Acute Myelogenous Leukemia Clinical Trial
Official title:
A Randomized Trial Comparing CD3/CD19 Depleted or CD3 Depleted/CD56 Selected Haploidentical Donor Natural Killer (NK) Cell Based Therapy in Older Adults With Acute Myelogenous Leukemia in First Complete Remission
This is a phase II trial designed to test the safety and efficacy (disease free survival [DFS]) of related donor HLA-haploidentical NK-cell based therapy for the treatment of acute myelogenous leukemia (AML). The natural killer (NK) cell product will be given to patients 60 years and older who are in a first complete remission after 1 or 2 courses of standard AML induction. After a preparative regimen of cyclophosphamide and fludarabine, patients will receive a single infusion of either CD3-/CD19- NK cells or CD3-/CD56+ NK cells followed by a short course of Interleukin-2 (IL-2) to facilitate NK cell survival and expansion.
The trial will use a single-stage design and will take place in two parts. The first part
will support the selection of the better NK cell product as measured by in vivo NK cell
expansion. Successful in vivo NK cell expansion is defined as 40% donor DNA and 40% of
lymphocytes are NK cells at day 7 post infusion OR 20% donor DNA and 20% of lymphocytes are
NK cells at day 14 post infusion.
Part 1: 1:1 randomization with 10 patients per cohort to either:
1. CD3-/CD19- NK cell product or
2. CD3-/CD56+ purified NK cell product The product with better NK cell expansion will be
used for the rest of the trial. If the results and safety profile are equivalent, the
CD56+ selection approach will be used. If neither approach results in successful NK cell
expansion, the trial will be stopped and the platform redesigned.
Part 2: complete the trial by enrolling an additional 26 patients using the product deemed
successful during part 1 to estimate the primary endpoint (DFS at 12 months)
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