IS-free Treg HaploHCT

PHASE1RecruitingINTERVENTIONAL
Enrollment

30

Participants

Timeline

Start Date

January 12, 2021

Primary Completion Date

August 31, 2028

Study Completion Date

August 31, 2029

Conditions
Stem Cell Transplant ComplicationsGraft Vs Host DiseaseMyeloid Leukemia, AcuteMyeloid Leukemia in Relapse (Disorder)Myelodysplastic Syndromes
Interventions
RADIATION

Radiation

"For MAC regimen:~Total Myeloid and Lymphoid Irradiation (TMLI) delivered through Radiation Oncology institutional standards and comprised of 13.5 Gy TMI (9 fractions, 1.5 Gy per fraction, 2 fractions per day) and 11.7 Gy TLI (9 fractions, 1.3 Gy per fraction, 2 fractions per day).~OR Total Body Irradiation (TBI) comprised of 12 Gy (6 fractions, 2 Gy per fraction, 2 fractions per day)~For RIC regimen:~TBI comprised of 2 Gy in 1 fraction."

DRUG

Fludarabine

"For MAC regimen: 30 mg/m\^2/d in 100 ml normal saline (NS) will be administered as a bolus infusion administered by IV infusion over approximately 30 minutes for 5 days (on day -10, -9, -8, -7, -6)~For RIC regimen: 40 mg/m\^2/d in 100 ml NS will be administered as a bolus by IV infusion over approximately 30 minutes for 4 days (on day -10, -9, -8, -7)"

DRUG

Thiotepa

"For MAC regimen: 3.75 mg/kg diluted in NS to a final concentration of 1mg/mL will be administered by IV infusion over approximately 4 hours daily for 2 days (on day -10, -9)~For RIC regimen: 5 mg/kg diluted in NS to a final concentration of 1mg/mL will be administered by IV infusion over approximately 4 hours twice daily for 1 day (on day -11)"

DRUG

Cyclophosphamide

For MAC regimen only: 15 mg/kg diluted in NS per institutional standard and will be administered by IV over 1 hour or as directed per institutional standard practice, daily on D-8, -7.

DRUG

Mesna

For MAC regimen only: 3.75mg/kg (25% of cyclophosphamide dose) diluted in 50 mL NS and administered IV over 30 min, will be infused starting 30 min prior to cyclophosphamide and for 3 doses thereafter, at 3, 6 and 9h after cyclophosphamide

BIOLOGICAL

Treg-enriched donor cell

Target 'Treg-enriched' cell dose is 1-2 x 10\^6 cells/kg. Cells will be given intravenously on Day -4. The day -1 calculated unmodified PBMC T ('Teff') cell dose will be adjusted to maintain a targeted cell ratio of 2 'Treg-enriched' cells:1 'Teff' cell.

BIOLOGICAL

Unmodified donor T Cell

"Unmodified donor PBMCs will be infused at a calculated 'Teff' dose of 1x10\^6 CD3+ T cells/kg, adjusted per the caveats below:~A) If the 'Treg-enriched' product infused was at target dose of 2x106 cells/kg but had ≥30% CD4+CD25+CD127hi cells, the unmodified 'Teff' (calculated) cell dose infused on day -1 will be halved to 0.5x10\^6 CD3+ T cells/kg.~B) If the 'Treg-enriched' product was in the range of 1-2x106 cells/kg, the unmodified 'Teff' (calculated) cell dose on day -1 will be adjusted to between 0.5-1x10\^6 CD3+ T cells/kg, dosed to maintain a 2 'Treg-enriched':1 'Teff' (calculated) ratio of infused cells.~C) If the 'Treg-enriched' product infused met both caveats A and B above, the unmodified 'Teff' (calculated) cell dose infused on day -1 will be halved to 0.5x10\^6 CD3+ T cells/kg."

PROCEDURE

CD34+ Haplo Peripheral Blood Stem Cell

The megadose donor CD34+ PBSC infusion target is \>10x10\^6 CD34+ cells/kg (ABW or IBW, whichever is greater). If the CD34+ graft has \<6x10\^6 CD34+ cells/kg (ABW or IBW, whichever is greater) (below megadose minimum) it WILL be infused in order to rescue recipient hematopoiesis, and the patient will remain on study.

DRUG

Melphalan

For RIC regimen only: 100 mg/m2 will be administered as a bolus by IV infusion over approximately 30 minutes for 1 day (on day -6)

Trial Locations (1)

02115

RECRUITING

Dana Farber Cancer Institute, Boston

All Listed Sponsors
lead

Dana-Farber Cancer Institute

OTHER

NCT04678401 - IS-free Treg HaploHCT | Biotech Hunter | Biotech Hunter