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Primary Immunodeficiency (PID)Phase 2HSCT+RICNCT01962415

Reduced Intensity Conditioning for Non-Malignant Disorders Undergoing UCBT, BMT or PBSCT

A Phase 2 study testing Hydroxyurea, Alemtuzumab and Fludarabine in people with Primary Immunodeficiency (PID) and Congenital Bone Marrow Failure Syndromes, run by Paul Szabolcs at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The objective of this study is to evaluate the efficacy of using a reduced-intensity condition (RIC) regimen with umbilical cord blood transplant (UCBT), double cord UCBT, matched unrelated donor (MUD) bone marrow transplant (BMT) or peripheral blood stem cell transplant (PBSCT) in patients with non-malignant… Read more about this study

Who is it for?
Ages 2 months to 55 years
What is being tested?
Hydroxyurea, Alemtuzumab and Fludarabine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
100 participants
Where
1 siteUnited States
Study dates
4 Feb 2014to Nov 2027
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 2 months to 55 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • A 4/6, 5/6 or 6/6 HLA matched related or unrelated UCB unit available that will deliver a pre-cryopreservation total nucleated cell dose of ≥ 3 x 10e7 cells/kg, or double unit grafts, each cord blood unit delivering at least 2 x 10e7 cells/kg OR an 8 of 8 or 7 of 8 HLA allele level matched unrelated donor bone marrow or peripheral blood progenitor graft.
  • Adequate organ function as measured by:
  • Creatinine ≤ 2.0 mg/dL and creatinine clearance ≥ 50 mL/min/1.73 m2.
  • Hepatic transaminases (ALT/AST) ≤ 4 x upper limit of normal (ULN).
  • Adequate cardiac function by echocardiogram or radionuclide scan (shortening fraction > 26% or ejection fraction > 40% or > 80% of normal value for age).
  • Pulmonary evaluation testing demonstrating CVC or FEV1/FVC of ≥ 50% of predicted for age and/or resting pulse oximeter ≥ 92% on room air or clearance by the pediatric or adult pulmonologist. For adult patients DLCO (corrected for hemoglobin) should be ≥ 50% of predicted if the DLCO can be obtained.
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  • Written informed consent and/or assent according to FDA guidelines.
  • Negative pregnancy test if pubertal and/or menstruating.
  • HIV negative.
  • A non-malignant disorder amenable to treatment by stem cell transplantation, including but not limited to:
  • Primary Immunodeficiency syndromes including but not limited to:
  • Severe Combined Immune Deficiency (SCID) with NK cell activity
  • Omenn Syndrome
  • Bare Lymphocyte Syndrome (BLS)
  • Combined Immune Deficiency (CID) syndromes
  • Combined Variable Immune Deficiency (CVID) syndrome
  • Wiskott-Aldrich Syndrome
  • Leukocyte adhesion deficiency
  • Chronic granulomatous disease (CGD)
  • X-linked Hyper IgM (XHIM) syndrome
  • IPEX syndrome
  • Chediak - Higashi Syndrome
  • Autoimmune Lymphoproliferative Syndrome (ALPS)
  • Hemophagocytic Lymphohistiocytosis (HLH) syndromes
  • Lymphocyte Signaling defects
  • Other primary immune defects where hematopoietic stem cell transplantation may be beneficial
  • Congenital bone marrow failure syndromes including but not limited to:
  • Dyskeratosis Congenita (DC)
  • Congenital Amegakaryocytic Thrombocytopenia (CAMT)
  • Osteopetrosis
  • Inherited Metabolic Disorders (IMD) including but not limited to:
  • Mucopolysaccharidoses
  • Hurler syndrome (MPS I)
  • Hunter syndrome (MPS II)
  • Leukodystrophies
  • Krabbe Disease, also known as globoid cell leukodystrophy
  • Metachromatic leukodystrophy (MLD)
  • X-linked adrenoleukodystrophy (ALD)
  • Hereditary diffuse leukoencephalopathy with spheroids (HDLS)
  • Other inherited metabolic disorders
  • alpha mannosidosis
  • Gaucher Disease
  • Other inheritable metabolic diseases where hematopoietic stem cell transplantation may be beneficial.
  • Hereditary anemias
  • Thalassemia major
  • Sickle cell disease (SCD) - patients with sickle disease must have one or more of the following:
  • Overt or silent stroke
  • Pain crises ≥ 2 episodes per year for past year
  • One or more episodes of acute chest syndrome
  • Osteonecrosis involving ≥ 1 joints
  • Priapism
  • Diamond Blackfan Anemia (DBA)
  • Other congenital transfusion dependent anemias
  • Inflammatory Conditions
  • Crohn's Disease/Inflammatory Bowel Disease

