Trial Search Results
Phase 1 Infused Donor T Regulatory Cells in Steroid Dependent/Refractory Chronic GVHD
Chronic graft versus host disease (cGVHD) is a common complication of bone marrow or hematopoietic cell transplant from another person (allogeneic transplant). This study will determine if subjects with steroid dependent/refractory cGVHD can tolerate infusion of donor regulatory T cells and whether their cGVHD responds to the infusion.
Stanford is currently not accepting patients for this trial.
Lead Sponsor:
Laura Johnston
Collaborator: National Institutes of Health (NIH)
Stanford Investigator(s):
Intervention(s):
- Biological: Regulatory T Cells
Phase:
Phase 1
Eligibility
Inclusion Criteria:
- Steroid dependent/refractory cGVHD defined as:
- Steroid dependent disease: Persistent cGVHD manifestations requiring a
glucocorticoid dose >= prednisone 0.25 mg/kg/day (0.5 mg/kg orally [po] every
other day) for at least 12 weeks
- Steroid refractory disease: Progressive cGVHD manifestations despite treatment
with a glucocorticoid dose >= prednisone 0.5 mg/kg/day (1 mg/kg po every other
day) for at least 4 weeks
- Participants must be receiving systemic glucocorticoid therapy for cGVHD; all
immunosuppressive therapy may include but not be limited to tacrolimus, sirolimus,
CellCept, cyclosporine, and systemic corticosteroid must be at stable doses for 28
days prior to the first cell infusion
- Chronic GVHD manifestations that can be followed on physical or laboratory exam; these
include but are not necessarily limited to:
- Skin changes
- Oral mucosa changes
- Bronchiolitis obliterans
- Ocular changes
- Karnofsky performance status >= 60
- Serum creatinine =< 2 mg/dL
- Absolute neutrophil count (ANC) > 1 x 10^9/L
- Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) =< 20 x upper limit
of normal (ULN) or
- Total bilirubin =< 10 x ULN
- Allogeneic hematopoietic cell transplant recipient
- Transfusion independent
- Oxygen saturation during exertion is maintained at >= 88% on room air
- Does not have clinically significant, symptomatic uncontrolled heart disease (e.g.,
unstable angina, congestive heart failure, or uncontrolled hypertension)
- DONOR: Age >= 18 to =< 75 years old
- DONOR: Karnofsky performance status of >= 70% defined by institutional standards
- DONOR: Must be the same sibling donor from whom the recipient's blood and marrow graft
was collected for the original allogeneic transplant that is human leukocyte antigen
(HLA) 7/8 or 8/8 matched at the HLA-A, B,C, DRB1
- DONOR: Serologies for human immunodeficiency virus (HIV) antigen (Ag), HIV 1 and HIV 2
antibody (Ab), human T-lymphotropic virus type I (HTLV 1) and HTLV 2 Ab, hepatitis B
surface antigen (sAg) or polymerase chain reaction positive (PCR+), or hepatitis C Ab
or PCR+, Syphilis (Treponema) screen and HIV 1 and hepatitis C by nucleic acid testing
(NAT) have been collected prior to apheresis
- DONOR: Female donors of child-bearing potential must have a negative serum or urine
beta-human chorionic gonadotropin (HCG) test within three weeks of apheresis
- DONOR: Capable of undergoing leukapheresis, have adequate venous access, and be
willing to undergo insertion of a central catheter should leukapheresis via peripheral
vein be inadequate
- DONOR: Donor selection will be in compliance with 21 Code of Federal Regulations (CFR)
1271
Exclusion Criteria:
- Original transplant utilized an unrelated donor graft
- Uncontrolled infections that are not responsive to antimicrobial therapy
- Progressive malignant disease, including post-transplant lymphoproliferative disease
unresponsive to therapy
- Second malignancy except for skin cancer within the last 5 years
- Received any investigational agent =< 28 days before Treg infusions
- Received filgrastim (GCSF) treatment within one month of enrollment
- Received a donor lymphocyte infusion (DLI) or hematopoietic cell transplantation (HCT)
within 3 months of enrollment
- DONOR: Evidence of active infection or viral hepatitis
- DONOR: HIV positive
- DONOR: Pregnant donor
Ages Eligible for Study
18 Years - N/A
Genders Eligible for Study
All
Not currently accepting new patients for this trial
Contact Information
Stanford University
School of Medicine
300 Pasteur Drive
Stanford,
CA
94305
CCTO
650-498-7061
Not Recruiting