This is a single-institution, phase II study to determine the event-free survival at 1 year post allogeneic transplant and serial mesenchymal stem cell (MSC) infusions from a related donor (HLA identical, mismatched or haploidentical) or matched unrelated donor for the biochemical correction of severe epidermolysis bullosa (EB).
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
17
0.5 mg/kg IV over 6 hours on day -9 and 2 mg/kg IV over 4 hours on day -8 and day -7 with premeds and solumedrol through day -2
14.5 mg/kg IV over 1 hour day -6 and -5 50 mg/kg IV over 2 hours with mesna 40 mg/kg IV day +2 and +3
30 mg/m2 IV over 60 minutes days -6 through day -2
University of Minnesota Masonic Cancer Center and Medical Center
Minneapolis, Minnesota, United States
Event-free Survival
An event defined as death or a 50% increase in a patient's IScoreEB from baseline
Time frame: 1 year post-transplant
Change of a Patient's iscorEB
iscorEB surveys are a validated, standard of care tool used to assess disease status in patients with Epidermolysis Bullosa. Measure changes in quality of life (QOL) through pain, itching, and general QOL IScorEB questionnaire. Scores can range from 16 to 112. The QOLS scores are summed so that a higher score indicates higher quality of life.
Time frame: 1 year post-transplant
Transplant-related Mortality
Cumulative incidence will be used to estimate the probability of relapse treating non-relapse death as a competing risk and transplant-related mortality conversely treating relapse as a competing risk.
Time frame: 180 days post-transplant
Average Change in Quality of Life
Measured by the Lansky or Karnofsky score (10-100). Higher scores indicate a better outcome. Midpoint of change in scores used to indicate median.
Time frame: 1 year post-transplant
Average Change in Quality of Life
Measured by the Lansky or Karnofsky score (10-100). The Karnofsky Performance Scale is an assessment tool intended to gauge a patient's functional status and ability to carry out activities of daily living. Higher scores indicate a better outcome. Midpoint of change in scores used to indicate median.
Time frame: 2 years post-transplant
Lymphoid Chimerism
Median hematopoietic cells that are of donor origin per participant.
Time frame: Day 28, 60, 100, 180, and year 1 and 2 post-transplant
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See arm description for dosing.
Bone marrow infusion on Day 0
Day +5 through day +100 with goals of 5-10 ug/L (not used for HLA-identical related donors). When used in non-MSD recipients, tapered over 6-8 weeks starting at day +100.
15 mg/kg IV q8h (based upon actual body weight) with the maximum total daily dose not to exceed 3 grams. Day +5 through day 35
Day 60, 100 and 180 (collected during donor BM harvest for graft)
busulfan IV over 3 hours on days -3 and -2 for HLA-mismatched BM recipients only (Arms F and G)
Myeloid Chimerism
Median hematopoietic cells that are of donor origin per participant.
Time frame: Day 28, 60, 100, 180, and year 1 and 2 post-transplant
Average Change of a Patient's iscorEB
iscorEB surveys are a validated, standard of care tool used to assess disease status in patients with Epidermolysis Bullosa. Measure percent of changes in quality of life (QOL) through pain, itching, and general QOL IScorEB questionnaire. Scores can range from 16 to 112. The QOLS scores are summed so that a higher score indicates higher quality of life.
Time frame: 2 year post-transplant