Trial record 2 of 208240 for:    ALL

Mobilization and Collection of Peripheral Blood Stem Cells in Patients With Fanconi Anemia Using G-CSF and Plerixafor (FancoMob)

This study is not yet open for participant recruitment. (see Contacts and Locations)
Verified February 2016 by Assistance Publique - Hôpitaux de Paris
Sponsor:
Collaborator:
EuroFancolen
Information provided by (Responsible Party):
Assistance Publique - Hôpitaux de Paris
ClinicalTrials.gov Identifier:
NCT02678533
First received: February 5, 2016
Last updated: February 8, 2016
Last verified: February 2016
  Purpose
The purpose of this study is to assess the feasibility of Plerixafor used in combination with G-CSF (Granulocyte Colony Stimulating Factor) in 5 Fanconi anemia patients to mobilize and collect a sufficient number of peripheral blood CD34+ cells for peripheral blood apheresis, for further gene therapy study.

Condition Intervention Phase
Fanconi Anemia
Drug: G-CSF and Plerixafor
Phase 1
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Pilot Study Assessing the Feasibility of CD34+ Cells Mobilization and Collection After Treatment With G-CSF and Plerixafor in Patients With Fanconi Anemia for Subsequent Treatment by Gene Therapy

Resource links provided by NLM:


Further study details as provided by Assistance Publique - Hôpitaux de Paris:

Primary Outcome Measures:
  • level of CD34+ cells mobilization [ Time Frame: 8 days ] [ Designated as safety issue: No ]
    kinetic from Day 5 to Day 8 after the first injection of G-CSF


Secondary Outcome Measures:
  • number of treatment-related adverse events as a measure of tolerability [ Time Frame: 30 days after cytapheresis ] [ Designated as safety issue: Yes ]
    Occurrence of adverse effect due to G-CSF and plerixafor administration


Estimated Enrollment: 8
Study Start Date: February 2016
Estimated Study Completion Date: May 2019
Estimated Primary Completion Date: July 2018 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Fanconi anemia
G-CSF and Plerixafor
Drug: G-CSF and Plerixafor
D1 to D4 : Injection of 12 µg/kg of G-CSF twice a day . D5 : injection of 12 µg/kg of G-CSF (once/ twice a day according to cytapheresis's realization) and an injection of 24mg/kg of plerixafor once a day until cytapheresis has be done (maximum of 4 days)

Detailed Description:

Fanconi anemia is an autosomal recessive disease with an average survival of around 24 years old. The number of cells producted by bone marrow decreases around 5-10 years old. Hematological symptoms occur around 7 years old. 80% of patients with Fanconi anemia have clinical signs of bone marrow failure in the first decade of life. Generally macrocytosis is the first noticeable sign. Then it leads to thrombocytopenia, anemia and pancytopenia.

Epidemiologic studies show that nearly all of the patients will have medullar aplasia before 40 years old, which is then the first cause of mortality.

It must be emphasized that these complications may occur simultaneously for the same patient, so joint therapeutic intervention is needed.

There is no basic treatment. Some currently used treatments cure cytopenias. These treatments involve blood transfusion, oral androgen, hematopoietic growth factor administration, such as Epo and G-CSF to treat anemia and neutropenia. These treatments are not curative. Hematopoietic stem cell transplantation is the only treatment able to restore permanently hematopoiesis. However, this treatment leads to a high level risk of developing solid tumors and other complications.

All these data justify of developing a stem cells gene therapy treatment using a lentiviral vector expressing wild-type FANCA gene under CIBER promoter.

Three studies have shown the potential number of cells to be mobilized in patients with Fanconi anemia.

The aim is first, to show if administering G-CSF with plerixafor may lead to collect enough cells to potentially perform a gene therapy graft. Secondly the study will assess the tolerance, the stem cells' mobilization kinetic and collected cells' biological features.

This study will be performed in Necker Children Hospital. 8 patients will be enrolled in order to reach 5 treated patients and to analyse how many injections and days are required to reach the cells' number goal.

