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Bone Marrow vs Liver as Site for Islet Transplantation (IsletBOM2)

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ClinicalTrials.gov Identifier: NCT01722682
Recruitment Status : Completed
First Posted : November 7, 2012
Last Update Posted : February 9, 2018
Sponsor:
Collaborator:
Ministry of Health, Italy
Information provided by (Responsible Party):
Piemonti Lorenzo, Ospedale San Raffaele

Brief Summary:
The goal of this study is to evaluate safety and efficacy of bone marrow (BM) as site for pancreatic islet transplantationin humans. Our hypothesis is that BM represents a better site than liver (currently the location of choice for this procedure) thanks to its potential capacity to favor islet engraftment. To address our hypothesis we propose herein a randomized phase II trial to compare BM and liver as sites for islet transplantation in T1D patients.

Condition or disease Intervention/treatment Phase
Type 1 Diabetes Biological: Human pancreatic islet transplantation Phase 1 Phase 2

Detailed Description:
The study is a phase II, single center, open label, pilot study. We will recruit 12 patients with T1D to be randomly (1:1) assigned to receive islet either into the liver through the portal venous circulation (standard procedure; arm A, n=6) or directly into the BM at the level of the iliac crest (arm B, n=6). Patients will be selected from those eligible for islet Tx based on local practice and guidelines.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 9 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Bone Marrow vs Liver as Site for Islet Transplantation in Patients With Type 1 Diabetes: Pilot Study to Evaluate Efficacy
Study Start Date : June 2012
Actual Primary Completion Date : September 2017
Actual Study Completion Date : December 2017

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Active Comparator: A: intraportal islet infusion
Patients will received islet into the liver through the portal venous circulation (standard procedure)
Biological: Human pancreatic islet transplantation
Experimental: B: intra BM islet infusion
Patients will received an intra BM islet infusion at the level of the iliac crest. The direct intra BM administration will be performed following the same procedures that our institution utilizes for administration of cord-blood cells in patients with acute leukemia (Lancet Oncol. 2008;9:831). The procedure is easy and reproducible: a standard needle for BM aspiration is inserted in the iliac crest and cells are gently infused.
Biological: Human pancreatic islet transplantation



Primary Outcome Measures :
  1. Insulin secretion under stimulation [ Time Frame: month 12 post-Tx ]
    basal and -10 to 120 min time course of glucose, C-pep levels and insulin derived from the mixed meal tolerance test


Secondary Outcome Measures :
  1. Incidence and severity of Adverse Events (AE) and Serious Adverse Events (SAE) [ Time Frame: throughout the study up to 1 year after first transplant ]
  2. Insulin requirement [ Time Frame: month 1, 3, 6, 9, 12 post- transplant ]
    Change in average daily insulin requirements

  3. Islet function [ Time Frame: month 1, 3, 6, 9, 12 post-Tx ]
    change in HbA1c, Transplant Estimated Function (TEF) and fasting C-peptide levels



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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • diabetic patients eligible for pancreatic islet transplantation based on local accepted practice and guidelines. This includes at least: a)clinical history compatible with T1D with insulin-dependence for >5 years; b) undetectable stimulated (arginine or MMTT) C-peptide levels (<0.3 ng/mL) in the 12 months before transplant c)presence of severe hypoglycaemic events

Exclusion Criteria:

  • presence of hematologic disease

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01722682


Locations
Italy
Ospedale San Raffaele
Milan, Italy, 20132
Sponsors and Collaborators
Ospedale San Raffaele
Ministry of Health, Italy
Investigators
Principal Investigator: Lorenzo Piemonti, MD Ospedale San Raffaele

Responsible Party: Piemonti Lorenzo, Head of Beta Cell Biology Unit, CO-Director Human Islet Transplantation Program (ITP), Ospedale San Raffaele
ClinicalTrials.gov Identifier: NCT01722682     History of Changes
Other Study ID Numbers: IsletBOM2
First Posted: November 7, 2012    Key Record Dates
Last Update Posted: February 9, 2018
Last Verified: February 2018

Keywords provided by Piemonti Lorenzo, Ospedale San Raffaele:
Diabetes

Additional relevant MeSH terms:
Diabetes Mellitus, Type 1
Diabetes Mellitus
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases
Autoimmune Diseases
Immune System Diseases