Who cannot join

  • Allogeneic hematopoietic stem cell transplant within the previous 6 months.
  • Any active malignancy or MDS.
  • Severe acquired aplastic anemia.
  • Uncontrolled bacterial, viral or fungal infection (currently taking medication and with progression of clinical symptoms).
  • Pregnancy or nursing mother.
  • Poorly controlled pulmonary hypertension.
  • Any condition that precludes serial follow-up.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Paul Szabolcs, MD contact

412-692-5427

paul.szabolcs@chp.edu

Shawna McIntyre, RN contact

412-692-5552

mcintyresm@upmc.edu

United States1 site, 1 recruiting
  • UPMC Children's Hospital of Pittsburgh

    Pittsburgh, Pennsylvania, 15224

    Shawna McIntyre, RN, 412-692-5552, mcintyresm@upmc.edu

    Paulina Horvei, MD

    Recruiting

Other trials in United States

About this study

Official title: A Phase II Study of Reduced Intensity Conditioning in Pediatric Patients and Young Adults ≤55 Years of Age With Non-Malignant Disorders Undergoing Umbilical Cord Blood, Bone Marrow, or Peripheral Blood Stem Cell Transplantation

The objective of this study is to evaluate the efficacy of using a reduced-intensity condition (RIC) regimen with umbilical cord blood transplant (UCBT), double cord UCBT, matched unrelated donor (MUD) bone marrow transplant (BMT) or peripheral blood stem cell transplant (PBSCT) in patients with non-malignant disorders that are amenable to treatment with hematopoietic stem cell transplant (HSCT). After transplant, subjects will be followed for late effects and for ongoing graft success.

Read the detailed description

For some non-malignant diseases (NMD; i.e., thalassemia, sickle cell disease, most immune deficiencies) a hematopoietic stem cell transplant may be curative by healthy donor stem cell engraftment alone. HSCT in patients with NMD differs from that in malignant disorders for two important reasons: 1) these patients are typically naïve to chemotherapy and immunosuppression. This may potentially lead to difficulties with engraftment. And 2) RIC with subsequent bone marrow chimerism may be beneficial even in mixed chimerism and result in decreased transplant-related mortality (TRM). Nevertheless, any previous organ damage, as a result of the underlying disease, may remain present after the HSCT.

For other diseases (metabolic disorders, some immunodeficiencies, etc.), a transplant is not curative. For these diseases, the main intent of the transplant is to slow down, or stop, the progress of the disease. In select few cases/diseases, the presence of healthy bone marrow derived cells may even prevent progression and prevent neurological decline.

Research funds are not available to assist with enrollment on this trial.

In this research study, instead of using the standard myeloablative conditioning, the study doctor is using RIC, in which significantly lower doses of chemotherapy will be used. The lower doses may not eradicate every stem cell in the patient's bone marrow, however, in the presented combination, the intention is to eliminate already formed immune cells and provide maximum growth advantage to healthy donor stem cells. This paves the way to successful engraftment of donor stem cells. Engrafting donor stem cells can outcompete, and donor lymphocytes could suppress, the patients' surviving stem cells. With RIC, the side effects on the brain, heart, lung, liver, and other organ functions are less severe and late toxic effects should also be reduced.

The purpose of this study is to collect data from the patients undergoing reduced-intensity conditioning before HSCT, and compare it to the standard myeloablative conditioning. It is expected there will be therapeutic benefits, paired with better survival rate, less organ toxicity and improved quality of life, following the RIC compared to the myeloablative regimen.

Being tested
Hydroxyurea, Alemtuzumab, Fludarabine, Melphalan, Thiotepa
Keywords
Severe Combined Immune Deficiency (SCID), Omenn Syndrome, Bare Lymphocyte Syndrome (BLS), Combined Immune Deficiency (CID) syndromes, Combined Variable Immune Deficiency (CVID) syndrome, Wiskott-Aldrich Syndrome, Leukocyte adhesion deficiency, Chronic granulomatous disease (CGD), X-linked Hyper IgM (XHIM) syndrome, IPEX syndrome, Chediak - Higashi Syndrome, Autoimmune Lymphoproliferative Syndrome (ALPS), Hemophagocytic Lymphohistiocytosis (HLH) syndromes, Lymphocyte Signaling defects, Dyskeratosis Congenita (DC), Congenital Amegakaryocytic Thrombocytopenia (CAMT), Osteopetrosis, Mucopolysaccharidoses, Hurler syndrome (MPS I), Hunter syndrome (MPS II)
Medical subject headings
Primary Immunodeficiency Diseases, Congenital Bone Marrow Failure Syndromes, Arthritis, Juvenile, Severe Combined Immunodeficiency, Syndrome, Wiskott-Aldrich Syndrome, Leukocyte adhesion deficiency type 1, Granulomatous Disease, Chronic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • HydroxyureaDrug

    Also called hydroxycarbamide, Hydrea, Droxia

    Oral administration

  • AlemtuzumabDrug

    Also called Campath

    Intravenous (IV) administration.

