RECRUITING

ABBA CORD: dCBT w/ Abatacept for aGVHD Prophylaxis

Conditions

Acute Myelogenous Leukemia Acute Lymphatic Leukemia Chronic Myelogenous Leukemia Myelodysplastic Syndromes Myelodysplastic Syndrome Other Chronic Myelomonocytic Leukemia Lymphoma Hodgkin Lymphoma Chronic Myelomonocytic Lymphoma Umbilical Cord Blood Transplant Double Umbilical Cord Transplant Cord blood

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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

The goal of this clinical trial is to see if adding abatacept to tacrolimus and MMF prevents or reduces the chances of acute graft versus host disease which is a complication that can occur after transplant in participants with blood cancer. The usual therapy for graft versus host disease prevention after a cord blood transplant includes tacrolimus and MMF. The main question this clinical trial aims to answer is whether or not abatacept will be safe and effective in reducing aGVHD rates in dCBT. Participants will: * Partake in exams, tests, and procedures as part of usual cancer care. * Partake in conditioning, which is the treatment that is given before a transplant. * Have a cord blood transplant. * Partake in radiation following the transplant.

Official Title

ABBA CORD: Double Umbilical Cord Blood Transplants With Abatacept for Graft Versus Host Disease Prophylaxis

Quick Facts

Study Start:2025-02-25

Study Completion:2028-10-31

Study Type:Not specified

Phase:Not Applicable

Enrollment:Not specified

Status:RECRUITING

Study ID

NCT06680661

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 65 Years

Sexes Eligible for Study:ALL

Accepts Healthy Volunteers:No

Standard Ages:ADULT, OLDER_ADULT

Inclusion Criteria	Exclusion Criteria
* Patients with the following hematologic malignancies: * Acute myelogenous leukemia (AML): High-risk and intermediate-risk AML including: * Antecedent hematological disease (e.g., myelodysplasia (MDS)) * Treatment-related leukemia * Complete Remission (CR1) with poor or intermediate-risk cytogenetics or molecular markers (e.g. Flt 3 mutation, 11q23, del 5, del 7, complex cytogenetics) * CR2 or CR3 * Induction failure or 1st relapse with \< 10% blasts in the marrow * Acute lymphoblastic leukemia (ALL): * High-risk CR1 including: * Poor-risk cytogenetics (e.g., Philadelphia chromosome t(9;22)or 11q23 rearrangements) * Philadelphia chromosome-like ALL * Presence of minimal disease by flow cytometry after 2 or more cycles of chemotherapy * No CR within 4 weeks of initial treatment * Induction failure with \< 10% blasts in the marrow * CR2 or CR3 * Myelodysplastic syndromes (MDS), Intermediate, High or Very High Risk by the revised international prognostic scoring system or treatment related MDS. * Bi-phenotypic or mixed-phenotypic acute leukemia in: * CR. * Induction failure or 1st relapse with \< 10% blasts in the marrow. * Chronic Myelogenous Leukemia (CML) in second chronic phase after accelerated or blast crisis. * Chronic Myelomonocytic Leukemia (CMML) * Hodgkin's Lymphoma that is relapsed or refractory * Age \> or equal to 18 years, \< or equal to 70yrs * KPS \> or equal to 80 for Flu/Cy/Thio/TBI; KPS \> 60 for Flu/Treo/TBI * Patients without a suitable HLA-matched related or unrelated donor * Patient with the following CB units: * At least two 4-8/8 HLA high resolution matched CB units. Both must have a cell dose of 1.5x107 TNC/kg each and 1.5x105 CD34+/kg * A minimum of 1 CB unit as back up. * Concurrent Therapy for Extramedullary Leukemia or CNS Lymphoma: Concurrent