This is a research protocol that will examine Hematopoietic Stem Cell Transplantation (HSCT) using a reduced conditioning regimen (RIC) with total body Irradiation (TBI) in those diagnosed with Common Variable Immunodeficiency (CVID) and Other Autoimmune Manifestations of Primary Immune Regulatory Disorders (PIRD).
Hematopoietic stem cell transplant (HSCT) with reduced-intensity conditioning has been demonstrated as the best definitive therapy to correct many of these inheritable immune defects (Common Variable Immunodeficiency (CVID) and Other Autoimmune Manifestations of Primary Immune Regulatory Disorders (PIRD). This is a single center, open label, non-randomized, Phase II study in which subjects receive an allogenic, fully (8 of 8 match) or partially Human Leukocyte Antigen (HLA)-matched (6-7/8 HLA-matched), stem cell transplant utilizing a conditioning regimen of alemtuzumab/Campath, anti-thymocyte globulin/rabbit (ATG), Fludarabine and Melphalan and Total Body Irradiation (TBI). Graft sources include bone marrow or mobilized peripheral blood stem cells from either a related or unrelated donor. After stem cell infusion, subjects are followed for 2 years per standard of care practices.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
25
The participant will receive an allogenic, fully (8 of 8 match) or partially HLA-matched (6-7/8 HLA-matched), stem cell transplant utilizing a conditioning regimen of alemtuzumab/Campath, anti-thymocyte globulin/rabbit ATG, Fludarabine and Melphalan and total body irradiation.
Survival post-HSCT
review of the existing medical records to check on the participant's survival status
Time frame: 2 years post transplant
engraftment, based upon chimerism data
review of chimerism test results in the existing medical records to check on degree of donor engraftment measured by the percentage of donor-derived blood cells in the HSCT recipient
Time frame: 1 month, 2 months, 3 months, 6 months, 12 months, 18 months, 24 months
Assess myeloid, B and T cell chimerism
review test results from medical records to check how donor and recipient cells populate different immune lineages post-transplant
Time frame: up to 2 years post translant
Assess Immunoglobulin A (IgA), Immunoglobulin (IgM), and Immunoglobulin E (IgE) reconstitution
review of the existing medical records to check on the participant's humoral immune recovery.
Time frame: up to 2 years post transplant
independence of immunoglobulin replacement (IVIG, IgG)
Determine and probability
Time frame: 1 and 2 year post transplant
incidence of acute graft versus host disease (GVHD)
grades 3-4
Time frame: 6 months post transplant
chronic graft-versus-host-disease
grades 3-4
Time frame: 1 year post transplant
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