Sickle Cell Disease Clinical Trial
Official title:
Phase I/II Pilot Study of Mixed Chimerism to Treat Hemoglobinopathies
The goal of this research study is to establish chimerism and avoid graft-versus-host disease in patients with Hemoglobinopathies to halt disease progression.
Hematopoietic stem cell transplantation (HSCT) is emerging as a therapeutic alternative for
patients with sickle cell disease. Conventional HSCT therapy has been limited to extremely
high-risk hemoglobinopathy patients. Those patients who may be difficult to identify before
end-organ damage develops.
Also, conventional HSCT is only available to the minority of candidates who have
Histocompatibility Leukocyte Antigen (HLA) identical siblings to donate bone marrow or
mobilized peripheral blood stem cells.
This study proposes two important improvements over conventional HSCT:
- Donor peripheral blood or bone marrow will be processed via a new technology, which will
deplete mature immune cells while enriching hematopoietic stem cells (HSC) and graft
facilitating cells (FC).
- A reduced intensity recipient conditioning regimen will be used to promote mixed
allogeneic chimerism, as opposed to full donor chimerism, following HSCT.
These two elements may significantly improve the benefit:risk ratio of HSCT for patients with
hemoglobinopathies. Stem cell transplantation may become a more feasible option for patients
that do not have HLA-identical siblings that can donate stem cells. Also, transplantation may
be offered to patients earlier in the disease progression, before end-organ damage occurs.
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