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Brief Title: Antiviral Cellular Therapy for Enhancing T-cell Reconstitution Before or After Hematopoietic Stem Cell Transplantation
Official Title: Antiviral Cellular Therapy for Enhancing T-cell Reconstitution Before or After Hematopoietic Stem Cell Transplantation (ACES) PBMTC SUP1701
Study ID: NCT03475212
Brief Summary: The purpose of this study is to evaluate whether virus-specific T cell lines (VSTs) are safe and can effectively control three viruses (EBV, CMV, and adenovirus) in patients who have had a stem cell transplant and also in patients that have a primary immunodeficiency disorder with no prior stem cell transplant.
Detailed Description: The primary purpose of the study is to evaluate whether most closely HLA-matched multivirus-specific T cell lines obtained from a bank of allogeneic virus-specific T cell lines (VSTs) have antiviral activity against three viruses: EBV, CMV and adenovirus. Reconstitution of anti-viral immunity by donor-derived VSTs has shown promise in preventing and treating infections associated with CMV, EBV and adenovirus post-transplant. However, the time required to prepare patient-specific products and lack of virus-specific memory T cells in cord blood and seronegative donors, limits their value. An alternative is to use banked partially HLA-matched allogeneic VSTs. A prior phase II study at Baylor College of Medicine using trivirus-specific VSTs generated using monocytes and EBV-transformed B cells gene-modified with a clinical grade adenoviral vector expressing CMV-pp65 to activate and expand specific T cells showed the feasibility, safety and activity of this approach for the treatment of refractory CMV, EBV and Adenovirus infections. More recent protocols utilizing synthetic viral peptide pools allow ex vivo expansion of T-cells targeting multiple viral antigens in 10-12 days without use of viral transduction. The study will evaluate whether partially-HLA matched allogeneic multivirus-specific VSTs, activated using overlapping peptide libraries spanning immunogenic antigens from CMV, adenovirus and EBV, will be safe and produce anti-viral effects in immunodeficient recipients infected with one of more of the targeted viruses that are persistent despite conventional anti-viral therapy. This study will evaluate safety and efficacy of partially-matched VST therapy in A) patients who have persistent viral infections in the post-HSCT period, and B) patients with primary immunodeficiency conditions who have persistent viral infections and have not undergone HSCT. The study agent will be assessed for safety and antiviral activity.
Minimum Age:
Eligible Ages: CHILD, ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Phoenix Children's Hospital, Phoenix, Arizona, United States
City of Hope, Duarte, California, United States
University of California, Los Angeles, Los Angeles, California, United States
Children's Hospital Los Angeles, Los Angeles, California, United States
Stanford Lucile Packard Children's Hospital, Palo Alto, California, United States
UCSF Medical Center, San Francisco, California, United States
Children's Hospital Colorado, Aurora, Colorado, United States
Yale, New Haven, Connecticut, United States
Children's National Medical Center, Washington, District of Columbia, United States
Emory University/Children's Healthcare of Atlanta, Atlanta, Georgia, United States
Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, United States
Riley Hospital for Children - Indiana University, Indianapolis, Indiana, United States
Tufts Medical Center, Boston, Massachusetts, United States
Dana-Farber Cancer Institute/ Boston Children's Hospital, Boston, Massachusetts, United States
University of Michigan, Ann Arbor, Michigan, United States
Spectrum Health - Helen DeVos Children's Hospital, Grand Rapids, Michigan, United States
University of Minnesota, Minneapolis, Minnesota, United States
Washington University, Saint Louis, Missouri, United States
Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States
Columbia University Medical Center, New York, New York, United States
Duke University Medical Center, Durham, North Carolina, United States
Oregon Health & Science University, Portland, Oregon, United States
The Children's Hospital, Philadelphia, Pennsylvania, United States
Medical University of South Carolina, Charleston, South Carolina, United States
St. Jude, Memphis, Tennessee, United States
UT Southwestern Medical Center, Dallas, Texas, United States
Children's Mercy, San Antonio, Texas, United States
Methodist Healthcare System of San Antonio, San Antonio, Texas, United States
Virginia Commonwealth University, Richmond, Virginia, United States
Fred Hutchinson Cancer Research Center/Seattle Chlindren's/University of Washington School of Medicine, Seattle, Washington, United States
Name: Michael Pulsipher, MD
Affiliation: Children's Hospital Los Angeles
Role: STUDY_CHAIR
Name: Michael Keller, MD
Affiliation: Children's National Research Institute
Role: STUDY_CHAIR