ACTIVE_NOT_RECRUITING

Conditioning SCID Infants Diagnosed Early

Conditions

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

The investigators want to study if lower doses of chemotherapy will help babies with SCID to achieve good immunity with less short and long-term risks of complications after transplantation. This trial identifies babies with types of immune deficiencies that are most likely to succeed with this approach and offers them transplant early in life before they get severe infections or later if their infections are under control. It includes only patients receiving unrelated or mismatched related donor transplants. The study will test if patients receiving transplant using either a low dose busulfan or a medium dose busulfan will have immune recovery of both T and B cells, measured by the ability to respond to immunizations after transplant. The exact regimen depends on the subtype of SCID the patient has. Donors used for transplant must be unrelated or half-matched related (haploidentical) donors, and peripheral blood stem cells must be used. To minimize the chance of graft-versus-host disease (GVHD), the stem cells will have most, but not all, of the T cells removed, using a newer, experimental approach of a well-established technology. Once the stem cell transplant is completed, patients will be followed for 3 years. Approximately 9-18 months after the transplant, vaccinations will be administered, and a blood test measuring whether your child's body has responded to the vaccine will be collected.

Official Title

A Randomized Trial of Low Versus Moderate Exposure Busulfan for Infants With Severe Combined Immunodeficiency (SCID) Receiving TCRαβ+/CD19+ Depleted Transplantation: A Phase II Study by the Primary Immune Deficiency Treatment Consortium (PIDTC) and Pediatric Blood and Marrow Transplant Consortium (PBMTC)

Quick Facts

Study Start:2018-10-22
Study Completion:2028-12-01
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:ACTIVE_NOT_RECRUITING

Study ID

NCT03619551

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:0 Years to 2 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:CHILD
Inclusion CriteriaExclusion Criteria
  1. 1. Typical SCID is defined as either of the following
  2. * Absence or very low number of T cells (CD3+ T cells \<300/microliter AND no or very low T cell function (\<10% of lower limit of normal) as measured by response to phytohemagglutinin OR
  3. * Presence of maternally derived T cells
  4. 2. Leaky SCID is defined as the following
  5. 3. Omenn syndrome • Generalized skin rash
  6. * Maternal lymphocytes tested for and not detected.
  7. * \>80% of CD3+ or CD4+ T cells are CD45RO+ AND/OR \>80% of CD3+ or CD4+ T cells are CD62L negative AND/OR \>50% of CD3+ or CD4+ T cells express HLA-DR (\<2 years of age)
  8. * Absent or low (up to 30% lower limit of normal (LLN)) T cell proliferation to antigens (Candida, tetanus) to which the patient has been exposed IF: Proliferation to antigen was not performed, but at least 4 of the following 8 supportive criteria, at least one of which must be among those marked with an asterisk (\*) below are present, the patient is eligible as Omenn Syndrome.
  9. 1. Hepatomegaly
  10. 2. Splenomegaly
  11. 3. Lymphadenopathy
  12. 4. Elevated IgE
  13. 5. Elevated absolute eosinophil count
  14. 6. \*Oligoclonal T cells measured by CDR3 length or flow cytometry (upload report)
  15. 7. \*Proliferation to PHA is reduced to \< 50% of lower limit of normal (LLN) or SI \< 30
  16. 8. \*Low TRECs and/or percentage of CD4+/RA+ CD31+ or CD4+/RA+ CD62L+ cells below the lower level of normal
  17. 1. Haploidentical related mobilized peripheral blood cells
  18. 2. 9/10 or 10/10 allele matched (HLA-A, -B, -C, -DRB1, -DQB1) volunteer unrelated donor mobilized peripheral blood cells 5. Age 0 to 2 years at enrollment
  19. 1. Cardiac:
  20. 2. Hepatic:
  21. 3. Renal:
  22. 4. Pulmonary No need for supplemental oxygen and O2 saturation \> 92% on room air at sea level (with lower levels allowed at higher elevations per established center standard of care).
  1. 1. Presence of any serious life-threatening or opportunistic infection at time of enrollment and prior to the initiation of the preparative regimen. Serious infections as defined below that occur after enrollment must be reported immediately to the Study Coordinating Center, and enrollment will be put on hold until the infection resolves. Ideally enrolled subjects will not have had any infection. If patients have experienced infections, these must have resolved by the following definitions:
  2. 2. Patients with HIV or HTLV I/II infection will be excluded.

