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NK Cell Transplantation for AML
This study is currently recruiting participants.
Verified by St. Jude Children's Research Hospital, October 2008
Sponsored by: St. Jude Children's Research Hospital
Information provided by: St. Jude Children's Research Hospital
ClinicalTrials.gov Identifier: NCT00187096
  Purpose

The purpose of this study is to assess the safety and efficacy of infusing natural killer cells from a donor as treatment for patients with acute myeloid leukemia in remission or who have experienced relapse.


Condition Intervention
Acute Myeloid Leukemia
Drug: Cyclophosphamide, Fludarabine, Clofarabine, Etoposide, Interleukin-2
Procedure: Natural Killer Cell Infusion
Device: CliniMACS System

MedlinePlus related topics: Leukemia, Adult Acute Leukemia, Adult Chronic Leukemia, Childhood
Drug Information available for: Cyclophosphamide Etoposide Fludarabine Fludarabine monophosphate Etoposide phosphate Interleukin-2 Clofarabine
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety Study
Official Title: Pilot Study Of Haplo-Identical Natural Killer Cell Transplantation For Acute Myeloid Leukemia

Further study details as provided by St. Jude Children's Research Hospital:

Primary Outcome Measures:
  • To assess the toxicities associated with NK infusion therapy in the non-transplant setting [ Time Frame: The first 100 days following NK cell infusion ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 27
Study Start Date: September 2005
Estimated Study Completion Date: January 2010
Estimated Primary Completion Date: January 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Stratum 1: Experimental

Stratum 1 (AML in complete remission)

Cyclophosphamide 60 mg/kg IV Day -7 Fludarabine 25 mg/m2/day IV Days -6 through -2 Donor pheresis Day -1 Start IL-2 on Day -1, then 3 times per week x 2 weeks NK Cell purification and infusion on Day 0

Drug: Cyclophosphamide, Fludarabine, Clofarabine, Etoposide, Interleukin-2
See Detailed Description section for additional details of treatment interventions.
Procedure: Natural Killer Cell Infusion
See Detailed Description section for additional details of treatment interventions.
Device: CliniMACS System
See Detailed Description section for additional details of treatment interventions.
Stratum 2: Experimental

Stratum 2 (AML that is refractory or relapsed or AML with increasing minimal residual disease)

Clofarabine 40 mg/m2 IV, days -6 through -2 Etoposide 100 mg/m2 IV, days -6 through -2 Cyclophosphamide 400 mg/m2 IV, days -6 through 02 Donor pheresis Day -1 Start IL-2 Day -1, and then 3 times per week x 2 weeks NK Cell purification and infusion on Day 0.

Drug: Cyclophosphamide, Fludarabine, Clofarabine, Etoposide, Interleukin-2
See Detailed Description section for additional details of treatment interventions.
Procedure: Natural Killer Cell Infusion
See Detailed Description section for additional details of treatment interventions.
Device: CliniMACS System
See Detailed Description section for additional details of treatment interventions.

Detailed Description:

Natural killer cells extracted from a [parental] donor are infused intravenously. Most patients are given a multi-agent chemotherapeutic conditioning regimen prior to the infusion. The conditioning regimen may be omitted for patients who have previously received traditional stem cell transplant.

Secondary objectives of this study are:

  • To explore the efficacy of NK infusion therapy
  • To describe in a descriptive manner, the engraftment, phenotypes, function, and engraftment of NK cells after infusion

Details of Treatment Plan:

Stratum 1 (AML in complete remission)

Cyclophosphamide 60 mg/kg IV Day -7 Fludarabine 25 mg/m2/day IV Days -6 through -2 Donor pheresis Day -1 Start IL-2 on Day -1, then 3 times per week x 2 weeks NK Cell purification and infusion on Day 0

Stratum 2 (AML that is refractory or relapsed or AML with increasing minimal residual disease)

Clofarabine 40 mg/m2 IV, days -6 through -2 Etoposide 100 mg/m2 IV, days -6 through -2 Cyclophosphamide 400 mg/m2 IV, days -6 through 02 Donor pheresis Day -1 Start IL-2 Day -1, and then 3 times per week x 2 weeks NK Cell purification and infusion on Day 0.

For patients who have received prior SCT, the conditioning regimen may be omitted if the NK cells are obtained from the original SCT donor.

Cytokine regimen (stratum 1 and 2): 1 million units/m2 of IL-2 given subcutaneously three times per week for two weeks (6 doses) starting on the evening of day -1.

NK Cell Transplantation (stratum 1 and 2): NK cells from haplo-identical family donor will be infused on day 0.

  Eligibility

Ages Eligible for Study:   up to 21 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Participants with AML that is in complete remission, is relapsed or refractory, or with increasing minimal residual disease.
  • Participants in complete remission must have recovered from toxicity of previous therapy and have evidence of bone marrow recovery
  • Participants who had prior stem cell transplant (SCT) must have no evidence of GVHD and 60 or more days have elapsed since the SCT.

Exclusion Criteria:

  • Participants who are pregnant
  • Participants with inadequate renal, liver, or pulmonary functions
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00187096

Contacts
Contact: Jeffrey E Rubnitz, MD PhD 1-866-278-5833 info@stjude.org

Locations
United States, Tennessee
St. Jude Children's Research Hospital Recruiting
Memphis, Tennessee, United States, 38105
Contact: Jeffrey E Rubnitz, MD PhD     866-278-5833     info@stjude.org    
Principal Investigator: Jeffrey E Rubnitz, MD PhD            
Sponsors and Collaborators
St. Jude Children's Research Hospital
Investigators
Principal Investigator: Jeffrey E. Rubnitz, M.D. St. Jude Children's Resarch Hospital
  More Information

St. Jude Children's Research Hospital  This link exits the ClinicalTrials.gov site

Publications:
Responsible Party: St. Jude Children's Research Hospital ( Jeffrey E. Rubnitz, MD / Principal Investigator )
Study ID Numbers: NKAML
Study First Received: September 12, 2005
Last Updated: October 1, 2008
ClinicalTrials.gov Identifier: NCT00187096  
Health Authority: United States: Food and Drug Administration

Keywords provided by St. Jude Children's Research Hospital:
Leukemia
Myeloid
Acute

Study placed in the following topic categories:
Clofarabine
Leukemia
Interleukin-2
Acute myelogenous leukemia
Fludarabine
Fludarabine monophosphate
Cyclophosphamide
Leukemia, Myeloid
Leukemia, Myeloid, Acute
Etoposide phosphate
Etoposide
Acute myelocytic leukemia

Additional relevant MeSH terms:
Neoplasms by Histologic Type
Immunologic Factors
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Physiological Effects of Drugs
Immunosuppressive Agents
Pharmacologic Actions
Neoplasms
Sensory System Agents
Analgesics, Non-Narcotic
Therapeutic Uses
Myeloablative Agonists
Peripheral Nervous System Agents
Analgesics
Antineoplastic Agents, Alkylating
Antirheumatic Agents
Central Nervous System Agents
Alkylating Agents

ClinicalTrials.gov processed this record on January 15, 2009