BrUOG 273:Cellular Immunotherapy For Refractory Hematological Malignancies:A Brown University Oncology Research Group Study View Homepage


Ontology type: schema:MedicalStudy     


Clinical Trial Info

YEARS

2013-2015

ABSTRACT

The study of whether an infusion of blood cells called lymphocytes from a donor can stimulate the immune system to fight your leukemia/lymphoma. Detailed Description There have been important advances in the modulation of the immune system for the treatment of hematologic malignancies and solid tumors. This protocol will build upon these previous observations as follows: - Haploidentical peripheral blood pheresed cells will be used at 1-2x108 CD3 cells/kg. - Total body radiation will not be utilized. - This modification may more effectively activate the recipient's immune system to attack their hematological malignancy by not damaging the recipient's immune cells prior to cellular infusion. Safety should be improved since the risk of graft versus host disease should be greatly reduced as the host's immune system will not be conditioned. - Granulocyte-colony stimulating factor (G-CSF) priming will not be used. - In our first clinical trial, G-CSF priming was not used for matched transplants. Our second trial did employ G-CSF priming in the haplo-identical setting. Previous data has cited a role for G-CSF in stimulation of invariant Natural Killer(NK) cells with enhanced GVL effects11. However, our most recent laboratory data with unprimed PBMC has shown effective cell kill activity without the addition of G-CSF. As G-CSF would be administered to healthy volunteers, the unclear benefit of the addition of this cytokine is offset by the potential side effects such as headache, fever, and bone pain. G-CSF mobilization serves to shift the response from a TH1 to TH2 through the increased production of T regulatory cells. The end result would be a decrease in immune stimulation. Since the goal of this study is to NOT have engraftment, the manipulation of the donor cells to dampen the host versus tumor stimulation is not needed nor desired. Furthermore, since this protocol is not a stem cell transplant, stem cells do not need to be mobilized with G-CSF. It is important to note that the proposed study is not a stem cell transplant study. In the situation of stem cell transplants, the goal of the procedure is to have engraftment, or sustainable donor chimerism in the marrow to provide hematopoietic reconstitution as well as immunologic reconstitution. In this study, we are evaluating the use of donor lymphocytes (not stem cells) to stimulate an immune response of the recipients' immune system. More... »

URL

https://clinicaltrials.gov/show/NCT01685606

Related SciGraph Publications

  • 2013-12. Cellular immunotherapy for refractory hematological malignancies in JOURNAL OF TRANSLATIONAL MEDICINE
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