Beta-Thalassemia Clinical Trial
Official title:
A Pilot Study to Assess the Safety and Efficacy of Mozobil ± G-CSF in Mobilizing Hematopoietic Stem Cells (CD34+ Cells) in Adults With Beta-thalassemia Major
Thalassemia is considered the most common genetic disorder worldwide, occurring with high
frequency in Mediterranean areas, the Middle East, Southeast Asia, and the Pacific Islands.
Currently, the only cure for thalassemia is bone marrow transplantation from a related,
compatible donor. Gene transfer, achieved by transplantation of the patient's own blood stem
cells that have been genetically-modified with the corrected gene, could potentially cure
thalassemia.
The first step in developing gene transfer for treatment of thalassemia is to develop a safe
and effective method to obtain blood stem cells from thalassemia patients. Eventually, high
numbers of genetically modified cells will need to be infused into the patient for clinical
gene transfer to be effective. The blood stem cells are obtained by giving a "mobilization"
agent to the patients. This causes the stem cells to leave the bone marrow and go into the
blood. The purpose of this study is to test the safety and effectiveness of the new
mobilization agent, Mozobil, in causing mobilization of blood stem cells for patients with
beta-thalassemia major.
The purpose of this study is to optimize blood stem cell mobilization in adults with beta
thalassemia major. We seek a method of mobilization that will be safe, with minimum side
effects, and that will yield high numbers of blood stem cells. For successful gene therapy
of thalassemia, high numbers of genetically modified stem cells will need to be introduced
into the patient. Participants will include beta-thalassemia patients who failed to mobilize
sufficiently with G-CSF (in our previous protocol) and new patients. In this study we will
focus on the safety and effectiveness of mobilization with Mozobil or with Mozobil plus
G-CSF. Following mobilization, blood stem cells will be recovered using leukapheresis, a
procedure similar to a blood donation, in which mobilized white blood cells are collected
from the blood of the patient.
During drug administration and leukapheresis, patients will be hospitalized at George
Papanicolaou Hospital in Thessaloniki, Greece. Patients who failed to mobilize in the
previous protocol will receive Mozobil and G-CSF and will be hospitalized for 5-8 days for
the duration of drug administration and leukapheresis. They will receive G-CSF for several
days; Mozobil will be added on the last few days of G-CSF. New patients will receive Mozobil
only and will be hospitalized for 2-3 days for drug administration and leukapheresis.
Mozobil is administered at 240µg/kg, under the skin. Participants will undergo two or three
leukapheresis procedures in a row if low numbers of blood stem cells were recovered in the
first (and possibly second) leukapheresis. Participants will be discharged from the hospital
the day following the last leukapheresis procedure. Weekly follow-up visits will occur for
the next month, either at G. Papanicolaou Hospital, or at the participant's local doctor's
office. The total period of study participation is approximately 5 weeks. In the event that
Mozobil alone does not cause mobilization of high levels of blood cells, patients will be
invited to repeat the protocol three months later, receiving Mozobil and G-CSF.
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Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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