Status:
RECRUITING
Study of Therapeutic Efficacy of Anti-CD19 CAR-T Cells in Children With Refractory Refractory AAV
Lead Sponsor:
The Children's Hospital of Zhejiang University School of Medicine
Collaborating Sponsors:
Children's Hospital of Chongqing Medical University
Conditions:
ANCA Associated Vasculitis
CAR-T Cell Therapy
Eligibility:
All Genders
5-25 years
Brief Summary
This is an investigator-initiated trial aimed at assessing the safety and efficacy of anti-CD19 CAR-T cells in the treatment of childhood-onset refractory ANCA-Associated Vasculitis.
Detailed Description
The anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis （AAV ）is one of the most devastating and potentially fatal autoimmune diseases, characterized by involvement of small blood vessel...
Eligibility Criteria
Inclusion
- Age:5-25 years old(including threshold);
- Diagnosed with AAV according to the 2022EULAR/ACR AAV classification criteria；despite of the Treatment with glucocorticoids (more than 1mg/kg/ day), cyclophosphamide, and rituximab for at least 3 months, still cannot achieve sustained response or disease recurred after response; Or use glucocorticoid combined with cyclophosphamide/rituximab plus more than one of the other immunosuppressants (including azathioprine, moxophenolate, methotrexate, leflunomide, tacrolimus, cyclosporine, beliuzumab, etc.) ≥3months，still failed to achieve sustained remission or relapsed after remission; Or meet the diagnostic criteria for severe vasculitis, clinical routine treatment is ineffective, the benefit is judged by the investigator to outweigh the risk, and the patient or guardian has fully informed consent, can be considered for inclusion。
- patient \<18 years old：PVAS≥15（total 63）；≥18 years old: BVAS≥15(total 63)
- The functions of important organs are basically normal: Cardiac function: Left ventricular ejection fraction (LVEF) ≥55% with no obvious abnormality in electrocardiogram; Renal function: eGFR≥30ML/min/1.73m2； Liver function: Asparagus cochinchinensis transase (AST) and Alanine Aminotransferase (ALT)≤3.0 ULN, Total Bilirubin (TBIL) in serum ≤2.0×ULN; Lung function: No serious lung lesions, SpO2≥92%;
- Met the standards of leukapheresis or intravenous blood collection, No contraindication for cell collection;
- Negative pregnancy test for female Subjects of childbearing age, agree to take effective contraceptive measures the first year after CAR-T infusion;
- Participants or their guardians agrees to participate in the clinical trial and sign the informed consent form which indicating that he/she understands the purpose and procedure of the clinical trial and is willing to participate in the study.
Exclusion
- Received CAR T cell therapy previously;
- Central nervous system (CNS) disease: CNS neurolupus requires intervention within 60 days);
- Pulmonary hemorrhage that need for pulmonary ventilation support for more than 1 week;
- Have a history of congenital heart disease or acute myocardial infarction within 6 months prior to screening; Or severe arrhythmias (including multisource frequent supraventricular tachycardia, ventricular tachycardia, etc.); Or combined with moderate to massive pericardial effusion, serious myocarditis, etc; Or patients with unstable vital signs who need hypertensive drugs；
- Suffer from other diseases that require long-term use of glucocorticoid or high-dose of immunosuppressive agents;
- Uncontrollable infection, or active infection that requires systemic treatment within 1 week prior to screening；
- History of organ transplantation or hematopoietic stem cell transplantation, or ≥Grade 2 GVHD within 2 weeks prior to screening；
- Hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) positive and peripheral blood hepatitis B virus (HBV) DNA titer greater than the normal reference value range; Or hepatitis C virus (HCV) antibody positive and peripheral blood hepatitis C virus (HCV) RNA titer greater than the normal reference value range; Or positive for human immunodeficiency virus (HIV) antibodies; Or syphilis test positive; Or cytomegalovirus (CMV) DNA test positive;
- Received live vaccine within 4 weeks before screening;
- Tested positive in Blood pregnancy test；
- Previous or concurrent malignancy；
- Patients who participated in other clinical study within 3 months prior to enrollment;
- Any other conditions that the investigators deem it unsuitable for the study
Key Trial Info
Start Date :
August 1 2024
Trial Type :
OBSERVATIONAL
Allocation :
ESTIMATED
End Date :
July 31 2027
Estimated Enrollment :
12 Patients enrolled
Trial Details
Trial ID
NCT06508346
Start Date
August 1 2024
End Date
July 31 2027
Last Update
December 2 2024
Active Locations (1)
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1
Children's Hospital, Zhejiang University School of Medicine
Hangzhou, Zhejiang, China