Skip to main content
OpenTrials
Completed

NCT Number: NCT01280955

Donor Enhancement With Plerixafor Post Myeloablative Allogeneic Transplant

This phase I/II clinical trial will test the safety and the efficacy of post transplant administration of plerixafor in enhancing hematological recovery in humans. Patients who are appropriate candidates for myeloablative allogeneic stem cell transplantation from an HLA-matched sibling, matched unrelated donor or umbilical cord blood are eligible for enrollment. The investigators plan to enroll a total of 50 patients for this study (30 patients with HLA-matched sibling or matched unrelated donor transplant, and 20 patients with umbilical cord blood transplant). During phase I study, a small number of patients (3-6 patients from each group) will be enrolled to determine the safety of post transplant administration of plerixafor. Patients will receive plerixafor given at 240 µg/kg subcutaneously every other day beginning at day +2 after transplant until day +21 or engraftment. Limiting toxicities are defined as primary or secondary graft failure, plerixafor-related severe premature ventricular arrhythmia or death. If safety criteria are met from the investigators phase I study, the investigators will proceed with phase II study to determine the efficacy of post transplant administration of plerixafor in enhancing haematological recovery. The experimental aspect of this study is the use of plerixafor and all other aspects of care will be in line with the standard of care. Both Phase I and Phase II patients will be combined for efficacy analysis, and data collected from this study will be compared with the investigators historical control. The results from this study will set the stage and provide the justification for a larger phase 3 trial.

Completed

Looking for future studies?

Notify Me

Key information

Conditions

Failure of Bone Marrow Graft

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1 / Phase 2

Primary location

Duke University Medical Center, Durham, North Carolina, United States

Loading trial locations.

About this study

Recruitment to this trial will be stratified by donor type as HLA (human leukocyte antigen) matched sibling, matched unrelated donor or umbilical cord blood. Patients will be conditioned with a myeloablative regimen such as, but not limited to, total body irradiation and cyclophosphamide. The donor stem cell grafts will come from mobilized peripheral blood of 8/8 or 7/8 HLA-identical family members, 8/8 (HLA A, B, C, DRBeta1) allele-level matched unrelated donors, or dual umbilical cord blood grafts with at least 4 of 6 HLA matching at HLA A and B (low resolution) and DRBeta1 (at high resolution). The target CD34+ cell dose will be 5 X 10(6)/kg recipient ideal body weight. For HLA matched sibling or matched unrelated donor (MUD) transplants, all patients will receive a minimum of 2 X 10(6) CD 24+ cells/kg. For cord blood transplants, each unit will contain a minimum total nucleated cell count of of 1.5 X 10(7)/kg. Post-transplant GVHD (graft versus host disease) prophylaxis will be given per institutional standard.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age 18 to 65 years.
  • 8/8 or 7/8 HLA-identical matched sibling OR Allele level 8/8 (HLA-A, B, C, DR Beta1)matched unrelated donor or 4/6 or better HLA matched cord blood.
  • Patients with high risk hematologic malignancies who are appropriate candidates for a myeloablative allogeneic stem cell transplantation.
  • Patients with a history of CNS disease must have been treated and have no active CNS disease at the time of protocol treatment.
  • ECOG performance status < or equal to 2
  • Patients must have adequate function of other organ systems as measured by:
  • Creatinine clearance (by Cockcroft Gault equation) > or equal to 30ml/min. Hepatic transaminases (ALT/AST) < or equal to 4 x normal, bilirubin < or equal to 2.0 mg/dl.
  • Pulmonary function tests demonstrating FVC and FEV1 of > or equal to 50% of predicted for age and DLCO > or equal to 50% of predicted.
  • Ejection fraction of > or equal to 45% by echocardiogram, radionuclide scan or cardiac MRI.
  • Patients must be HIV negative.
  • Patients must not be pregnant.

Exclusion criteria

  • Patients with > 5% blasts in bone marrow or peripheral circulation.
  • Uncontrolled infection.
  • Class III or IV angina as per NYHA criteria.

Treatment and study plan

plerixafor

Drug

Matched sibling or Dual Cord donor subjects will receive plerixafor at 240 ug/kg subcutaneously every other day beginning at day +2 after transplant until day +21 or engraftment occurs.

Other names: AMD3100, Mozobil

Primary outcomes

  1. Time to Neutrophil Recovery

    Time frame: 100 Days post Transplant

    leukocytes > 500/ul on 2 consecutive days

  2. Time to Platelet Recovery

    Time frame: 100 Days Post Transplant

    platelet > 20,000/ul on 2 consecutive days

  3. Plerixafor-associated Adverse Events

    Time frame: 100 Days Post Transplant

Secondary outcomes

  1. Transplant-related Mortality

    Time frame: 100 Days Post Transplant

  2. Absolute Lymphocyte Count at Day 90

    Time frame: 90 days

    Cell reconstitution - absolute lymphocyte count at day 90 post transplant.

  3. IL-12 at Day 30

    Time frame: 30 days

    IL-12 at day 30; Interleukin 12 (IL-12) is an interleukin that is naturally produced by dendritic cells, macrophages, neutrophils, and human B-lymphoblastoid cells (NC-37) in response to antigenic stimulation.

  4. Participants Experiencing Grade II-IV Acute Graft Versus Host Disease

    Time frame: 100 days

    We are reporting on the number of participants experiencing a grade II-IV acute graft versus host disease will be assessed weekly through Day 100 post transplant. Staging and grading of Acute GvHD is graded by pattern of organ involvement and clinical performance status using the Grading Index of Acute GvHD (Gluckman) and the Grading Index of Acute GVHD by the CIBMTR (Centers for International Blood and Marrow Transplant Research)

  5. CD3+ Cell Count at Day 90

    Time frame: 90 Days

    Cell reconstitution - CD3+ cell count at day 90 post transplant. This is a marker for the function of your immune system.

