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Vaccine Therapy in Treating Patients With Acute Lymphoblastic Leukemia

This study has been terminated.
(Slow accrual)
Sponsor:
Collaborator:
National Cancer Institute (NCI)
Information provided by (Responsible Party):
Nicholas Haining, MD, Dana-Farber Cancer Institute
ClinicalTrials.gov Identifier:
NCT00020670
First received: July 11, 2001
Last updated: June 19, 2017
Last verified: June 2017
  Purpose
The prognosis for children and adults with acute lymphoblastic leukemia (ALL) has improved significantly over the years. Nevertheless, patients who experience disease relapse or induction failure along with patients having unfavorable genetics [t(4;11) or t(9;22)] have dismal prognosis. For these patients, novel therapeutic approaches such as immunotherapy are needed. In this clinical trial, investigators evaluate whether it is feasible to make a vaccine from leukemia cells and whether this vaccine enables direct immunity against cancer cells in patients.

Condition Intervention Phase
Leukemia Biological: CD 40 Early Phase 1

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase I Study of Vaccination With Autologous CD40-Activated Acute Lymphoblastic Leukemia Cells

Resource links provided by NLM:


Further study details as provided by Nicholas Haining, MD, Dana-Farber Cancer Institute:

Primary Outcome Measures:
  • Rate Of Successful Vaccine Preparation [ Time Frame: 6 weeks ]
    Vaccine preparation is a success if an adequate number of CD40 activated cells (at least 1 x 10^8 cells) can be generated.


Enrollment: 9
Actual Study Start Date: February 20, 2001
Study Completion Date: July 1, 2003
Primary Completion Date: April 1, 2003 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: CD40 Cell Vaccination
Patients will undergo tumor cell collection followed by vaccine preparation and then vaccination. Autologous acute lymphoblastic leukemia (ALL) cells are harvested, cultured with CD40 ligand, pulsed with keyhole limpet hemocyanin (KLH), and then irradiated to produce the vaccine. Patients receive either 1 x 10^7 or 1 x 10^8 CD40 cells/vaccination depending on the number of tumor cells obtained. Vaccinations are administered every two weeks as outpatient therapy. Evaluable patients receive the course of at least 4 vaccinations at weeks 0, 2, 4, 6. Patients may continue receiving vaccinations every 2 weeks if chemotherapy is not required for symptomatic disease.
Biological: CD 40
Other Name: Autologous tumor cell vaccine

Detailed Description:

OBJECTIVES Primary

  • To determine feasibility of generating a cellular vaccine composed of CD40-activated autologous ALL cells
  • To determine feasibility of vaccine administration according to the proposed schedule
  • To determine toxicity of vaccination with CD40-activated autologous ALL cells

Secondary

  • To assess ALL-specific immunity following vaccination
  • To assess the generation of immunity to control antigens
  • To develop preliminary information on effect vaccination on tumor response
  Eligibility

Ages Eligible for Study:   Child, Adult, Senior
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria

  • B-cell acute lymphoblastic leukemia
  • Disease involving at least 30% of bone marrow or circulating blasts
  • In first relapse with at least 1 of the following high-risk features:

    • Age under 1 year at diagnosis
    • Age over 18 years at diagnosis
    • t(9;22)
    • Occurrence of first relapse less than 18 months after diagnosis
    • In second relapse or beyond
    • Refractory disease
  • Successful generation of adequate CD40 ligand-activated autologous tumor cell vaccine
  • Less than 1 year since tumor cell collection
  • Patients in first relapse or beyond must be ineligible for or have declined allogeneic bone marrow transplantation in order to receive study vaccine
  • Patients need not be in complete remission to receive study vaccine
  • Patients may have received an allogeneic hematopoetic stem cell transplant in the past
  • No chemotherapy, radiotherapy, immunotherapy or immunosuppressive treatment or within 3 weeks of vaccination
  • Adequate hepatic function as defined by: Bilirubin < 2x normal; AST < 3x normal; ALT < 6x normal
  • Adequate renal function defined by: Creatinine < 2x normal
  • <1 year since tumor cell collection

Exclusion Criteria

  • Concurrent treatment as part of another therapeutic research protocol
  • Pregnancy or nursing mothers
  • Clinically significant pulmonary or cardiac disease
  • Clinically significant autoimmune disease
  • Documented infection that is active and/or not responding to therapy
  • Evidence of HIV infection or known positive HIV serology
  • Lansky performance scale (if <18yo) <60%, Karnofsky performance scale (if >18yo) >60%
  • Once vaccination course has started: patients may not receive chemotherapy, radiotherapy, immunotherapy or immunosuppressive treatment, hematopoetic growth factors. However between tumor cell collection and vaccine administration, patients may receive non-protocol chemotherapy.

********************************************NOTE***************************************************

It is anticipated that there will be a number of patients at first relapse who are eligible for tumor cell collection and vaccine preparation but who are not eligible to receive the vaccination course. These patients will be evaluable for Objective 3.1.1 (feasibility of vaccine preparation). Patients at first relapse who are eligible for vaccine preparation but not administration should instead be treated with standard salvage regimens which may include allogeneic bone marrow transplantation according to the judgement of their primary oncologist. However, these patients represent a population at extremely high risk for progression of their disease following salvage therapy. Many of these patients will therefore be likely to fulfill eligibility criteria for vaccination in the future (i.e.

should they relapse again, or fail to enter 2nd complete remission). The majority of those patients who relapse for a second time will do so within 1 year. Those patients who become eligible for vaccination because of 2nd relapse within 1 year of tumor cell collection will receive the original vaccine and will not have further vaccine made from tumor cells collected at the time of 2nd relapse. Given the proliferative thrust of the disease in many patients, it will be advantageous to have vaccines already prepared for these patients to reduce the amount of time from 2nd relapse to vaccination.***

  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00020670

Locations
United States, Massachusetts
Massachusetts General Hospital Cancer Center
Boston, Massachusetts, United States, 02114
Dana-Farber Cancer Institute
Boston, Massachusetts, United States, 02115
Sponsors and Collaborators
Dana-Farber Cancer Institute
National Cancer Institute (NCI)
Investigators
Study Chair: W. Nicholas Haining, BM, BCh Dana-Farber Cancer Institute
  More Information

Responsible Party: Nicholas Haining, MD, Haining, Nicholas MD, Dana-Farber Cancer Institute
ClinicalTrials.gov Identifier: NCT00020670     History of Changes
Other Study ID Numbers: 00-053
P01CA068484 ( U.S. NIH Grant/Contract )
P30CA006516 ( U.S. NIH Grant/Contract )
DFCI-00053
NCI-H01-0074
Study First Received: July 11, 2001
Last Updated: June 19, 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Keywords provided by Nicholas Haining, MD, Dana-Farber Cancer Institute:
recurrent childhood acute lymphoblastic leukemia
recurrent adult acute lymphoblastic leukemia
B-cell childhood acute lymphoblastic leukemia
B-cell adult acute lymphoblastic leukemia

Additional relevant MeSH terms:
Leukemia
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Leukemia, Lymphoid
Neoplasms by Histologic Type
Neoplasms
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Vaccines
Immunologic Factors
Physiological Effects of Drugs

ClinicalTrials.gov processed this record on August 17, 2017