Vaccine Therapy in Treating Patients With Myelodysplastic Syndromes
Recruitment status was Active, not recruiting
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Purpose
RATIONALE: Vaccines made from cancer cells may help the body build an effective immune response to kill abnormal cells.
PURPOSE: This clinical trial is studying how well vaccine therapy works in treating patients with myelodysplastic syndromes (MDS).
| Condition | Intervention |
|---|---|
|
Myelodysplastic Syndromes |
Biological: GM-K562 cell vaccine Genetic: cytogenetic analysis Genetic: fluorescence in situ hybridization Other: flow cytometry Other: immunoenzyme technique Other: laboratory biomarker analysis |
| Study Type: | Interventional |
| Study Design: | Masking: Open Label Primary Purpose: Treatment |
| Official Title: | K562/GM-CSF Vaccination in Patients With Myelodysplastic Syndrome |
- Safety [ Designated as safety issue: Yes ]
- Hematologic response, defined as achieving a major response in ≥ 1 lineage as described by an erythroid increase > 2 g/dL, platelet increase of 30,000/mm³, or neutrophil increase by 100% [ Designated as safety issue: No ]
- Cytogenetic response, defined as normalization of pretreatment cytogenetic abnormalities [ Designated as safety issue: No ]
- Immune response to common myeloid antigens (e.g., Wilms' tumor-1 [WT-1], survivin, or proteinase-3) as measured by Elispot assay [ Designated as safety issue: No ]
- Correlation of immune response with clinical response (hematologic response, resolution of cytogenetic abnormalities, or decrease in other parameters, such as WT-1 mRNA levels) [ Designated as safety issue: No ]
| Estimated Enrollment: | 15 |
| Study Start Date: | August 2006 |
| Estimated Primary Completion Date: | December 2012 (Final data collection date for primary outcome measure) |
OBJECTIVES:
Primary
- Determine the safety of GM-K562 cell vaccine in patients with myelodysplastic syndromes.
- Determine the hematologic and cytogenetic response in patients treated with this vaccine.
Secondary
- Determine if vaccination with GM-K562 cell vaccine can induce an immune response to common myeloid antigens (e.g., Wilms' tumor-1 [WT-1], survivin, or proteinase-3), as defined by a 30% increase from baseline in specific cytotoxic T-cells measured by Elispot assay, in patients with myelodysplastic syndromes.
- Determine if immune response correlates with any clinical responses (e.g., hematologic response, resolution of cytogenetic abnormalities, or decrease in other parameters, such as WT-1 mRNA levels).
OUTLINE: This is an open-label study.
Patients receive GM-K562 cell vaccine subcutaneously once in weeks 0, 3, 6, 9, and 17 in the absence of disease progression or unacceptable toxicity.
Blood and tissue samples are collected periodically for correlative and biomarker studies. Samples are analyzed by cytogenetic studies, fluorescent in situ hybridization (FISH), and flow cytometry. Elispot is used to quantify cellular cytotoxic T-cell response to Wilms' tumor-1 (WT-1), survivin, and proteinase 3.
After completion of study treatment, patients are followed every 3 months for 1 year.
PROJECTED ACCRUAL: A total of 15 patients will be accrued for this study.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Pathologically confirmed myelodysplastic syndromes (MDS), including any of the following:
- Refractory anemia (RA)
- RA with ringed sideroblasts
- Refractory cytopenias with multilineage dysplasia (RCMD)
- RCMD with ringed sideroblasts
- RA with excess blasts 1 (5-9% blasts)
- RA with excess blasts 2 (10-19% blasts)
Must have poor-risk MDS, defined by the following:
- At least 2 lineages involved
- Unfavorable cytogenetics (i.e., abnormalities of chromosome 5 or 7, 11q23, t[6;9], trisomy 8, inv3, or multiple/complex karyotype)
- Transfusion requirement of > 2 units of packed red blood cells monthly
- No chronic myelomonocytic leukemia
- No transformation to acute myeloid leukemia
PATIENT CHARACTERISTICS:
- ECOG performance status 0-2
- Creatinine < 2.5 mg/dL
- Bilirubin < 2.5 mg/dL (unless due to Gilbert's syndrome)
- Room air oxygen saturation ≥ 94% at rest
- Fertile patients must use effective contraception
- Negative pregnancy test
- No other malignancy within the past 5 years except in situ cervical cancer or adequately treated nonmelanoma skin cancer
No active autoimmune disease or history of autoimmune disease requiring systemic immunosuppressants including, but not limited to, any of the following:
- Autoimmune hemolytic anemia
- Idiopathic thrombocytopenia purpura
- Inflammatory bowel disease
- Vasculitis
- Thyroiditis
- Rheumatic illnesses
- No known HIV serum antibody positivity
- No other disease requiring long-term corticosteroids or other immunosuppressants, such as severe chronic obstructive pulmonary disease or asthma
PRIOR CONCURRENT THERAPY:
- At least 2 weeks since prior systemic corticosteroids or other immunosuppressants (e.g., cyclosporine, azathioprine, tacrolimus, or mycophenolate mofetil)
- At least 3 weeks since prior growth factors
- At least 2 months since prior azacitidine for MDS
- No prior bone marrow or other organ transplantation
- No concurrent cytotoxic-based therapy for MDS
- No other concurrent growth factors, including epoetin alfa, filgrastim (G-CSF), or sargramostim (GM-CSF)
Contacts and Locations| United States, Maryland | |
| Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins | |
| Baltimore, Maryland, United States, 21231 | |
| Principal Investigator: | B. Douglas Smith, MD | Sidney Kimmel Comprehensive Cancer Center |
More Information
Additional Information:
No publications provided
| ClinicalTrials.gov Identifier: | NCT00361296 History of Changes |
| Other Study ID Numbers: | J05115, CDR0000491987, P30CA006973, JHOC-J05115 |
| Study First Received: | August 4, 2006 |
| Last Updated: | October 1, 2010 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Sidney Kimmel Comprehensive Cancer Center:
|
refractory anemia with excess blasts refractory anemia with ringed sideroblasts refractory anemia refractory cytopenia with multilineage dysplasia |
de novo myelodysplastic syndromes previously treated myelodysplastic syndromes secondary myelodysplastic syndromes |
Additional relevant MeSH terms:
|
Myelodysplastic Syndromes Preleukemia Bone Marrow Diseases |
Hematologic Diseases Precancerous Conditions Neoplasms |
ClinicalTrials.gov processed this record on May 23, 2013