Acute Myeloid LeukemiaPhase 1NCT02508038
Alpha/Beta CD19+ Depleted Haploidentical Transplantation + Zometa for Pediatric Hematologic Malignancies and Solid Tumors
A Phase 1 study testing TCRαβ+/CD19+ depleted Haploidentical HSCT and Zoledronate in people with Acute Myeloid Leukemia and Acute Lymphoblastic Leukemia, run by University of Wisconsin, Madison at 1 site in United States.
Trial summary
This phase I trial studies the safety of transplantation with a haploidentical donor peripheral blood stem cell graft depleted of TCRαβ+ cells and CD19+ cells in conjunction with the immunomodulating drug, Zoledronate, given in the post-transplant period to treat pediatric patients with relapsed or refractory… Read more about this study
- Who is it for?
- Ages 7 months to 21 years
- Conditions the study is for
- Acute Myeloid Leukemia, Acute Lymphoblastic Leukemia, Hodgkin Lymphoma
- What is being tested?
- TCRαβ+/CD19+ depleted Haploidentical HSCT and Zoledronate
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 22 participants
- Where
- 1 siteUnited States
- Study dates
- 12 Feb 2016to Dec 2027
- Phase
- Phase 1
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 7 months to 21 years
- All sexes
- No healthy volunteers
- Child, Adult
Who may be able to join
- Availability of an eligible haploidentical donor
- Hematologic malignancy or solid tumor
- Patients with more than one malignancy (hematologic or solid tumor) are eligible
- Patients with hematologic malignancy must have no HLA identical sibling or suitable unrelated donor OR time needed to find an acceptable unrelated donor match would likely result in disease progression such that the patient may become ineligible for any type of potentially curative transplant
- Relapsed or primary therapy-refractory AML with bone marrow blast < 20%
- High-risk refractory or relapsed ALL in patients for whom transplantation is deemed indicated (relapse occurring < 30 months from diagnosis, patients relapsing after previous allogeneic transplant, relapse after 2nd remission, primary induction failure or hypodiploidy)
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- Relapsed Hodgkin lymphoma unable to achieve 2nd remission or Very Good Partial Response (VGPR) and therefore ineligible to receive autologous hematopoietic stem cell transplant (auto-HSCT)
- Hodgkin lymphoma relapsing after auto-HSCT
- Primary refractory or relapsed non-Hodgkin lymphoma unable to achieve 2nd remission or VGPR and therefore ineligible to receive auto-HSCT
- Non-Hodgkin lymphoma relapsing after auto-HSCT
- Myelodysplastic Syndrome/Myeloproliferative Syndrome
- Solid Tumor
- Patients with solid tumor must have failed or have been ineligible to receive auto-HSCT or if auto-HSCT would not offer > 20% chance of cure
- Neuroblastoma
- high risk with relapsed or refractory disease
- Soft tissue sarcomas (Rhabdomyosarcoma, Ewing sarcoma, Primitive Neuroectodermal Tumor or other high-risk extracranial solid tumors)
- Relapsed or primary refractory metastatic
- 1st complete remission, but very high-risk features (i.e., < 20% survival with conventional therapy)
- Osteosarcoma
- Failure to achieve Complete Response (CR) following initial therapy
- Relapsed with pulmonary or bone metastases and did not achieve a CR with surgery and/or chemotherapy
- Karnofsky (patients > 16 years) or Lansky (patients 16 years or older) performance score of ≥ 60
- Life expectancy of ≥ 3 months
- Patient must have fully recovered from acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy prior to entering this study
- Study enrollment no earlier than 3 months after preceding HSCT
- Glomerular Filtration Rate (GFR) ≥ 60 ml/min/1.73m2
- Total bilirubin < 3 mg/dL
- ALT (alanine aminotransferase, SCPT) ≤ 5 x Upper LImit of Normal (ULN) for age
- Ejection fraction of > 40% by Multigated Acquisition Scan (MUGA) or echocardiogram
- No evidence of dyspnea at rest
- No supplemental oxygen requirement
- If measured, carbon monoxide diffusion capacity (DLCO) >50%
- No severe peripheral neuropathy, signs of leukoencephalopathy or active Central Nervous System (CNS) infection
- Patients with seizure disorders may be enrolled if seizures are well controlled on anticonvulsant therapy
- If of reproductive potential, negative pregnancy test and willing to use effective birth control method
- Informed consent from patient or legal guardian (if patient is minor)
- Donor must be 18 years of age minimum, 65 years of age maximum
- Donor must be in good general health as determined by evaluating medical provider
- Must meet donor criteria for human cells, tissues, and cellular and tissue-based products per Code of Federal Regulations 21 CFR 1271, subpart C. Specifically:
- Donor screening in accordance with 1271.75 indicates that the donor:
- Is free from risk factors for, and clinical evidence of, infection due to relevant communicable disease agents and diseases; and
- Is free from communicable disease risks associated with xenotransplantation; and
- The results of donor testing for relevant communicable disease agents in accordance with 1271.80 and 1271.85 are negative or nonreactive, except as provided in 1271.80(d)(1).
