This is a single arm pilot study of peripheral stem cell transplantation (PSCT) with ex vivo t-cell receptor alpha beta+(TCRαβ+) T cell and cluster of differentiation 19+ beta (CD19+ B) cell depletion of unrelated donor (URD) grafts using the CliniMACS device in patients with sickle cell disease (SCD) and beta thalassemia major (BTM).
This is a single arm pilot study of peripheral stem cell transplantation (PSCT) with ex vivo TCRαβ+ T cell and CD19+ B cell depletion of URD grafts using the CliniMACS device in patients with SCD and BTM. Apart from CliniMACS-based cell processing, PSCT will be performed according to current standards of care in the Children's Hospital of Philadelphia (CHOP) Cell Therapy and Transplant Section, including the use of a standard chemotherapy conditioning regimen and standard follow-up laboratory assessments. The study will determine efficacy of this strategy in terms of engraftment, rates of acute and chronic Graft versus Host Disease (GvHD), and one-year overall and event-free survival.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
9
Peripheral blood stem cells from closely matched unrelated donors will be processed using the CliniMACS device to remove TCRalpha/beta T cells and B cells, in accordance with the Investigator Brochure and Technical Manual following the laboratory standard operating procedures (SOPs) and using aseptic technique
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
Rate of graft failure
Number of patients with primary graft failure (defined as no evidence of neutrophil engraftment by day +30 after stem cell infusion) and secondary graft failure (defined as ANC \<500 for at least 7-10 days after initial engraftment occurs in the absence of known infection or drug-mediated suppression, and confirmed by hypocellular bone marrow biopsy and/or total donor chimerism percentage from blood or bone marrow \< 10 percent)
Time frame: Up to 1year post-transplantation
Time to neutrophil engraftment
Number of days to neutrophil engraftment (first day of ANC \>500/µl for the first of 3 consecutive days)
Time frame: Up to 60 days post-transplantation
Incidence of acute graft vs. host disease (GVHD)
Number of patients with acute GvHD (graded according to the current guidelines for reporting by the Center for International Bone Marrow Transplant Registry)
Time frame: Up to 100 days post-transplantation
Incidence of chronic graft vs. host disease (GVHD)
Number of patients with Grade II-IV acute GVHD, Severe Grade III-IV acute GVHD, and Chronic Extensive GVHD
Time frame: Up to three years post-transplantation
Number of deaths due to treatment
Number of deaths due to treatment
Time frame: Up to 100 days post-transplantation
Probability of event-free survival (EFS)
Number of patients without complications or events
Time frame: Up to 1 year post-transplantation
Probability of overall survival (OS)
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Number of patients with the following survival outcome: one-year overall survival (OS)
Time frame: 1 year post-transplantation
Incidence of viral reactivation and symptomatic viral infection
Number of patients experiencing viral reactivation requiring therapy and symptomatic viral infections, including CMV, adenovirus, and EBV
Time frame: Up to 1 year post-transplantation