RECRUITING

Safety of Belimumab in People With Idiopathic CD4 Lymphopenia and Autoantibodies (Phoebe)

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

Background: People with Idiopathic CD4 lymphopenia (ICL) have lower numbers of a type of white blood cell called CD4 cells. White blood cells fight against infections. Low levels of CD4 cells may make a person more likely to get sick. There are no approved treatments for ICL. Researchers think a drug called belimumab may be able to help in specific situations. Objective: To see if belimumab is safe for people with ICL. Eligibility: People ages 18-70 who have ICL and are participating in NIH protocol 09-I-0102 (EPIC) Design: Participants will be screened with: Medical and medication history Physical exam Questionnaire about mental health and depression Blood and urine tests Participants will have a baseline visit. This will include some repeats of the screening tests. They may also have leukapheresis: Blood will be taken from a needle in one arm and passed through a machine that separates out the white blood cells. The rest of the blood will be returned through a needle in the other arm. Participants will receive 8 doses of belimumab through IV: A needle will insert a thin plastic tube into an arm vein. Belimumab will be given through the IV line. The first 3 doses will be given every 2 weeks. The other 5 will be given once every 4 weeks. Participants will have a physical exam and blood and urine tests at each dosing visit. They will be monitored for up to 4 hours after the infusion. Participants will have 3 follow-up visits, at around 8, 16, and 24 weeks after the last dose of belimumab. They will have a physical exam and blood and urine tests. Once they finish this protocol and they will continue to be followed under 09-I-0102 (EPIC study).

Official Title

A Phase 1 Evaluation of the Safety of Belimumab in People With Idiopathic CD4 Lymphopenia and Autoantibodies (Phoebe)

Quick Facts

Study Start:2020-01-13
Study Completion:2025-12-29
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT04097561

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:18 Years to 70 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. * Aged 18-70 years.
  2. * Enrolled in study 09-I-0102.
  3. * Has a documented diagnosis of ICL, defined as the following:
  4. * CD4 count \< 300 cells/microliter in at least 2 separate measurements 6 weeks apart at any point in the past, AND
  5. * CD4 count \< 300 cells/microliter within previous 90 days.
  6. * Evidence for autoantibody positivity (eg, ANA or in the research flow method looking for antilymphocyte antibodies).
  7. * Female participants of childbearing potential must agree to use adequate contraception when engaging in sexual activities that can result in pregnancy, beginning at day 0 (or day 30 for hormonal contraception) until 4 months after the last dose of belimumab.
  8. * Hormonal contraception.
  9. * Male or female condom.
  10. * Diaphragm or cervical cap with a spermicide.
  11. * Intrauterine device.
  12. * Able to provide informed consent.
  13. * Willing to allow samples to be stored for future research.
  1. * Prior receipt of belimumab for any reason.
  2. * Allergy to any component of belimumab formulation.
  3. * HIV infection or other recognized congenital or acquired immunodeficiency.
  4. * Current moderate or severe acute illness (eg, febrile illness, seizure, myocardial infarction, cerebrovascular accident, pulmonary embolism) or progressive serious infection related to ICL that, in the opinion of the principal investigator, would make the participant unsuitable for the study. Pre-existing infections that have been stable both clinically and with laboratory (eg, cryptococcal antigen titer or histoplasma antigen level) and radiographic evaluations on maintenance therapy over at least a year will be eligible.
  5. * Untreated hepatitis B or C (acute or chronic).
  6. * Active tuberculosis infection.
  7. * Serum creatinine \> 1.5 times the upper limit of normal (ULN).
  8. * Hemoglobin \< 8 g/dL.
  9. * Alanine transaminase or aspartate transaminase \> 2 times ULN.
  10. * Serum IgG \< 400 mg/L.
  11. * Current use of systemic glucocorticosteroids, with the exception of corticosteroid nasal spray or inhaler and topical steroids.
  12. * Any cancer diagnosis or autoimmune condition requiring systemic chemotherapy or immunomodulant-affecting antibody responses (eg, rituximab, ibrutinib), IV or SC Ig supplementation, radiation therapy, or any such treatment within the previous 6 months. Apremilast, Plaquenil, or nonsteroidal anti-inflammatory drugs will not be exclusionary.
  13. * Severe depression. Psychiatry may be consulted prior to final eligibility decision.
  14. * Infections (recently acquired or exacerbation of a chronic infection) that required new medications for management within the past 60 days.
  15. * Receipt of any vaccination within the past 30 days.
  16. * Pregnant.
  17. * Breastfeeding.
  18. * Any behavioral or substance use issue that would compromise appropriate follow up and participation in this study.

Contacts and Locations

Study Contact

Irini Sereti, M.D.
CONTACT
(301) 496-5533
isereti@niaid.nih.gov

Principal Investigator

Irini Sereti, M.D.
PRINCIPAL_INVESTIGATOR
National Institute of Allergy and Infectious Diseases (NIAID)

Study Locations (Sites)

National Institutes of Health Clinical Center
Bethesda, Maryland, 20892
United States

Collaborators and Investigators

Sponsor: National Institute of Allergy and Infectious Diseases (NIAID)

  • Irini Sereti, M.D., PRINCIPAL_INVESTIGATOR, National Institute of Allergy and Infectious Diseases (NIAID)

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 Date2020-01-13
Study Completion Date2025-12-29

Study Record Updates

Study Start Date2020-01-13
Study Completion Date2025-12-29

Terms related to this study

Keywords Provided by Researchers

  • CD8 Counts
  • B-Cell Activating Factor (BAFF)
  • Heterogeneous Disorder
  • Autoimmune Disease

Additional Relevant MeSH Terms

  • Idiopathic CD4 Lymphopenia