- Haploidentical by HLA-typing
- Preference will be given to donors who demonstrate KIR incompatibility with recipient HLA class I ligands defined as the donor expressing a KIR gene for which the corresponding HLA class I ligand is not expressed by the recipient.
- Negative testing for relevant communicable diseases:
- Hepatitis B surface antigen (HBsAg)
- Hepatitis B core antibody (Anti-HBc)
- Hepatitis C antibody (Anti-HCV)
- HIV 1 \& 2 antibody (Anti-HIV-1, 2 plus O)
- HTLV I/II antibody (Anti-HTLV I/II)
- RPR (Syphilis TP)
- CMV (Capture CMV)
- MPX for: HepB (HBV-PCR), HepC (HCV-PCR), HIV (HIV-PCR)
- NAT for West Nile Virus (WNV-PCR)
- T. Cruzi - EIA (Chagas)
Who cannot join
- Pregnant or breast-feeding
- HIV infection
- Heart failure or uncontrolled cardiac rhythm disturbance
- Uncontrolled, Serious Active Infection
- Prior organ allograft
- Significant serious intercurrent illness unrelated to cancer or its treatment not covered by other exclusion criteria expected to significantly increase the risk of HSCT
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- Any mental or physical condition, in the opinion of the PI (or PI designee), which could interfere with the ability of the subject (or the only parent or legal guardian available to care for the subject) to understand or adhere to the requirements of the study
- Enrollment in any other clinical study from screening up to Day 100 (unless PI judges such enrollment would not interfere with endpoints of this study)
- Lactating females
- Pregnant females
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Celeste Matsushima contact
United States1 site, 1 recruiting
- Recruiting
University of Wisconsin Carbone Cancer Center
Madison, Wisconsin, 53705
Pediatric HemOnc Main Line, 608-263-6200, PedsHemOncResearch@g-groups.wisc.edu
Cancer Connect, 800-622-8922, clinicaltrials@cancer.wisc.edu
About this study
Official title: TCR-αβ+ and CD19+ Depleted KIR/KIR Ligand-mismatched Haploidentical Hematopoietic Stem Cell Transplant and Zoledronate for Pediatric Relapsed/Refractory Hematologic Malignancies and High Risk Solid Tumors
This phase I trial studies the safety of transplantation with a haploidentical donor peripheral blood stem cell graft depleted of TCRαβ+ cells and CD19+ cells in conjunction with the immunomodulating drug, Zoledronate, given in the post-transplant period to treat pediatric patients with relapsed or refractory hematologic malignancies or high risk solid tumors.
Read the detailed description
CONDITIONING REGIMENS: Patients with high-risk leukemia will receive myeloablative conditioning with anti-thymocyte globulin intravenously (IV) over 4-6 hours on days -12 through -9, Fludarabine IV over 30 minutes on days -8 through -5, Thiotepa IV every every 12 hours on day -4 and Total Body Irradiation (TBI) on days -3 through -1. All other patients receive reduced intensity conditioning consisting of anti-thymocyte globulin intravenously (IV) over 4-6 hours on days -12 through -9, fludarabine IV over 30 minutes on days -8 through -5, thiotepa IV over 4 hours every 12 hours on day -4, and melphalan IV on days -3 and -2.
PERIPHERAL BLOOD STEM CELL TRANSPLANTATION: Patients undergo TCR-alpha/beta+ and CD19+ depleted KIR/KIR ligand-mismatched haploidentical donor peripheral blood stem cell transplantation on day 0. If the graft contains less than 4 x 10^6 CD34+ cells/kg, a second HSC graft may be administered.
PROPHYLAXIS FOR GVHD: Patients receiving a graft containing > 25 x 10^3 CD3+ TCR alpha/beta+ cells receive mycophenolate mofetil IV twice daily over 2 hours on days 1 to 30 with a rapid taper. Patients with TCR alpha/beta+ cells exceeding 100,000/kg also receive tacrolimus IV continuously or orally (PO) every 12 hours on days 0-90 with a taper at the discretion of the Principal Investigator.