  6. CD4 Cell Count at Day 90

    Time frame: 90 days

    CD4 cell count at Day 90; CD4+ T helper cells are white blood cells that are an essential part of the human immune system. They are often referred to as CD4 cells, T-helper cells or T4 cells.

  7. CD8 Cell Count at Day 90

    Time frame: 90 days

    CD8 cell count at Day 90; CD8 (cluster of differentiation 8) is a transmembrane glycoprotein that serves as a co-receptor for the T cell receptor (TCR).

  8. NK Cell Count at Day 90

    Time frame: 90 days

    NK cell count at Day 90;Natural killer cells or NK cells are a type of cytotoxic lymphocyte critical to the immune system.

  9. B Cell Count at Day 90

    Time frame: 90 days

    B cell count at Day 90; B cells, also known as B lymphocytes, are a type of white blood cell of the lymphocyte subtype and they function as part of the immune system.

  10. IFN Gamma at Day 30

    Time frame: 30 days

    IFN gamma at day 30; Interferon gamma (IFNγ) is a dimerized soluble cytokine that is the only member of the type II class of interferons which are important for immunity against infection.

  11. TNF-alpha at Day 30

    Time frame: 30 days

    TNF-alpha at day 30; Tumor necrosis factor is a cell signaling protein (cytokine) involved in systemic inflammation and is one of the cytokines that make up the acute phase reaction. The primary role of TNF is in the regulation of immune cells.

  12. CD4 Cell Count at Day 30

    Time frame: 30 days

    CD4 cell count at Day 30; CD4+ T helper cells are white blood cells that are an essential part of the human immune system. They are often referred to as CD4 cells, T-helper cells or T4 cells.

  13. CD4 Cell Count at Day 60

    Time frame: 60 days

    CD4 cell count at Day 60; CD4+ T helper cells are white blood cells that are an essential part of the human immune system. They are often referred to as CD4 cells, T-helper cells or T4 cells.

  14. CD8 Cell Count at Day 30

    Time frame: 30 days

    CD8 cell count at Day 30; CD8 (cluster of differentiation 8) is a transmembrane glycoprotein that serves as a co-receptor for the T cell receptor (TCR).

  15. CD8 Cell Count at Day 60

    Time frame: 60 days

    CD8 cell count at Day 60; CD8 (cluster of differentiation 8) is a transmembrane glycoprotein that serves as a co-receptor for the T cell receptor (TCR).

  16. NK Cell Count at Day 30

    Time frame: 30 days

    NK cell count at Day 30;Natural killer cells or NK cells are a type of cytotoxic lymphocyte critical to the immune system.

  17. NK Cell Count at Day 60

    Time frame: 60 days

    NK cell count at Day 60;Natural killer cells or NK cells are a type of cytotoxic lymphocyte critical to the immune system.

  18. B Cell Count at Day 30

    Time frame: 30 days

    B cell count at Day 30; B cells, also known as B lymphocytes, are a type of white blood cell of the lymphocyte subtype and they function as part of the immune system.

  19. B Cell Count at Day 60

    Time frame: 60 days

    B cell count at Day 60; B cells, also known as B lymphocytes, are a type of white blood cell of the lymphocyte subtype and they function as part of the immune system.

  20. IL-12 at Day 7

    Time frame: 7 days

    IL-12 at day 7; Interleukin 12 (IL-12) is an interleukin that is naturally produced by dendritic cells, macrophages, neutrophils, and human B-lymphoblastoid cells (NC-37) in response to antigenic stimulation.

  21. IL-12 at Day 14

    Time frame: 14 days

    IL-12 at day 14; Interleukin 12 (IL-12) is an interleukin that is naturally produced by dendritic cells, macrophages, neutrophils, and human B-lymphoblastoid cells (NC-37) in response to antigenic stimulation.

  22. IFN Gamma at Day 7

    Time frame: 7 days

    IFN gamma at day 7; Interferon gamma (IFNγ) is a dimerized soluble cytokine that is the only member of the type II class of interferons which are important for immunity against infection.

  23. IFN Gamma at Day 14

    Time frame: 14 days

    IFN gamma at day 14; Interferon gamma (IFNγ) is a dimerized soluble cytokine that is the only member of the type II class of interferons which are important for immunity against infection.

  24. TNF-alpha at Day 7

    Time frame: 7 days

    TNF-alpha at day 7; Tumor necrosis factor is a cell signaling protein (cytokine) involved in systemic inflammation and is one of the cytokines that make up the acute phase reaction. The primary role of TNF is in the regulation of immune cells.

  25. TNF-alpha at Day 14

    Time frame: 14 days

    TNF-alpha at day 14; Tumor necrosis factor is a cell signaling protein (cytokine) involved in systemic inflammation and is one of the cytokines that make up the acute phase reaction. The primary role of TNF is in the regulation of immune cells.

Sponsors and collaborators

Lead sponsor

Mitchell Horwitz, MD

Other

Collaborators

  • Genzyme, a Sanofi Company

Registry information

Official study title

A Phase I/II Study: Enhancing Donor Hematopoietic Cell Engraftment With Plerixafor in Myeloablative Allogeneic Hematopoietic Cell Transplantation

Important dates

Study start
2011
Primary completion
2014
Study completion
2015
First posted
Jan 21, 2011
Registry last updated
Apr 25, 2017

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.