (HD) in 2nd or greater complete
remission, partial remission, or refractory relapse,

- Chronic lymphocytic leukemia (CLL), Rai Stage 2-4, failing at least 2 prior regimens,
OR

- Multiple myeloma (MM), Stage 2-3.

- Adequate cardiac function with a left ventricular ejection fraction ≥ 40%.

- Adequate pulmonary function defined as NO severe or symptomatic restrictive or
obstructive lung disease, and formal pulmonary function testing showing an FEV1 ≥50%
of predicted and a DLCO ≥40% of predicted, corrected for hemoglobin.

- Adequate renal function as defined by a serum creatinine clearance of ≥75% of normal
(Cockcroft-Gault equation).

- Adequate hepatic function as defined by a total bilirubin <2x normal or absence of
hepatic fibrosis/cirrhosis.

- Adequate neurologic function as defined by NO evidence of a severe central or
peripheral neurologic abnormality. Patients with a history of previous CNS tumor
involvement are eligible provided they are without symptoms or signs and the CNS is
now free of disease on lumbar puncture and CT scan of the brain.

- No evidence of active infection at the time of the transplant preparative regimen or
at time of transplantation.

- Patient must be HIV-1&2 antibody and HTLV-I & II antibody sero-negative, by FDA
licensed test.

- Patient has an ECOG performance status of 0 or 1.

- Patient must demonstrate ability to be compliant with medical regimen.

- Patient must not have active alcohol or substance abuse within 6 months of study
entry.

- Patient must not be enrolled on another investigational agent concurrently.

- Patient must not have any medical condition, which, in the opinion of the clinical
investigator, would interfere with the evaluation of the patient.

Exclusion Criteria:

- See Inclusion criteria above

Type of Study:

Interventional

Study Design:

Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

To reduce the number of donors treated with IV AMD3100 who require a second collection to obtain the minimum CD34/kg (2 X 106) necessary for allogeneic stem cell transplant when compared to our historic group who received 240ug SC AMD3100.

Outcome Time Frame:

1 year

Safety Issue:

Yes

Principal Investigator

John DiPersio, M.D., Ph.D.

Investigator Role:

Principal Investigator

Investigator Affiliation:

Washington University School of Medicine

Authority:

United States: Food and Drug Administration

Study ID:

09-0713 / 201103429

NCT ID:

NCT00914849

Start Date:

August 2009

Completion Date:

February 2012

Related Keywords:

  • Hematologic Neoplasms
  • Neoplasms
  • Hematologic Neoplasms

Name

Location

Washington University School of Medicine Saint Louis, Missouri  63110