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Phase I Study of Immune Ablation and CD34+ Peripheral Blood Stem Cell Support in Patients With Systemic Lupus Erythematosus

This study is ongoing, but not recruiting participants.

Sponsored by: Northwestern Memorial Hospital
Information provided by: Office of Rare Diseases (ORD)
ClinicalTrials.gov Identifier: NCT00017641
  Purpose

OBJECTIVES:

I. Determine the safety of immune ablation with high-dose cyclophosphamide and anti-thymocyte globulin followed by peripheral blood stem cell support in patients with systemic lupus erythematosus.


Condition Intervention Phase
Systemic Lupus Erythematosus
Drug: anti-thymocyte globulin
Drug: cyclophosphamide
Drug: filgrastim
Procedure: CD34+ Peripheral Blood Stem Cell Reinfusion
Phase I

MedlinePlus related topics:   Lupus   

ChemIDplus related topics:   Cyclophosphamide    Filgrastim   

U.S. FDA Resources

Study Type:   Interventional
Study Design:   Treatment

Further study details as provided by Office of Rare Diseases (ORD):

Estimated Enrollment:   10
Study Start Date:   April 2001

Detailed Description:

PROTOCOL OUTLINE: Patients receive cyclophosphamide IV over 1 hour for 2 doses. Patients receive filgrastim (G-CSF) subcutaneously (SC) beginning 24 hours after completion of cyclophosphamide and continuing until leukapheresis is complete. Leukapheresis continues daily until target number of cells is harvested. CD 34+ cells are isolated from peripheral blood stem cells (PBSC) in vitro.

Patients then receive cyclophosphamide IV over 1 hour on days -5 to -2, anti-thymocyte globulin IV over 10 hours on days -4 to -2, and G-CSF SC beginning on day 0 and continuing until blood counts recover. Patients undergo reinfusion of CD34+ PBSC on day 0.

Patients are followed weekly for 90 days, monthly for 1 year, and at 2 years.

  Eligibility
Ages Eligible for Study:   up to 59 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Criteria

PROTOCOL ENTRY CRITERIA:

--Disease Characteristics--

Diagnosis of systemic lupus erythematosus with 1 of the following malignant features:

  • Nephritis (WHO class III or IV)
  • Failed NIH short-course cyclophosphamide therapy
  • Vasculitis/immune complex deposition causing end organ signs or symptoms (e.g., cerebritis, transverse myelitis, pulmonary hemorrhage, cardiac failure, or renal failure)
  • Hematologic cytopenias that are immune mediated and uncontrolled by conservative measures with any of the following:

Transfusion-dependent anemia with untransfused hemoglobin less than 8 g/dL

Platelet count less than 40,000/mm3 (without transfusions)

Granulocyte count less than 1,000/mm3

Catastrophic anti-phospholipid syndrome

--Patient Characteristics--

Cardiovascular:

  • LVEF at least 35%
  • No lupus-induced myocarditis
  • No history of unstable angina

Pulmonary:

  • FEV1/FVC at least 50% predicted
  • DLCO at least 50% predicted

Other:

  • HIV negative
  • No prior or concurrent malignancy except localized basal cell or squamous cell skin cancer
  • No uncontrolled diabetes mellitus
  • No medical illness that would preclude study
  • No psychiatric illness or mental deficiency that would preclude study
  • No known hypersensitivity to E. coli-derived proteins
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00017641

Locations
United States, Illinois
Northwestern Memorial Hospital    
      Chicago, Illinois, United States, 60611
United States, Wisconsin
University of Wisconsin Hospital and Clinics    
      Madison, Wisconsin, United States, 53792-0001

Sponsors and Collaborators
Northwestern Memorial Hospital

Investigators
Study Chair:     Ann Traynor     Northwestern Memorial Hospital    
  More Information


Study ID Numbers:   199/14976, NU-95LU1
First Received:   June 6, 2001
Last Updated:   June 23, 2005
ClinicalTrials.gov Identifier:   NCT00017641
Health Authority:   Unspecified

Keywords provided by Office of Rare Diseases (ORD):
arthritis & connective tissue diseases  
immunologic disorders and infectious disorders  
rare disease  
systemic lupus erythematosus  

Study placed in the following topic categories:
Antilymphocyte Serum
Autoimmune Diseases
Lupus Erythematosus, Systemic
Arthritis
Rare Diseases
Connective Tissue Diseases
Cyclophosphamide

Additional relevant MeSH terms:
Molecular Mechanisms of Pharmacological Action
Immunologic Factors
Immune System Diseases
Antineoplastic Agents
Therapeutic Uses
Physiological Effects of Drugs
Myeloablative Agonists
Antineoplastic Agents, Alkylating
Antirheumatic Agents
Alkylating Agents
Immunosuppressive Agents
Pharmacologic Actions

ClinicalTrials.gov processed this record on October 10, 2008




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