  • FludarabineDrug

    Also called Fludara

    IV administration

  • MelphalanDrug

    Also called Melphalan hydrochloride, Alkeran

    IV administration

  • ThiotepaDrug

    IV administration

Study groups in NCT01962415
Study groupRoleWhat they receive
UCBT:transfusion dependent anemias or increased rejection riskExperimentalAlemtuzumab, Hydroxyurea, Fludarabine, Melphalan, and Thiotepa conditioning regimen prior to allogenic HSCT.
Receives: Drug: Hydroxyurea; Drug: Alemtuzumab; Drug: Fludarabine; Drug: Melphalan; Drug: Thiotepa
BMT, PBSCT and not transfusion dependent UCBTExperimentalAlemtuzumab, Hydroxyurea, Fludarabine, Melphalan, and Thiotepa conditioning regimen prior to allogenic HSCT.
Receives: Drug: Hydroxyurea; Drug: Alemtuzumab; Drug: Fludarabine; Drug: Melphalan; Drug: Thiotepa

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Post-transplant treatment-related mortality (TRM)

    The number of deaths related to the research intervention at day 100, 6 months, and 1 year post-transplant.

    Measured: 1 year post-transplant

  2. Neurodevelopmental milestones

    Evaluation of the pace of attaining neurodevelopmental milestones after reduced-intensity conditioning as compared to myeloablative conditioning historical controls from the target population(s).

    Measured: 1 year post-transplant

  3. Immune Reconstitution

    Evaluation of the pace of immune reconstitution.

    Measured: 1 year post-transplant

  4. Severe opportunistic infections

    Evaluation of the incidence of severe opportunistic infections.

    Measured: 1 year post-transplant

  5. GVHD occurrence

    Description of the incidence of acute graft versus host disease (GVHD) (II-IV) and chronic extensive GVHD.

    Measured: 1 year post-transplant

Secondary outcomes (6)
  1. Donor cell engraftment

    Determination of the feasibility of attaining robust donor cell engraftment (>50% donor chimerism at 6 months) following reduced-intensity conditioning (RIC) regimens prior to HSCT in the target population(s).

    Measured: 6 months post-transplant

  2. Normal enzyme level

    Determination of the feasibility of attaining and sustaining normal enzyme levels in the target population(s).

    Measured: 1 year post-transplant

  3. Neutrophil recovery

    Determination of the pace of neutrophil recovery.

    Measured: 1 year post-transplant

  4. Platelet recovery

    Determination of the pace of platelet recovery.

    Measured: 1 year post-transplant

  5. Grade 3-4 organ toxicity

    The number of grade 3-4 organ adverse events.

    Measured: 1 year post-transplant

  6. Late graft failure

    Evaluation of the incidence of late graft failure.

    Measured: 1 year post-transplant

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Oct 2013 (estimated)
  2. Study start4 Feb 2014
  3. Primary completionNov 2026 (estimated)
  4. Study completionNov 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01962415
Sponsor's protocol ID
STUDY19060337
Acronym
HSCT+RIC
Status last verified
Dec 2025
First submitted
10 Oct 2013
Last updated
15 Dec 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Vander Lugt MT, Chen X, Escolar ML, et al. Reduced-intensity single-unit unrelated cord blood transplant with optional immune boost for nonmalignant disorders. Blood Adv. 2020;4(13):3041-3052. Blood Adv. 2020 Aug 11;4(15):3508. doi: 10.1182/bloodadvances.2020002967. No abstract available.

    PubMed 32750127
  • Vander Lugt MT, Chen X, Escolar ML, Carella BA, Barnum JL, Windreich RM, Hill MJ, Poe M, Marsh RA, Stanczak H, Stenger EO, Szabolcs P. Reduced-intensity single-unit unrelated cord blood transplant with optional immune boost for nonmalignant disorders. Blood Adv. 2020 Jul 14;4(13):3041-3052. doi: 10.1182/bloodadvances.2020001940.

    PubMed 32634238

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Hydroxyurea, Alemtuzumab and Fludarabine in people with Primary Immunodeficiency (PID) and Congenital Bone Marrow Failure Syndromes, run by Paul Szabolcs at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 55 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 15 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Paul Szabolcs, MD (412-692-5427, paul.szabolcs@chp.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Post-transplant treatment-related mortality (TRM) (time frame: 1 year post-transplant). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01962415, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Dec 2025.

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