This study is designed for determining the safety and relative engraftment levels of the redirected autologous T cells transduced with the anti-CD19 lentiviral vector in patients with CD19-positive B cell leukemia and malignant lymphoma.
A single arm open-label pilot study is designed to determine the safety, tolerability and engraftment potential of CAR-CD19 T cells in patients with CD19-positive malignant B cell leukemia and lymphoma. All subjects will receive CAR-CD19 T cells infusion. Primary objectives: 1. Determine the safety and feasibility of the chimeric antigen receptor T cells transduced with the anti-CD19 lentiviral vector (referred to as "CAR-CD19 T" cells). 2. Determine the duration of in vivo survival of CAR-CD19 T cells. Secondary objectives: 1. For patients with detectable disease, measure anti-tumor response due to CAR-CD19 T cells infusions. 2. To determine the amplification and survival of CAR-CD19 T 4-1BB:CD3ζ and CD28:CD3ζ as measured by the relative engraftment levels of CAR-CD19 T 4-1BB:CD3ζ and CD28:CD3ζ cells over time. 3. Estimate relative trafficking of CAR-CD19 T cells to tumors in bone marrow and lymphnodes. 4. Determine if cellular or humoral host immunity develops against the murine anti-CD19, and assess correlation with loss of detectable CAR-CD19 T (loss of engraftment). 5. Determine the relative subsets of CAR-CD19 T cells.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
45
Initial dose: A total of 1 - 10×10\^7 CAR-CD19 T cells/kg will be administered by 1 - 3 infusions. Subsequent dose will be based on the subject's response to initial dose.
30 mg/m\^2/day×4 days
500 mg/m\^2/day×2 days
Renji Hospital, Shanghai Jiaotong University School of Medicine
Shanghai, Shanghai Municipality, China
Study related adverse events
Occurrence of study related adverse events, defined as NCI CTC ≥ Grade 3 signs/symptoms, laboratory toxicities and clinical events that are possible, likely or definitely related to study treatment at any time from the infusion until week 24, including infusional toxicity and any toxicity possibly related to the CAR-CD19 T cells.
Time frame: 24 weeks
Primary engraftment endpoint
Duration of in vivo survival of CAR-CD19 T cells is defined as "engraftment". The primary engraftment endpoint is the # DNA vector copies per mg blood of CAR-CD19 T cells on week 4 after the first infusion. Q-PCR for CAR-CD19 T vector sequences will also be performed after infusion at 24 hours, weekly x 4, monthly x 6, and every 3 months thereafter until any 2 sequential tests are negative documenting loss of CAR-CD19 T cells.
Time frame: 2 years
Anti-tumor responses
Describe anti-tumor responses to CAR-CD19 T cell infusions.
Time frame: 2 years
Overall survival
Describe overall survival and cause of death.
Time frame: 2 years
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