Effect of rabbit ATG PK on outcomes after TCR-αβ/CD19-depleted pediatric haploidentical HCT for hematologic malignancy.
Christopher C Dvorak, Janel R Long-Boyle, Lucia Holbrook-Brown...
https://pubmed.ncbi.nlm.nih.gov/39042892/Actively Recruiting
Led by Christopher Dvorak · Updated on 2026-04-13
90
Participants Needed
1
Research Sites
260 weeks
Total Duration
Patients who need an allogeneic hematopoietic cell transplant HCT face the risk of developing graft-versus-host disease GVHD. To reduce this risk, one approach uses ex vivo alpha-beta T-cell depletion of donor cells. The CliniMACS Device, approved by the FDA for a limited use, can process these cells, but other uses require research protocols. This study explores the feasibility of using the CliniMACS system for alpha-beta T-cell depletion in stem cell transplant recipients to better understand its application beyond approved indications. The CliniMACS CD34 Reagent System uses antibodies linked to magnetic particles to select blood stem cells CD34 cells from donor samples. In this study, stem cell products depleted of alpha-beta T-cells using the CliniMACS system are infused intravenously at a rate based on body weight. The aim is to deliver a target dose of CD34 cells and minimize alpha-beta T-cell numbers to reduce the risk of GVHD. This approach also includes simultaneous depletion of CD19 B cells. The study evaluates this method as an alternative to traditional CD34-selection techniques. Participants will receive the alpha-beta T-cell depleted stem cell infusion and be monitored for outcomes including the incidence of severe acute GVHD within 100 days. Other assessments include engraftment success, transplant-related mortality, chronic GVHD requiring steroids, autoimmunity needing immunosuppressive treatment, and T-cell immune recovery over the first year after transplant. Safety and effectiveness of the procedure are followed up to one year, with the total participation duration varying accordingly.
CONDITIONS
A Feasibility Study Using CLINIMACS® for Alpha/Beta T-Cell Depletion in Stem Cell Transplant
C
Christopher C. Dvorak, MD
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Christopher Dvorak
Lead Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Investigational CliniMACS® CD34-Selected, Alpha/Beta T-Cell Depleted HCT | Current-Care: Unmodified Haploidentical Transplant with Post-Transplant Cyclophosphamide |
|---|---|---|
| What it is | Uses the CliniMACS® system to selectively deplete alpha/beta T cells and CD19+ B cells from allogeneic donor cells, providing a CD34-enriched graft to reduce the risk of graft-versus-host disease (GVHD) in children and young adults who need transplantation. | Allogeneic hematopoietic cell transplant from a haploidentical donor, using standard grafts (unmodified) with post-transplantation cyclophosphamide (PTCy) to prevent GVHD, widely used for patients without matched donors. |
| Role in trial | Investigational transplantation method studied in a single group of eligible pediatric and young adult patients. | Contextual comparator: established clinical approach for transplantation in the same patient population, not studied in this trial. |
| Primary use | Intended to reduce the risk of severe acute and chronic GVHD while enabling engraftment after allogeneic transplantation. | Widely used approach for facilitating engraftment from haploidentical donors and lowering GVHD risk via high-dose cyclophosphamide after transplantation. |
| How it is given or performed | Donor stem cells (bone marrow or peripheral blood) are processed with the CliniMACS® device to remove alpha/beta T-cells and CD19+ B cells, then infused into the patient after a myeloablative preparative regimen. | Unmodified donor stem cells are infused following a conditioning regimen; post-transplant, patients receive high-dose cyclophosphamide (PTCy) as GVHD prophylaxis. |
| Evidence status | Currently under investigation in this trial; final results for outcomes such as Grade III-IV acute GVHD and engraftment are not yet established. | Multiple studies support favorable pediatric outcomes for engraftment, GVHD prevention, and overall survival using this approach. |
| Important limitations | As an investigational approach, the long-term efficacy and risks (including infection, relapse, or immune recovery) remain incompletely characterized in this population; no published outcome data are yet available for the current trial. | Risks include risk of graft-versus-host disease, infection, delayed immune recovery, and potential for relapse after transplant, as noted in published pediatric/young adult series. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
You may qualify if you...
You will not qualify if you...
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Single treatment period during transplant admission
Participants receive a stem cell product that has been alpha-beta T-cell depleted using the CliniMACS system. The cells are given intravenously over a period based on the volume of the infused product.
1 infusion visit (in-person)
Duration - Up to 12 months after treatment
Participants are monitored for transplant outcomes including acute graft-versus-host disease, engraftment, transplant-related mortality, chronic GVHD, autoimmunity, and immune reconstitution.
Multiple visits over 12 months for monitoring
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NA
Model
SINGLE_GROUP
Primary Purpose
TREATMENT
Number of Arms
1
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Lead Sponsor