In this Phase I study, the study team will evaluate the safety of Valproic Acid (VPA) expanded cord blood stem cells defined by the lack of serious infusion reactions or graft failure in patients with hematological malignancies undergoing umbilical cord blood transplantation. Moreover, the study team will also evaluate time to neutrophil and platelet engraftment as well as transplant related outcomes such as graft versus host disease (GVHD), treatment related mortality (TRM), and overall survival (OS).
This is a phase I trial for safety of VPA expanded cord blood stem cells in patients with hematological malignancies undergoing allogeneic stem cell transplantation. The primary endpoint of the study is safety as defined by the incidence of infusion reactions and graft failure, lack of neutrophil engraftment by day +42. The trial will consist of two cohorts. First cohort of 5-7 patients, will undergo double umbilical cord blood (UCB) transplantation. One UCB unit will undergo CD34 selection followed VPA based expansion. CD34 negative portion of that unit will be cryopreserved to be infused later following infusion of the expanded portion. Infusion of the second unmanipulated UCB will follow it. Preparative regimen is Fludarabine 150 mg/m2/Cytoxan 50 mg/m2/Thiotepa 10 mg/m2/TBI 400cGy. Following successful engraftment in the first cohort, second cohort (10 patients) will only receive single manipulated unit. Otherwise, patients will receive standard allogeneic stem cell transplantation care.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
7
CD34 selected VPA expanded umbilical cord blood cells used in combination with or without unmanipulated umbilical cord blood .
Valproic Acid (VPA) expanded cord blood stem cells
Fludarabine 150 mg/m2
Cytoxan 50 mg/m2
Thiotepa 10 mg/m2
TBI 400cGy
Icahn School of Medicine at Mount Sinai
New York, New York, United States
Number of Infusion Reaction
Safety as measured by the incidence of infusion related reactions.
Time frame: 42 days
Number of Graft Failure
Safety as measured by the incidence of graft failures.
Time frame: 42 days
Time to neutrophil engraftment
Transplant related outcomes: time to neutrophil engraftment
Time frame: 1 year
Time to platelets engraftment
Transplant related outcomes: time to platelets engraftment
Time frame: 1 year
Number of transplant-related mortality (TRM)
Transplant related outcomes: transplant-related mortality (TRM)
Time frame: 1 year
Number of disease free survivals
Transplant related outcomes: Number of disease free survivals
Time frame: 1 year
Number of overall survivals
Transplant related outcomes: Number of overall survivals
Time frame: 1 year
Number of participants at risk of GVHD
Transplant Related Outcomes: risk of GVHD
Time frame: 1 year
Number of infectious complications
Transplant Related Outcomes: incidence of infectious complications - which is any documented bacterial, viral, or fungal infections.
Time frame: 1 year
Time to myeloid engraftment
Assess the kinetics of engraftment and immune reconstitution by assessing time to myeloid engraftment
Time frame: 42 days
Time to lymphoid engraftment
Assess the kinetics of engraftment and immune reconstitution by assessing time to lymphoid engraftment
Time frame: 42 days
Change in T cell count
Assess the kinetics of engraftment and immune reconstitution by assessing the T cell count at 42 days as compared to baseline
Time frame: Baseline and 42 days
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