Natural Killer (NK) Cells in Cord Blood Transplantation
The goal of this clinical research study is to learn if giving cells called natural killer (NK) cells after receiving fludarabine, melphalan, lenalidomide, and a UCB transplant can improve response in patients with leukemia, lymphoma, or MM. The safety of this treatment and whether NK cells can lessen the risk of graft vs. host disease (GVHD) will also be studied.
Patients with a disease that is CD20-positive will also receive rituximab on this study.
The first 3 patients enrolled on this study will not receive NK cells but will receive a cord blood transplant.
UCB and NK cells may be able to kill leukemia, lymphoma, or myeloma cells that remain in your body after chemotherapy treatment.
The UCB cells are also designed to increase blood production and strengthen your immune system.
Chronic Lymphocytic Leukemia
Drug: Fludarabine monophosphate
Procedure: NK Infusion
Procedure: CB Infusion
Drug: Mycophenolate mofetil
|Study Design:||Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Natural Killer Cells In Allogeneic Cord Blood Transplantation|
- Success Rate [ Time Frame: 3 months ] [ Designated as safety issue: No ]Success is ability to generate adequate NK cells in a patient (a minimum of 3x10e8 natural killer (NK) cells). Success Rate is number of participants achieving success divided by total participants.
- Treatment-Related Mortality (TRM) [ Time Frame: 100 days ] [ Designated as safety issue: No ]100-day treatment-related mortality (TRM) following the methods described by Thall et al.
|Study Start Date:||May 2013|
|Estimated Primary Completion Date:||May 2016 (Final data collection date for primary outcome measure)|
Experimental: CB NK + Chemotherapy
Lenalidomide 10 mg by mouth day -8 to -2. Fludarabine 40 mg/m2 intravenous (IV) from day -7 to -4. Melphalan 140 mg/m2 IV on day -4. The NK cell infusion administered intravenously on day -2 over a period of 30 minutes. The NK dose infused will be 5x 106/kg. Remaining cells discarded if not needed for laboratory studies. On Day 0, unmanipulated products (smaller cord blood unit and remnant of the larger unit) infused. Tacrolimus 0.03 mg/kg or 0.015 mg/kg (ideal body weight) by vein starting on Day -2 and tapered around Day +180 if no GvHD is present. Mycophenolate mofetil 15 mg/kg (actual body weight with a maximum dose of 1 gram twice daily) by vein or by mouth Days -3 to Day +100 in the absence of GvHD.
CD20 positive participants admitted to hospital on day -9 to start hydration, receive rituximab 375 mg/m2 by vein on day -8, receive the designated preparative regimen on days -8 through -4. CD20 negative participants will not receive rituximab and admitted on day -8.
10 mg by mouth on days -8 to -2.
Other Names:Drug: Fludarabine monophosphate
40 mg/m2 by vein on days -7 to -4.
Other Names:Drug: Melphalan
140 mg/m2 by vein on day -4.
Other Name: AlkeranProcedure: NK Infusion
The NK cell infusion will be administered intravenously on day -2 over a period of 30 minutes. The NK dose infused will be 5x 106/kg. Remaining cells will be discarded if not needed for laboratory studies.
Other Names:Procedure: CB Infusion
On Day 0, the unmanipulated products (smaller cord blood unit and the remnant of the larger unit) will be infused.
Other Names:Drug: Tacrolimus
0.03 mg/kg or 0.015 mg/kg (ideal body weight) by vein starting on Day -2 and tapered around Day +180 if no GvHD is present.
Other Name: PrografDrug: Mycophenolate mofetil
15 mg/kg (actual body weight with a maximum dose of 1 gram twice daily) by vein or by mouth Days -3 to Day +100 in the absence of GvHD.
Other Names:Drug: Rituximab
375 mg/m2 by vein on day -8 for CD20 positive participants.
Other Name: Rituxan
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|Contact: Chitra M. Hosing, MD||713-792-8750|
|United States, Texas|
|UT MD Anderson Cancer Center||Recruiting|
|Houston, Texas, United States, 77030|
|Principal Investigator:||Chitra M. Hosing, MD||UT MD Anderson Cancer Center|