therapy or prophylaxis for testicular leukemia, CNS leukemia, and CNS lymphoma including standard intrathecal chemotherapy and/or radiation therapy will be allowed as clinically indicated. Such treatment may continue until the planned course is completed. Subjects must be in CNS remission at the time of protocol enrollment if there is a history of CNS involvement. Maintenance therapy after transplant is allowed. * Subjects must have the ability to understand and the willingness to sign a written informed consent document. * For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use a contraceptive method with a failure rate of \< 1% per year during the treatment period and for 12 months after the last dose of abatacept. * A woman is considered to be of childbearing potential if she is \< 60 years old, postmenarcheal, has not reached a postmenopausal state (\< 12 continuous months of amenorrhea with no identified cause other than menopause), and has not undergone surgical sterilization (removal of ovaries and/or uterus). * Examples of contraceptive methods with a failure rate of \< 1% per year include bilateral tubal ligation, male sterilization, hormonal contraceptives that inhibit ovulation, hormone-releasing intrauterine devices, and copper intrauterine devices. * For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive measures with female partners of reproductive potential, and agreement to refrain from donating sperm, as defined below: * With female partners of childbearing potential, men must remain abstinent or use a condom plus an additional contraceptive method that together result in a failure rate of \< 1% per year during the treatment period and for 12 months after the last dose of abatacept. Men must refrain from donating sperm during this same period. With pregnant female partners, men must remain abstinent or use a condom during the treatment period and for at least 12 months after the last dose of abatacept. * The reliability of sexual abstinence should be evaluated in relation to the duration of the clinical trial and the preferred and usual lifestyle of the patient. Periodic abstinence (e.g., calendar, ovulation, symptothermal, or postovulation methods) and withdrawal are not acceptable methods of contraception.	* Patients with inadequate Organ Function as defined by: * Creatinine clearance \< 50ml/min * Bilirubin \> 2X institutional upper limit of normal unless Gilbert syndrome * AST (SGOT) \> 3X institutional upper limit of normal * ALT (SGPT) \> 3X institutional upper limit of normal * Pulmonary function: DLCOc \< 60% normal * Cardiac: left ventricular ejection fraction \< 50 * Patients with uncontrolled inter-current illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements. * Pregnant or breastfeeding women are excluded from this study because chemotherapy involved with RIC have the significant potential for teratogenic or abortifacient effects. * Any condition that would, in the investigator's judgment, interfere with full participation in the study, including administration of study drug and attending required study visits; pose a significant risk to the subject; or interfere with interpretation of study data. * Known allergies, hypersensitivity, or intolerance to any of the study medications, excipients, or similar compounds. * Presence of donor-specific antibodies against chosen graft source. * Hematopoietic Cell Transplantation Comorbidity index (HCT-CI) \> 5. * Prior autologous or allogenic stem cell transplant within the preceding 12 months.

