RECRUITING

Alpha/Beta CD19+ Depleted Haploidentical Transplantation + Zometa for Pediatric Hematologic Malignancies and Solid Tumors

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Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

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.

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

Quick Facts

Study Start:2016-02-12

Study Completion:2026-12

Study Type:Not specified

Phase:Not Applicable

Enrollment:Not specified

Status:RECRUITING

Study ID

NCT02508038

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:7 Months to 21 Years

Sexes Eligible for Study:ALL

Accepts Healthy Volunteers:No

Standard Ages:CHILD, ADULT

Inclusion Criteria	Exclusion Criteria
* 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) * 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 * 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)	* 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 * 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

Inclusion Criteria

Exclusion Criteria

* 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)
* 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
* 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)

* 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
* 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

Contacts and Locations

Study Contact

Jenny Weiland

CONTACT

608-890-8070

PedsHemOncResearch@g-groups.wisc.edu

Celeste Matsushima

CONTACT

608-890-8069

Principal Investigator

Christian Capitini, MD

PRINCIPAL_INVESTIGATOR

University of Wisconsin, Madison

Study Locations (Sites)

University of Wisconsin Carbone Cancer Center

Madison, Wisconsin, 53705

United States

Collaborators and Investigators

Sponsor: University of Wisconsin, Madison

Christian Capitini, MD, PRINCIPAL_INVESTIGATOR, University of Wisconsin, Madison

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2016-02-12

Study Completion Date2026-12

Study Record Updates