A Phase I Study to Examine the Toxicity of Killer IG-Like Receptor (KIR) Mismatched Umbilical Cord Blood for Pediatric Patients With Malignant Solid Tumors
N/A
21 Years
Both
Unspecified Childhood Solid Tumor, Protocol Specific
Trial Information
A Phase I Study to Examine the Toxicity of Killer IG-Like Receptor (KIR) Mismatched Umbilical Cord Blood for Pediatric Patients With Malignant Solid Tumors
OBJECTIVES:
- Examine the impact of the use of killer cell immunoglobulin-like receptor
(KIR)-mismatched umbilical cord blood as a source of hematopoietic stem cells, after
busulfan, melphalan, and anti-thymocyte globulin in pediatric patients with relapsed or
refractory solid tumors.
- Determine the toxicity of this regimen, in terms of incidence of grade 3-4 acute
graft-versus-host disease, donor/host chimerism, and cellular immunity against tumor
cell lines, in these patients.
OUTLINE:
- Transplantation: Patients receive busulfan orally or IV every 6 hours on days -8 to -5,
anti-thymocyte globulin IV over 6 hours on days -4 to -1, and melphalan IV over 15-20
minutes on days -4 to -2. Patients undergo allogeneic umbilical cord blood stem cell
infusion on day 0. Patients receive sargramostim (GM-CSF) subcutaneously beginning on
day 7 and continuing until blood counts recover.
- Graft-vs-host disease prophylaxis: Patients receive cyclosporine IV over 1 hour or
orally twice daily on days -1 to 180 and methylprednisolone IV or orally once or twice
daily on days 5 - 49.
Blood samples are collected periodically for immunophenotyping and flow cytometric analysis
(including interferon gamma and other TH1 and TH2 cytokines).
After completion of study treatment, patients are followed periodically.
PROJECTED ACCRUAL: A total of 20 patients will be accrued for this study.
Inclusion Criteria
DISEASE CHARACTERISTICS:
- Diagnosis of malignant solid tumor
- Relapsed or refractory disease
- No isolated local recurrence of disease (in the site of the primary tumor) > 1
year after completing therapy
- No brain tumors or brain metastases
- Unrelated cord blood donor available
- May be HLA 6/6 matched (HLA-A, -B, -DR) OR mismatched for 1, 2, or 3 of these
HLA loci, but must be mismatched for HLA-C group as indicated by their following
killer cell immunoglobulin-like receptor (KIR) group specificity:
- KIR2DL1
- Cw 2
- Cw 0307
- Cw 4, 5, 6
- Cw 0707, 0709
- Cw 1204, 1205
- All other Cw 15 alleles
- Cw 1602
- Cw 17
- Cw 18
- KIR2DL2
- Cw 1
- All other Cw 3 alleles
- All other Cw 7 alleles
- Cw 8
- Cw 1202, 1203, 1206
- Cw 1301
- Cw 1402, 1403
- Cw 1507
- Cw 1601, 1604
- Cord blood specimen must have ≥ 1 x 10^7 nucleated cells/kg patient ideal body weight
PATIENT CHARACTERISTICS:
- ECOG performance status (PS) 0-2 OR Lansky PS 70-100%
- Cardiac ejection fraction ≥ 50%
- Creatinine clearance ≥ 50%
- Bilirubin ≤ 3.0 mg/dL
- DLCO ≥ 70% OR O_2 saturation ≥ 95% on room air
PRIOR CONCURRENT THERAPY:
- Prior autologous stem cell transplantation allowed
Type of Study:
Interventional
Study Design:
Masking: Open Label, Primary Purpose: Treatment
Outcome Measure:
Safety
Safety Issue:
Yes
Principal Investigator
Kenneth G. Lucas, MD
Investigator Role:
Study Chair
Investigator Affiliation:
Milton S. Hershey Medical Center
Authority:
United States: Federal Government
Study ID:
CDR0000529361
NCT ID:
NCT00436761
Start Date:
May 2004
Completion Date:
Related Keywords:
- Unspecified Childhood Solid Tumor, Protocol Specific
- unspecified childhood solid tumor, protocol specific
- Neoplasms
Name | Location |
|---|---|
| Penn State Cancer Institute at Milton S. Hershey Medical Center | Hershey, Pennsylvania 17033-0850 |