Inclusion Criteria

Exclusion Criteria

* Patients with the following hematologic malignancies:
* Acute myelogenous leukemia (AML): High-risk and intermediate-risk AML including:
* Antecedent hematological disease (e.g., myelodysplasia (MDS))
* Treatment-related leukemia
* Complete Remission (CR1) with poor or intermediate-risk cytogenetics or molecular markers (e.g. Flt 3 mutation, 11q23, del 5, del 7, complex cytogenetics)
* CR2 or CR3
* Induction failure or 1st relapse with \< 10% blasts in the marrow
* Acute lymphoblastic leukemia (ALL):
* High-risk CR1 including:
* Poor-risk cytogenetics (e.g., Philadelphia chromosome t(9;22)or 11q23 rearrangements)
* Philadelphia chromosome-like ALL
* Presence of minimal disease by flow cytometry after 2 or more cycles of chemotherapy
* No CR within 4 weeks of initial treatment
* Induction failure with \< 10% blasts in the marrow
* CR2 or CR3
* Myelodysplastic syndromes (MDS), Intermediate, High or Very High Risk by the revised international prognostic scoring system or treatment related MDS.
* Bi-phenotypic or mixed-phenotypic acute leukemia in:
* CR.
* Induction failure or 1st relapse with \< 10% blasts in the marrow.
* Chronic Myelogenous Leukemia (CML) in second chronic phase after accelerated or blast crisis.
* Chronic Myelomonocytic Leukemia (CMML)
* Hodgkin's Lymphoma that is relapsed or refractory
* Age \> or equal to 18 years, \< or equal to 70yrs
* KPS \> or equal to 80 for Flu/Cy/Thio/TBI; KPS \> 60 for Flu/Treo/TBI
* Patients without a suitable HLA-matched related or unrelated donor
* Patient with the following CB units:
* At least two 4-8/8 HLA high resolution matched CB units. Both must have a cell dose of 1.5x107 TNC/kg each and 1.5x105 CD34+/kg
* A minimum of 1 CB unit as back up.
* Concurrent Therapy for Extramedullary Leukemia or CNS Lymphoma: Concurrent therapy or prophylaxis for testicular leukemia, CNS leukemia, and CNS lymphoma including standard intrathecal chemotherapy and/or radiation therapy will be allowed as clinically indicated. Such treatment may continue until the planned course is completed. Subjects must be in CNS remission at the time of protocol enrollment if there is a history of CNS involvement. Maintenance therapy after transplant is allowed.
* Subjects must have the ability to understand and the willingness to sign a written informed consent document.
* For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use a contraceptive method with a failure rate of \< 1% per year during the treatment period and for 12 months after the last dose of abatacept.
* A woman is considered to be of childbearing potential if she is \< 60 years old, postmenarcheal, has not reached a postmenopausal state (\< 12 continuous months of amenorrhea with no identified cause other than menopause), and has not undergone surgical sterilization (removal of ovaries and/or uterus).
* Examples of contraceptive methods with a failure rate of \< 1% per year include bilateral tubal ligation, male sterilization, hormonal contraceptives that inhibit ovulation, hormone-releasing intrauterine devices, and copper intrauterine devices.
* For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive measures with female partners of reproductive potential, and agreement to refrain from donating sperm, as defined below:
* With female partners of childbearing potential, men must remain abstinent or use a condom plus an additional contraceptive method that together result in a failure rate of \< 1% per year during the treatment period and for 12 months after the last dose of abatacept. Men must refrain from donating sperm during this same period. With pregnant female partners, men must remain abstinent or use a condom during the treatment period and for at least 12 months after the last dose of abatacept.
* The reliability of sexual abstinence should be evaluated in relation to the duration of the clinical trial and the preferred and usual lifestyle of the patient. Periodic abstinence (e.g., calendar, ovulation, symptothermal, or postovulation methods) and withdrawal are not acceptable methods of contraception.

* Patients with inadequate Organ Function as defined by:
* Creatinine clearance \< 50ml/min
* Bilirubin \> 2X institutional upper limit of normal unless Gilbert syndrome
* AST (SGOT) \> 3X institutional upper limit of normal
* ALT (SGPT) \> 3X institutional upper limit of normal
* Pulmonary function: DLCOc \< 60% normal
* Cardiac: left ventricular ejection fraction \< 50
* Patients with uncontrolled inter-current illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
* Pregnant or breastfeeding women are excluded from this study because chemotherapy involved with RIC have the significant potential for teratogenic or abortifacient effects.
* Any condition that would, in the investigator's judgment, interfere with full participation in the study, including administration of study drug and attending required study visits; pose a significant risk to the subject; or interfere with interpretation of study data.
* Known allergies, hypersensitivity, or intolerance to any of the study medications, excipients, or similar compounds.
* Presence of donor-specific antibodies against chosen graft source.
* Hematopoietic Cell Transplantation Comorbidity index (HCT-CI) \> 5.
* Prior autologous or allogenic stem cell transplant within the preceding 12 months.

Contacts and Locations

Study Contact

Leland Metheny, MD

CONTACT

216-844-0139

Leland.Metheny@uhhospitals.org

Principal Investigator

Leland Metheny, MD

PRINCIPAL_INVESTIGATOR

University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center

Study Locations (Sites)

University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center

Cleveland, Ohio, 44106

United States

Collaborators and Investigators

Sponsor: Leland Metheny

Leland Metheny, MD, PRINCIPAL_INVESTIGATOR, University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center

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 Date2025-02-25

Study Completion Date2028-10-31

Study Record Updates

Study Start Date2025-02-25

Study Completion Date2028-10-31

Terms related to this study

Keywords Provided by Researchers

Chronic Myelomonocytic Lymphoma
Umbilical Cord Blood Transplant
Double Umbilical Cord Transplant
Cord blood

Additional Relevant MeSH Terms

Acute Myelogenous Leukemia
Acute Lymphatic Leukemia
Chronic Myelogenous Leukemia
Myelodysplastic Syndromes
Myelodysplastic Syndrome Other
Chronic Myelomonocytic Leukemia
Lymphoma
Hodgkin Lymphoma