Acute Myeloid Leukemia
Conditions
Keywords
allogenic double negative T cells, DNT cells
Brief summary
This study aims to determine the safety and toxicity of incremental doses of Double Negative T (DNT) cells in human subjects with high risk acute myeloid leukemia (AML). DNT cells are mature T lymphocytes that comprise \ 1% of white blood cells in humans. Injection of DNTs from healthy donors has been demonstrated to be effective against AML cells. DNT cells will be collected from healthy volunteers and injected into patients.
Interventions
BIOLOGICALDNT cells
DNT cells will be expanded (increased in numbers) in the laboratory, in order to enhance their tumour destroying potential before infusion into AML patients.
Sponsors
Ozmosis Research Inc.
University Health Network, Toronto
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Patient Inclusion Criteria: 1. Patients with AML who are 18 years of age or older. 2. Viably frozen cells from the time of diagnosis or relapse are available for sensitivity testing to DNT cells. 3. Patients have given informed consent. 4. Patients in remission following FLAG-Ida induction therapy who are receiving consolidation treatment. 5. Creatinine \< 1.5 x ULN within 7 days prior to day 1 of study treatment. 6. AST, ALP, bilirubin \< 1.5x ULN within 7 days prior to day 1 of study treatment. 7. Female patients of childbearing potential should be willing to use 2 methods of birth control (Refer to section 9.2.15 or be surgically sterile, or abstain from heterosexual activity for the course of the study from day 1 until 1 months following chemotherapy. Patients of childbearing potential are those who have not been surgically sterilized or have not been free from menses for \> 2 years. Male patients should use condoms or abstain from sex from the time of beginning chemotherapy to 1 month after the chemotherapy. 8. Patients must be able to comply with study procedures, at the minimum, until all DNT-UHN-1 cells are out of their system. Patient
Exclusion criteria
1. ECOG performance status \<2. 2. Patients with a known persistent infection. 3. Patients with known active CNS disease. 4. Life expectancy \< 3 months. 5. Patients should be off Cox2 inhibitors and corticosteroids for at least 3 days prior to and 7 days after infusion of DNT cells. 6. Patients who are HIV positive. 7. Patients for whom healthy donor DNT kill \<10% of patient's blast cells. Donor Inclusion Criteria: 1. Has given written informed consent. 2. Is 18 years of age or older. 3. No known prior blood product transfusion or surgery. 4. Blood electrolytes (Sodium, Potassium, Chloride, Bicarbonate, Magnesium, Phosphate, Calcium) within normal ranges. 5. Normal complete blood counts. 6. Normal liver and kidney function (Bilirubin, AST, ALT, ALP, LDH, plasma albumin, creatinine). 7. Negative for transfusion transmissible illnesses (CMV, HIV I/II, HTLV I/II, Hepatitis B Surface Antigen, Hepatitis B Surface Antibody, Hepatitis B Core Antibody, Hepatitis C Antibody) within 30 days of blood collection for DNT cell expansion for patient infusion. 8. Negative for evidence of exposure to West Nile Virus, Syphilis within 30 days of blood collection for DNT cell expansion for patient infusion. 9. DNT cell expansion yield is \>108 per mL blood using the standard protocol. Expanded DNT cells show ≥20% cytotoxicity to at least 3 AML cell lines (MV4-11 AML3, and U937). 10. The donor who meet all donor inclusion/
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients with adverse events and abnormal laboratory studies. | 2 years | Patients will be assessed for adverse events based upon, but not limited to, monitoring of vital signs and prescribed laboratory studies. Adverse events (AE) will use the descriptions and grading scales found in the revised NCI Common Terminology Criteria for Adverse Events (CTCAE). This study will utilize the CTCAE Version 4.03 for adverse event reporting. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of cells with disease specific mutations per patient | 2 years | Quantitive real time polymerase chain reaction (PCR) analysis for disease specific mutations will be performed on the bone marrow aspirate. |
| Leukemia load | 2 years | Peripheral blood will be obtained after DNT cell infusion to monitor leukemia load and residual disease by determining the frequency of leukemic cell markers on cells using flow cytometry. |
Countries
Canada
Outcome results
None listed