Allogeneic Stem Cell Transplantation of NiCord®, Umbilical Cord Blood-Derived Ex Vivo Expanded Stem and Progenitor Cells, in Combination With a Second, Unmanipulated Cord Blood Unit in Patients With Hematological Malignancies
Allogeneic hematopoietic stem cell transplantation (HSCT) is a potentially curative
procedure for various hematological malignancies, bone marrow failure syndromes and
inherited metabolic disorders. The application of allogeneic HSCT is limited by donor
availability such that only approximately one-third of the otherwise appropriate candidates
have suitably matched family donors. Alternative donors include mismatched family members or
matched unrelated donors, but these approaches are often complicated by an increased risk of
graft-versus-host disease (GvHD) and a prolonged and cumbersome search and procurement
process. In addition, far fewer subjects of racial minorities find suitable human leukocyte
antigen (HLA)-matched donors.
Umbilical cord blood has been increasingly used as an alternative source of stem cells and
has extended the availability of allogeneic HSCT to patients who would otherwise not be
eligible for this curative approach. In the last decade the number of cord blood
transplantations from related and unrelated donors has increased dramatically. It is
estimated that more than 20,000 patients have undergone cord blood transplantation from
unrelated donors to date for a variety of genetic, hematological, immunological, metabolic
and oncologic disorders. The major advantages of cord blood transplantation include easy
procurement, no risk to donors, reduced incidence of transmitting infections, immediate
availability, and reduced risk of acute GvHD in the setting of donor-recipient HLA mismatch.
Nevertheless, the low cell dose remains a main limitation of this cell source leading to
delayed hematopoietic reconstitution, higher risk of graft failure and relatively high
treatment related mortality rates as compared to other hematopoeitic cell sources. To
improve outcomes and extend applicability of cord blood transplantation, one potential
solution is ex vivo expansion of cord blood-derived stem and progenitor cells.
The Sponsor has undertaken to develop NiCord®, which is based on a novel technology for ex
vivo cell expansion of cord blood derived hematopoietic progenitor cells. By increasing the
number of the short and long-term reconstitution progenitor cells transplanted, NiCord® has
the potential to enable broader application of umbilical cord blood transplantation and
improve clinical outcomes in subjects with high-risk hematological malignancies.
The main objective of the current study is to evaluate the safety of co-transplantation of
NiCord® and an unmanipulated cord blood unit in patients with hematological malignancies
following myeloablative therapy.
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Safety and Tolerability: will be measured by acute NiCord® infusional toxicity, and assessment of the proportion of patients with neutrophil engraftment
180 days post-transplant
David Snyder, PhD
Gamida Cell ltd
United States: Food and Drug Administration
|Duke University Medical Center||Durham, North Carolina 27710|
|Loyola University, Cardinal Bernardin Cancer Center||Maywood, Illinois 60153|