Phase II clinical trial to assess the efficacy of donor regulatory enriched T cells in steroid-refractory chronic graft versus host disease patients who did not obtain complete remission under treatment with ruxolitinib
A number of 15 patients will be included to assess the efficacy of donor regulatory enriched T cells in steroid-refractory chronic graft versus host disease patients who did not obtain complete remission after 12 weeks of treatment with ruxolitinib. The doses of Treg-enriched cells will be 2x10\^6 cells/kg. Survival at 1 year after Treg infusion will be represented based on the clinical data with Kaplan Meier curves.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
15
Enrichment of cluster of differentiation 25hi regulatory T cells from cluster of differentiation antigen 8 and/or cluster of differentiation antigen19 pre-depleted leukapheresis products.
José Antonio Pérez Simón
Seville, Spain
RECRUITINGNumber of Participants with overall response rate.
Obtain ≥65% the overall response rate at 6 months after infusion
Time frame: 6 months post-infusion
Number of Participants with overall response rate.
Obtain ≥75% the overall response rate at 1 year after infusion
Time frame: 1 year post-infusion
Survival
Number of patients who survive after Regulatory T-cell enriched infusion
Time frame: 1 year after Regulatory T-cell enriched infusion
Disease evaluation through Symptoms of the disease
Symptoms of the disease through chronic graft-versus-host disease activity assessment (clinician) according to NIH consensus- form A
Time frame: Screening, weeks 1, 2, 4, 6, 12 and months 6, 9 and 12 months after infusion
Disease evaluation through measurement of quality of life
Measurement of quality of life through Functional Assessment of Cancer Therapy - Bone Marrow Transplantation
Time frame: Screening, weeks 1, 2, 4, 6, 12 and months 6, 9 and 12 months after infusion
Disease evaluation through Symptoms of the disease
Symptoms of the disease through chronic graft-versus-host disease symptom scoring scale
Time frame: Screening, weeks 1, 2, 4, 6, 12 and months 6, 9 and 12 months after infusion
Immunosuppressive requirements.
Evaluation of needs of additional permitted immunosuppressive treatment administered as concomitant medication
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Time frame: Screening, month1, months 3, 6, and 12 after infusion
Free survival
To evaluate failure free survival (change of immunosuppression, mortality or relapse)
Time frame: 1 year after infusion.
Immunologic monitoring and in vivo Treg tracking through immune globulins
Quantitative immune globulins
Time frame: 1 year after infusion and after infusion
Immunologic monitoring and in vivo Treg tracking through plasma
Plasma banking
Time frame: 1 year after infusion and after infusion
Immunologic monitoring and in vivo Treg tracking through mononuclear cells
Storage of additional mononuclear cells
Time frame: 1 year after infusion and after infusion
Immunologic monitoring and in vivo Treg tracking through lymphocyte
Detailed immunological evaluation of lymphocyte
Time frame: 1 year after infusion and after infusion
Immunologic monitoring and in vivo Treg tracking through Natural Killer cell subsets
Quantitative Natural Killer cell subsets
Time frame: 1 year after infusion and after infusion
Purity of Treg-enriched cell infusion
Percentage of cells viability, negative gram stain/endotoxin, percentage of cluster of differentiation 4+ cluster of differentiation 25+ cells and cluster of differentiation 4+cluster of differentiation25+cluster of differentiation127- Treg in order to consider for the infusion.
Time frame: Before 24 hours to infusion up infusion day
Toxicity monitoring of Treg-enriched cells
Number of grade 3 or higher Adverse Events and all Serious Adverse Events according to the Version 5.0 of the NCI Common Terminology Criteria for Adverse Events.
Time frame: Weeks 1, 2, 4, 6, 12 and months 6, 9 and 12 after infusion
Life-threatening infections
Number of infections
Time frame: Weeks 1, 2, 4, 6, 12 and months 6, 9 and 12 after infusion
Predictors of clinical response
Quantify predictors of clinical response among patients receiving ruxolitinib
Time frame: 1 year after infusion