Cancer Clinical Trial
Official title:
A PHASE II STUDY OF CELLULAR ADOPTIVE IMMUNOTHERAPY AS PROPHYLAXIS FOR CYTOMEGALOVIRUS DISEASE AFTER ALLOGENEIC BONE MARROW TRANSPLANTATION
RATIONALE: White blood cells from donors who have been exposed to cytomegalovirus may be
able to help prevent this infection from occurring in patients who are undergoing bone
marrow or peripheral stem cell transplantation.
PURPOSE: Phase II trial to study the effectiveness of donated white blood cells to prevent
cytomegalovirus infection in patients who are undergoing bone marrow or peripheral stem cell
transplantation.
OBJECTIVES: I. Determine whether adoptive immunotherapy comprising donor-derived CD8+,
CMV-specific, major histocompatibility complex class I-restricted cytotoxic T-lymphocyte
(CTL) clones (CD8+ CMV-specific CTL clones) and CD4+ CMV-specific T-helper (Th)-cell clones
is effective in preventing CMV viremia and disease in CMV-positive patients with
malignancies requiring allogeneic bone marrow or peripheral blood stem cell transplantation.
II. Determine whether the transfer of CD4+ CMV-specific Th-cell clones to patients with
deficient responses can reconstitute CD4+ Th-cell activity and augment adoptively
transferred CD8+ CMV-specific CTL clones.
OUTLINE: Allogeneic CD8+ CMV-specific, major histocompatibility complex class I-restricted
cytotoxic T-lymphocyte (CTL) clones (CD8+ CMV-specific CTL clones) and CD4+ CMV-specific
T-helper (Th)-cell clones are harvested and cultured in vitro at least 2 weeks before bone
marrow or peripheral blood stem cell (PBSC) transplantation. Bone marrow or PBSC are infused
on day 0. Patients receive the first infusion of CD8+ CMV-specific CTL clones beginning
between days 28 and 45 posttransplantation, followed 8 days later by the second infusion,
followed 2 days later by the first infusion of CD4+ CMV-specific Th-cell clones. Patients
who receive prednisone posttransplantation or have deficient CD8+ CTL responses (i.e., less
than 50% of the response measured in the immunocompetent bone marrow donor) after the second
infusion of CD8+ CMV-specific CTL clones receive a third infusion of CD8+ CMV-specific CTL
clones and a second infusion of CD4+ CMV-specific Th-cell clones before day 67.
PROJECTED ACCRUAL: A total of 30 patients will be accrued for this study within 12-18
months.
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Primary Purpose: Supportive Care
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