Myelodysplastic Syndrome (MDS) Clinical Trial
Official title:
A Feasibility Trial of Post-Transplant Infusion of Allogeneic Regulatory T Cells and Allogeneic Conventional T Cells in Patients With Hematologic Malignancies Undergoing Allogeneic Myeloablative Hematopoietic Cell Transplantation From Haploidentical-Related Donors
Patients with hematologic malignancies will receive myeloablative chemotherapy followed by stem cell rescue with bone marrow or hematopoietic peripheral blood stem cells collected by apheresis from a filgrastim- (G-CSF)-mobilized haploidentical related-donor, ie, hematopoietic peripheral blood stem cell transplant (HSCT).
This is dose-escalation study intended to evaluate the use of classification determinant
15-positive (CD15+), CD4+, CD127dim, and FoxP3+ regulatory T-cells (T-reg cells) supplemented
by conventional T-cells (T-con cells), to enhance the efficacy of allogeneic (CliniMACS CD34+
selected) hematopoietic stem cell transplantation (allo-HSCT), in the setting of leukemia,
lymphoma, and myelodysplastic syndrome (MDS). This study investigates amelioration of the
impaired immune recovery and address the significant relapse incidence in the haploidentical
HSCT setting.
Pre-transplant myeloablative conditioning will be melphalan; thiotepa; fludarabine and rabbit
antithymocyte globulin (rATG).
Stem cell rescue will be with CD34+ selected cells. The rescue infusion will be supplemented
with infusions of regulatory T-cells (T-reg) and conventional T-cells (T-con) from the same
donor collection, on Treatment Days 14 and 16 respectively. CD34+ cell infusion day is
Treatment Day 0.
T-reg cells are those cells enriched by immunomagnetic selection of CD25+ cells, and further
purified by flow cytometric cell sorting for the CD15+, CD4+, CD127dim, FoxP3+ cell
population. These cells are an enriched but naturally-occurring T-cell population.
T-con cells are unseparated/unfractionated cells, ie, as collected by the peripheral blood
stem cells apheresis procedure.
Post-transplant follow-up is for 5 years.
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