ZOLEDRONATE ADMINISTRATION: Patients will receive five doses of Zoledronate (IV) at 28 day intervals beginning on Day +28 post-HSCT.
Follow-up assessments will occur after transplantation.
- Conditions
- Acute Myeloid Leukemia, Acute Lymphoblastic Leukemia, Hodgkin Lymphoma, Non-Hodgkin Lymphoma, Myelodysplastic Syndrome, Myeloproliferative Syndrome
- Being tested
- TCRαβ+/CD19+ depleted Haploidentical HSCT, Zoledronate
- Keywords
- alpha beta depleted, alphabeta, TCR alpha beta depleted, alpha beta, haploidentical, Zoledronate, Zoledronic acid, Pediatric cancers, alfa beta, αβ T cell depleted HSCT, alpha beta T cell and B cell depleted HSCT, haploidentical HSCT
- Medical subject headings
- Leukemia, Myeloid, Acute, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Hodgkin Disease, Lymphoma, Non-Hodgkin, Myelodysplastic Syndromes, Rhabdomyosarcoma, Sarcoma, Ewing, Neuroectodermal Tumors, Primitive
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
TCRαβ+/CD19+ depleted Haploidentical HSCTProcedure or surgery
Patients with high-risk leukemia will receive myeloablative conditioning. All other patients will undergo a reduced-intensity conditioning with ATG, Fludarabine, Thiotepa and Melphalan followed by transplant with a KIR/KIR (Killer cell immunoglobulin-like recetptor) ligand mismatched haploidentical donor peripheral blood stem cell graft depleted of TCRab+ cells and CD19+ cells using the CliniMACS System.
ZoledronateDrug
Also called Zoledronic Acid, Zometa
Given IV. Patients will receive five doses of Zoledronate (each 1.25 mg/m2 at a 28 day interval) following transplant.
| Study group | Role | What they receive |
|---|---|---|
| TCRαβ+/CD19+ depleted Haploidentical HSCT+ Zoledronate | Experimental | Patients with high-risk leukemia (who are at least one year of age and who have not received TBI as conditioning for a previous HSCT) will receive myeloablative conditioning with ATG, Fludarabine, Thiotepa, and TBI. All other subjects will undergo a reduced-intensity conditioning regimen consisting of ATG, Fludarabine, Thiotepa, and Melphalan prior to transplant with a KIR/KIR ligand mismatched haploidentical donor peripheral blood stem cell graft depleted of TCR-αβ+ and CD19+ cells. Patients will receive 5 doses of zoledronate (at 28 day intervals) starting 28 days after stem cell transplant. Receives: Procedure: TCRαβ+/CD19+ depleted Haploidentical HSCT; Drug: Zoledronate |
What is being measured
The primary outcome is the main question the study is designed to answer.
Incidence of acute graft versus host disease (GVHD)
Measured: Within 100 days post-transplantation
Incidence of graft failure
Measured: At day 28
Secondary outcomes (2)
Immune reconstitution
Immune reconstitution outcomes, as determined by immune cell analysis.
Measured: Up to 1 year
Performance of the CliniMACS Reagent System utilizing the CliniMACS TCRαβ-biotin and CliniMACS CD19 reagent to produce a graft with defined cell content.
The performance of the CliniMACS Reagent System will be evaluated by measuring the number of viable stem cells, TCRαβ+ cells, TCRγδ+ cells, NK cells and B cells in the hematopoietic stem cell graft.
Measured: Day 0
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 Jul 2015 (estimated)
- Study start12 Feb 2016
- Primary completionDec 2026 (estimated)
- Study completionDec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Acute Myeloid LeukemiaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 1
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 22 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Wisconsin, Madison
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Christian Capitini, MD, Principal investigator, University of Wisconsin, Madison
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02508038
- Sponsor's protocol ID
- UW13090
- Other IDs
- NCI-2015-01163, 2015-0290, A536700, SMPH\PEDIATRICS\PEDIATRICS, Protocol Version 10/12/2021
- Status last verified
- Oct 2025
- First submitted
- 22 Jul 2015
- Last updated
- 16 Oct 2025
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Hattinger CM, Patrizio MP, Magagnoli F, Luppi S, Serra M. An update on emerging drugs in osteosarcoma: towards tailored therapies? Expert Opin Emerg Drugs. 2019 Sep;24(3):153-171. doi: 10.1080/14728214.2019.1654455. Epub 2019 Aug 14.
PubMed 31401903