Post-transplant Autologous Cytokine-induced Killer (CIK) Cells for Treatment of High Risk Hematologic Malignancies

Sally Arai

Status and phase

Completed

Phase 1

Conditions

Multiple Myeloma

Leukemia

Treatments

Drug: etoposide

Drug: melphalan

Drug: bcnu

Drug: CIK cells

Drug: cyclophosphamide

Drug: vinorelbine

Drug: gemcitabine

Study type

Interventional

Funder types

Other

Identifiers

NCT00477035

BMT173 (Other Identifier)

95889 (Other Identifier)

IRB-00245

Details and patient eligibility

About

The purpose of the study is to conduct a phase I study of adoptive immunotherapy with autologous, ex-vivo expanded cytokine-induced killer (CIK) cells to reduce the relapse rate in autologous stem cell transplant patients with high-risk hematologic malignancies.

Full description

Disease relapse remains the major cause of treatment failure in autologous stem cell transplantation for patients with high-risk disease. Relapse after autologous transplant is in part due to the persistence of residual cancer cells. Cellular immunotherapy using activated autologous effector cells to recognize and kill tumor targets in a minimal disease state after transplant is a strategy being explored to reduce relapse and improve survival. We hypothesize that cytokine-induced killer (CIK) cell-based immunotherapy can reduce the relapse rate after high-risk autologous stem cell transplantation by treating post-transplant minimal residual disease.

Enrollment

22 patients

Sex

All

Ages

18 to 75 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Patients between 18 and 75 years of age, inclusive candidates for standard autologous SCT who are at high risk for relapse:
- Acute myelogenous leukemia (AML), high risk, in CR1 or beyond without a donor (CR1 defined as: normal bone marrow morphology, resolution of any previously abnormal karyotype, neutrophils > 1000/ul, platelets > 100,000/ul, independence from red cell transfusion, no evidence extramedullary leukemia)
- Hodgkin's lymphoma relapsed or refractory, with the presence of >= 1 adverse risk factor (Adverse risk factors are defined as stage IV involvement of the lung or bone marrow, constitutional symptoms, and the presence of more than minimal residual disease before the preparatory regimen)
- Multiple myeloma with high risk features with only single autologous transplant option. High risk features defined as IgA myeloma, B2M > 2.5 mg/ml with normal kidney function, complex karyotypes or isolated chromosome 13 abnormalities, standard-dose therapy > 12 months, or inability to achieve at least 50% reduction of plasma cells in the bone marrow or 50% reduction in the paraprotein concentration after initial induction chemotherapy prior to transplant.
Patients must have ECOG performance status < 2
Patients must have adequate renal function with a serum creatinine of < 2 mg/dl or creatinine clearance > 50 ml/min.
Patients must have adequate liver function with a total bilirubin < 2 mg/dl or transaminases < 3 times the upper limit of normal.
Patients must have negative antibody serology for human immunodeficiency virus (HIV1 and 2)
Adult women and minorities will be included. Patients with childbearing potential must use effective contraception.
Patients must sign informed consent prior to initiation of any study-related treatments.

Exclusion criteria

ECOG performance status > 2
LVEF < 45%
Pulmonary diffusion capacity < 50% predicted
Total bilirubin > 2 mg/dl
Creatinine > 2 mg/dl
Pregnancy
Patients positive for HIV
Patients with engraftment failure at day 42 post transplant defined as failure to achieve a granulocyte count > 500/ul on 3 successive daily determinations and an unsupported platelet count of >= 50,000/ul by day 42
Patients with active, uncontrolled infection that is expected to continue beyond day 42-63.
Patients who fail to collect sufficient quantities of stem cells (> 1.6 x 10^9 cells) during apheresis to support CIK cell expansion cultures.