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Treatment of CD19 Chimeric Antigen Receptor T Cells for Pediatric Patients With CD19-positive B-cell Acute Lymphoblastic Leukemia Who Are Indicated for Hematopoietic Stem Cell Transplantation

Recruiting
- 25 years of age
Both
Phase 2

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Overview

This is a phase 2 clinical trial targeting pediatric and adolescent patients diagnosed with CD19-positive B-ALL, considered very high-risk group. The study aims to administer CD19 CAR-T therapy as an alternative to hematopoietic stem cell transplantation in patients eligible for such transplantation. The trial includes patients aged 25 or younger.

Eligibility

Inclusion Criteria:

  • Subject eligibility criteria include individuals who are under the age of 25 at the time of SNUH-CD19-CAR-T administration. Confirmation of B-cell acute lymphoblastic leukemia diagnosed at the initial assessment by a treating physician for the first diagnosis is required. Immunophenotypic analysis of CD19 expression on leukemia cells must be confirmed through immune profiling at the time of the initial diagnosis of B-cell acute lymphoblastic leukemia. In patients experiencing hematologic relapse of B-cell acute lymphoblastic leukemia, CD19 expression should also be confirmed at the time of relapse confirmation.
        Patients must achieve hematologic complete remission defined as less than 5% blasts in the
        bone marrow after the first-line or second-line chemotherapy (first salvage therapy).
        Eligible patients for hematopoietic stem cell transplantation, defined by indications for
        transplantation, include those meeting at least one of the following criteria:
          1. Philadelphia chromosome-positive due to t(9;22)(q34;q11) translocation.
          2. Hypodiploidy defined by fewer than 44 chromosomes.
          3. E2A-HLF gene fusion due to t(17;19) translocation.
          4. Detection of minimal residual disease (MRD) positive at 0.01% or higher by
             next-generation sequencing confirmed after consolidation therapy and maintenance
             therapy.
          5. Failure of the first-line therapy.
          6. Cases not meeting any of the above criteria but deemed eligible for hematopoietic stem
             cell transplantation based on the investigator's judgment.
        Exclusion Criteria:
          -  Patients who have undergone hematopoietic stem cell transplantation.
          -  Individuals for whom an adequate or sufficient leukapheresis product suitable for the
             production of SNUH-CD19-CAR-T cannot be obtained or is unavailable.
          -  Those known to be infected with the human immunodeficiency virus (HIV).
          -  Presence of uncontrolled active infections, determined by the investigator's
             assessment. If appropriate treatment has been administered for the infection, and
             there are no signs of progression at the time of enrollment, it is considered
             controlled. Persistent fever without other symptoms is not interpreted as progressive
             infection.
          -  Women who are pregnant or breastfeeding.
          -  Individuals deemed clinically inappropriate for participation in the clinical trial
             based on the investigator's clinical judgment.

Study details

Very High Risk Acute Lymphoblastic Leukemia, CD19 CAR-T Therapy

NCT06247501

Seoul National University Hospital

14 February 2024

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