This is a single center pilot study of a non-myeloablative umbilical cord blood transplant for the treatment of a hematological malignancy with a single infusion of T regulatory (Treg) given shortly after UCB transplantation.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
3
Allopurinol on day -7 to day 0 Cyclophosphamide 50 mg/kg IV over 2 hours on day -6 Fludarabine 30mg/m2 IV over 1 hour on day -6, -5, -4, -3, and -2 Total Body Irradiation 200 cGy as a single dose Sirolimus 8mg-12mg oral loading dose followed by single dose 4mg/day. Levels are to be monitored 3 times/week in the first week, weekly until day +60, and as clinically indicated until day +100 post-transplantation. Mycophenolate Mofetil (MMF) 3 gram/day IV/PO divided in 2 or 3 doses. Stop MMF at day +30 or 7 days after neutrophil recovery, whichever day is later, if no acute GVHD. DUCBT followed Tregs - double umbilical cord blood transplant (FIRST) followed by the Treg cell infusion (SECOND) no sooner than 1 hour, but within 24 hours after the 2nd cord blood infusion.
Masonic Cancer Center at University of Minnesota
Minneapolis, Minnesota, United States
Number of Participants Survived
Count of patients who survived 2 years post intervention
Time frame: 2 years
Number of Participants With Grade II-IV aGVHD
Probability of grade II-IV aGVHD
Time frame: Assessed weekly until day 100, then day 180, 360
Number of Participants Experiencing Treatment Related Mortality (TRM)
Evaluated with descriptive statistics and plots or cumulative incidence curves if enough evaluable patients are available for time-to-event endpoints.
Time frame: 6 months
Number of Participants Who Experienced Relapse
Evaluated with descriptive statistics and plots or cumulative incidence curves if enough evaluable patients are available for time-to-event endpoints.
Time frame: 1 year
Number of Participants With Incidence of Bacterial, Viral and Fungal Infections
Evaluated with descriptive statistics and plots or cumulative incidence curves if enough evaluable patients are available for time-to-event endpoints.
Time frame: 1 year
Number of Participant With Detectable Treg Cells at d14
The proportion of patients with detectable Treg cells at day 14 post infusion
Time frame: 14 days
Number of Participants With Immune Reconstitution
The proportion of patients with immune reconstitution. Continuous endpoints will be described by medians, ranges and interquartile ranges as well as means and standard deviations if normally distributed.
Time frame: Assessed at Day 4, weekly for 8 weeks
Number of Participants Experiencing Treg Cell Infusion Toxicity
Incidence of Adverse Events
Time frame: 48 hours post infusion
Length of Treg Survival
Length of Treg survival after infusion of Treg.
Time frame: 24 hours post infusion
Percentage of Donor Cell Chimerism
The incidence of chimerism in patients treated
Time frame: Day +100
Number of Participants Survived One Year Post-transplant
The probability of survival, one year post-treatment
Time frame: 1 year
Number of Participants With Neutrophil Recovery
The incidence of neutrophil recovery, that is return of neutrophil counts to ≥ 5 X 10\^8/L in treated patients
Time frame: Day 42
Number of Participants With Platelet Recovery
The incidence of platelet recovery (return of platelet counts to \> 20,000/μL) in treated patients
Time frame: 1 year
Number of Participants With Chronic GVHD
The incidence of chronic GVHD in treated patients after one year
Time frame: 1 year
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