Hodgkin Disease Clinical Trial
Official title:
Administration of Autologous Neomycin Resistant Gene Marked EBV Specific Cytotoxic T-Lymphocytes as Therapy for Patients Receiving Autologous Bone Marrow Transplant for Relapsed EBV-Positive Lymphoma.
Subjects have a type of lymph gland cancer called Hodgkin or non-Hodgkin Lymphoma, which has
come back or not gone away after treatment, including the best treatment we know for
relapsed Lymphoma. We are asking subjects to volunteer to be in a research study using
Epstein Barr virus (EBV) specific cytotoxic T lymphocytes, a new experimental therapy. This
therapy has never been used in patients with Hodgkin disease or this type of non-Hodgkin
Lymphoma but it has been used successfully in children with other types of blood cancer
caused by EBV after bone marrow transplantation.
Some patients with Hodgkin disease or non-Hodgkin Lymphoma show evidence of infection with
the virus that causes infectious mononucleosis Epstein Barr virus (EBV) before or at the
time of their diagnosis of Lymphoma. EBV is often found in the cancer cells suggesting that
it may play a role in causing Lymphoma. The cancer cells infected by EBV are very clever
because they are able to hide from the body's immune system and escape destruction. We want
to see if we can grow special white blood cells, called T cells, that have been trained to
kill EBV infected cells and give them back to subjects.
We will take 60-70 ml (12 teaspoonfuls) of blood from the subject. We will first make a B
cell line called a lymphoblastoid cell line or LCL by infecting the subjects blood with a
laboratory strain of EBV called B95. We will then use use this EBV infected cell line (which
have been treated with radiation so that they cannot grow) as stimulator cells and mix it
with more blood. This stimulation will train the T cells to kill EBV infected cells and
result in the growth of an EBV specific T cell line. We will then test the T cells to make
sure that they kill the EBV infected cells and not your normal cells and freeze them.
The cells will be thawed and injected into subjects over 10 minutes, after pretreatment with
Tylenol and Benadryl. A total of two doses will be given two weeks apart. All of the
treatments will be given at Texas Children's Hospital or The Methodist Hospital.
We will follow subjects in the clinic after the injections. At each visit about 10ml (2
teaspoonfuls) of blood will be taken every other week for 6 weeks after the injection and
then every 3 months for 1 year to monitor the subjects blood chemistry and hematology.
To learn more about the way the T cells are working in the subjects body, an extra 40mls (8
teaspoons) of blood will be taken pre-infusion, 3-4 days post infusion (optional) and at 1,
2, 4 and 6 weeks post-infusion and then at 3, 6, 9, and 12 months. The blood may be drawn
from the subjects central line at the time of their regular blood tests.
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Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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