Contacts and Locations

Principal Investigator

Sung-Yun Pai, MD
STUDY_CHAIR
National Institutes of Health (NIH)
Michael Pulsipher, MD
STUDY_CHAIR
Children's Hospital Los Angeles

Study Locations (Sites)

Univeristy of Alabama at Birmingham
Birmingham, Alabama, 35294
United States
Mayo Clinic Arizona and Phoenix Children's Hospital
Phoenix, Arizona, 85016
United States
Children's Hospital Los Angeles
Los Angeles, California, 90027
United States
UCLA Center for Health Sciences
Los Angeles, California, 90095
United States
Rady Children's Hospital, San Diego
San Diego, California, 92123
United States
University of California San Francisco Medical Center - Peds
San Francisco, California, 94143
United States
University of Colorado - Children's Hospital
Aurora, Colorado, 80045
United States
Nemours Alfred I. duPont Hospital for Children
Wilmington, Delaware, 19803
United States
Children's National Medical Center
Washington D.C., District of Columbia, 20010
United States
Shands HealthCare & University of Florida
Gainesville, Florida, 32610
United States
University of Miami/Jackson Memorial Hospital
Miami, Florida, 33136
United States
All Children's Hospital
St. Petersburg, Florida, 33701
United States
Children's Healthcare of Atlanta at Egleston
Atlanta, Georgia, 30329
United States
Comer Children's Hospital/University of Chicago Medicine
Chicago, Illinois, 60637
United States
Indiana University Hospital/Riley Hospital for Children
Indianapolis, Indiana, 46202
United States
University of Iowa Hospitals & Clinics
Iowa City, Iowa, 52242
United States
Children's Hospital / LSUHSC
New Orleans, Louisiana, 70118
United States
Dana Farber Cancer Institute - Peds
Boston, Massachusetts, 02115
United States
The University of Michigan
Ann Arbor, Michigan, 48109
United States
Helen DeVos Children's
Grand Rapids, Michigan, 49503
United States
University of Minnesota Blood and Marrow Transplant Program - Pediatrics
Minneapolis, Minnesota, 55455
United States
The Children's Mercy Hospitals and Clinics
Kansas City, Missouri, 64108
United States
Cardinal Glennon Children's Medical Center
St Louis, Missouri, 63104
United States
Washington University/St. Louis Children's Hospital
St Louis, Missouri, 63110
United States
Nebraska Medicine
Omaha, Nebraska, 68198
United States
Hackensack University Medical Center
Hackensack, New Jersey, 07601
United States
Morgan Stanley Children's Hospital of New York-Presbyterian - Columbia University Medical Center
New York, New York, 10032
United States
Memorial Sloan Kettering Cancer Center - Peds
New York, New York, 10065
United States
Cohen Children's Medical Center
Queens, New York, 11040
United States
Westchester Medical Center
Valhalla, New York, 10595
United States
Levine Children's Hospital
Charlotte, North Carolina, 28203
United States
Duke University Medical Center; Pediatric Blood and Marrow Transplant
Durham, North Carolina, 27705
United States
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, 45229
United States
Cleveland Clinic Foundation
Cleveland, Ohio, 44195
United States
Nationwide Children's Hospital
Columbus, Ohio, 43205
United States
Oregon Health and Science University
Portland, Oregon, 97239-3098
United States
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, 19104
United States
Children's Hospital of Pittsburgh of UPMC
Pittsburgh, Pennsylvania, 15224
United States
Vanderbilt University Medical Center
Nashville, Tennessee, 37232
United States
Children's Medical Center Dallas
Dallas, Texas, 75235
United States
M.D. Anderson Cancer Center
Houston, Texas, 77030
United States
Utah Blood and Marrow Transplant Program-Peds
Salt Lake City, Utah, 84112
United States
Virginia Commonwealth University Massey Cancer Center
Richmond, Virginia, 23220
United States
Fred Hutchinson Cancer Research Center
Seattle, Washington, 98109
United States
University of Wisconsin Hospital and Clinics
Madison, Wisconsin, 53792
United States
Children's Hospital of Wisconsin
Milwaukee, Wisconsin, 53226
United States

Collaborators and Investigators

Sponsor: Center for International Blood and Marrow Transplant Research

  • Sung-Yun Pai, MD, STUDY_CHAIR, National Institutes of Health (NIH)
  • Michael Pulsipher, MD, STUDY_CHAIR, Children's Hospital Los Angeles

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 Date2018-10-22
Study Completion Date2028-12-01

Study Record Updates

Study Start Date2018-10-22
Study Completion Date2028-12-01

Terms related to this study

Additional Relevant MeSH Terms

  • SCID