Sequential blood samples of patients will be drawn to monitor complete blood count (CBC), platelet, CD34+ cells rate and stem cells phenotype.

The clinical and biological data will be anonymously entered in a electronic case report by the investigators up to the end of the study.

  Eligibility

Ages Eligible for Study:   4 Years to 17 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patient with Fanconi anemia
  • Patient from 4 to 17 years old
  • Potential indication for allogenic bone arrow graft without HLA-identical brotherhood available
  • Patient's weight >20kg
  • Treated and followed for at least the previous two years in a specialized center where they got a full assessment of their disease
  • For women of childbearing age, not pregnant and use of an effective contraception during the entire participation in the research.
  • Affiliated or beneficiary of an health insurance regimen
  • Informed and signed consent

Exclusion Criteria:

  • Patient unable to follow the visits required by the protocol
  • Positive serology for HIV-1/2, HTLV-1/2, HCV and HbS
  • Bacterial, viral, fungal or parasitic active infection with clinical signs
  • Personal history of cancer, myeloproliferative hematopathy or immune deficiency
  • Heart failure and / or heart rhythm disorder
  • History of allogeneic graft of hematopoietic stem cells
  • Patient with an HLA-identical brotherhood donor available
  • Myelodysplasia diagnose on myelogram
  • Cytogenetic abnormality on karyotype
  • Malignant solid tumor
  • Documented spontaneous genetic reversion of medullary process
  • Diagnosis of a psychiatric disorder that could compromise his/her ability to participate in the study
  • Any disorder according to the investigator, that could compromise the ability of patient to give his writing consent and/or to comply with requiring study's procedures
  • Current Pregnancy
  • Heart, kidney or liver failure
  • Current participation in another interventional clinical trial
  • Patient under Medical Assistance State
  • Hypersensitivity to plerixafor or any excipient contained in MOZOBIL®
  • Hypersensitivity to filgrastim or any of its' excipient
  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: NCT02678533

Contacts
Contact: Francois LEFRERE, MD +33 1 44 49 52 74 francois.lefrere@nck.aphp.fr
Contact: Valerie JOLAINE, Master +33 1 42 19 28 79 valerie.jolaine@nck.aphp.fr

Locations
France
Hôpital necker-Enfants malades Not yet recruiting
Paris, France, 75015
Contact: Francois LEFRERE, MD    +33 1 44 49 52 74    francois.lefrere@nck.aphp.fr   
Sponsors and Collaborators
Assistance Publique - Hôpitaux de Paris
EuroFancolen
Investigators
Study Director: Marina CAVAZZANA, MD, PhD AP-HP, Necker hospital
  More Information

No publications provided

Responsible Party: Assistance Publique - Hôpitaux de Paris
ClinicalTrials.gov Identifier: NCT02678533     History of Changes
Other Study ID Numbers: P130103  2014-005264-14 
Study First Received: February 5, 2016
Last Updated: February 8, 2016
Health Authority: France: Ministry of Health

Keywords provided by Assistance Publique - Hôpitaux de Paris:
Fanconi Anemia
CD34+ cells mobilization
G-CSF
Plerixafor
gene therapy

Additional relevant MeSH terms:
Anemia
Fanconi Anemia
Fanconi Syndrome
Anemia, Aplastic
Anemia, Hypoplastic, Congenital
Bone Marrow Diseases
DNA Repair-Deficiency Disorders
Genetic Diseases, Inborn
Hematologic Diseases
Kidney Diseases
Metabolic Diseases
Metabolism, Inborn Errors
Renal Tubular Transport, Inborn Errors
Urologic Diseases
JM 3100
Lenograstim
Adjuvants, Immunologic
Anti-HIV Agents
Anti-Infective Agents
Anti-Retroviral Agents
Antiviral Agents
Immunologic Factors
Pharmacologic Actions
Physiological Effects of Drugs
Therapeutic Uses

ClinicalTrials.gov processed this record on February 08, 2016