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Matched Unrelated or Non-Genotype Identical Related Donor Transplantation For Chronic Granulomatous Disease (MUNCHR)
This study is currently recruiting participants.
Verified by Baylor College of Medicine, October 2009
First Received: December 19, 2007   Last Updated: December 3, 2009   History of Changes
Sponsor: Baylor College of Medicine
Information provided by: Baylor College of Medicine
ClinicalTrials.gov Identifier: NCT00578643
  Purpose

Chronic Granulomatous Disease (CGD) is a life threatening primary immunodeficiency caused by the abnormal function of any of four components of the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase system present in the phagocytic cells. The estimated incidence of CGD in the United States is between 1/200,000 - 1 /255,000 live births.

Patients will be treated with Campath (Alemtuzumab) an antibody directed against the CD52 antigen, which is present on most lymphocytes. This agent has shown efficacy as an immunosuppressive promoting donor engraftment and prevention of GVHD.


Condition Intervention Phase
Chronic Granulomatous Disease
Drug: Busulfan
Drug: alemtuzumab
Drug: Cyclophosphamide
Drug: Fludarabine
Drug: cyclosporine
Drug: MESNA
Procedure: stem cell infusion
Phase I

Study Type: Interventional
Study Design: Treatment, Open Label, Uncontrolled, Single Group Assignment, Efficacy Study
Official Title: HLA Matched Unrelated or Non-Genotype Identical Related Donor Transplantation For Chronic Granulomatous Disease

Resource links provided by NLM:


Further study details as provided by Baylor College of Medicine:

Primary Outcome Measures:
  • Treat patients with Chronic Granulomatous Disease refractory to conventional therapy and without a HLA matched sibling donor by performing stem cell transplantation from 5/6 or 6/6 HLA matched unrelated or 5/6 or 6/6 HLA phenotype matched related donors. [ Time Frame: 120 days ] [ Designated as safety issue: Yes ]
  • Estimate engraftment rate [ Time Frame: 120 days ] [ Designated as safety issue: Yes ]
  • To estimate the risk for acute and chronic GVHD and regimen related morbidity/mortality for patients with CGD following SCT from 5/6 or 6/6 HLA matched unrelated or 5/6 or 6/6 HLA phenotype matched related donors. [ Time Frame: 120 days ] [ Designated as safety issue: Yes ]
  • To examine the potential for reversal of organ toxicity (e.g. lung, liver, intestine) following engraftment and stable normal neutrophil function. [ Time Frame: 120 days ] [ Designated as safety issue: No ]

Estimated Enrollment: 15
Study Start Date: February 2004
Estimated Study Completion Date: February 2012
Estimated Primary Completion Date: February 2012 (Final data collection date for primary outcome measure)
Intervention Details:
    Drug: Busulfan

    days -9 through -6

    1 mg/kg initially (based on weight)

    Drug: alemtuzumab
    day -5 through day -2 dose: based on weight
    Drug: Cyclophosphamide
    days -5 through -2 50 mg/kg
    Drug: Fludarabine
    30 mg/m^2 day -5 through day -2
    Drug: cyclosporine
    Therapy: Cyclosporine will be administered beginning day -2. Initial dose will 5 mg/kg infused over 24 hours.
    Drug: MESNA
    days -5 through -2
    Procedure: stem cell infusion
    Stem Cell: Either bone marrow, cord blood, or peripheral blood stem cells may be used for stem cell transplantation. It is desired to infuse: for bone marrow, nucleated cells ≥ 4 X 10^8/kg recipient weight; for cord blood ≥ 3 X 10^7/kg nucleated cells; for peripheral blood stem cells ≥ 1 X 10^/kg CD34+ cells.
  Show Detailed Description

  Eligibility

Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

Patients with acute or chronic leukemia or advanced Hodgkin or non Hodgkin lymphoma or myelodsyplastic/myeloproliferative disease who are unlikely to be cured by standard chemotherapy treatments. This includes patients who have relapsed after standard chemotherapy treatments and patients in first remission with unfavorable prognostic features.

Patient must have a genotype HLA identical stem cell donor.

Exclusion Criteria:

Patients with a life expectancy (less than or equal to 6 weeks) limited by disease other than leukemia.

Patients with symptomatic cardiac failure unrelieved by medical therapy or evidence of significant cardiac dysfunction by echocardiogram (shortening fraction <20%).

Patients with severe renal disease (i.e., creatinine greater than 3 times normal for age).

Patients with pre-existing severe restrictive pulmonary disease (FVC less than 40% of predicted).

Patients with severe hepatic disease (direct bilirubin greater than 3 mg/dl or AST greater than 500 IU/L).

Patients with severe personality disorder or mental illness.

Patients with severe infection that in the estimation of the principal investigator prohibits the use of ablative chemotherapy.

Patients who are documented HIV positive.

Patients with a Karnofsky performance score <60% or Lansky performance score <50%.

NOTE: Patients who would be excluded from treatment on this protocol strictly for laboratory or performance abnormalities can be included at the principal investigator's discretion after consultation with the members of the SCT Policy and Procedures Committee.

  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00578643

Contacts
Contact: Robert Krance, MD 832-824-4661 rkrance@bcm.tmc.edu

Locations
United States, Texas
Texas Children's Hospital Recruiting
Houston, Texas, United States, 77030
Sub-Investigator: Bambi J Grilley            
Sub-Investigator: Malcolm K Brenner, MD            
Sub-Investigator: Helen E Heslop, MD            
Sub-Investigator: Stephen M Gottschalk, MD            
Sub-Investigator: Catherine M Bollard, MD            
Sub-Investigator: Caridad A Martinez, MD            
Sponsors and Collaborators
Baylor College of Medicine
Investigators
Principal Investigator: Robert Krance, MD Baylor College of Medicine
  More Information

No publications provided

Responsible Party: Baylor College of Medicine ( Robert A. Krance )
Study ID Numbers: H-14771
Study First Received: December 19, 2007
Last Updated: December 3, 2009
ClinicalTrials.gov Identifier: NCT00578643     History of Changes
Health Authority: United States: Institutional Review Board

Keywords provided by Baylor College of Medicine:
Transplant
Granulomatous Disease

Additional relevant MeSH terms:
Anti-Infective Agents
Cyclosporine
Molecular Mechanisms of Pharmacological Action
Immunologic Factors
Antineoplastic Agents
Physiological Effects of Drugs
Leukocyte Disorders
Cyclophosphamide
Cyclosporins
Pathologic Processes
Antifungal Agents
Alemtuzumab
Therapeutic Uses
Genetic Diseases, X-Linked
Dermatologic Agents
Alkylating Agents
Phagocyte Bactericidal Dysfunction
Immune System Diseases
Hematologic Diseases
Enzyme Inhibitors
Granuloma
Immunosuppressive Agents
Immunologic Deficiency Syndromes
Pharmacologic Actions
Lymphatic Diseases
Genetic Diseases, Inborn
Granulomatous Disease, Chronic
Myeloablative Agonists
Fludarabine
Antineoplastic Agents, Alkylating

ClinicalTrials.gov processed this record on February 08, 2010