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NCT04806347

PHASE1

Alpha/Beta T-cell Depleted Blood-forming Stem Cell Transplant From Related or Unrelated Donors for Blood Diseases in Children and Young Adults

Sponsor: University of Wisconsin, Madison

View on ClinicalTrials.gov

Summary

This study is being done to see if the investigators can take peripheral blood stem cells from either an adult family member or a closely matched unrelated donor, and run them through a special lab instrument to remove alpha/beta T cells and B cells and then give them to the patient to treat disease. This is an experimental way of doing a hematopoietic stem cell transplant (HSCT). The investigators want to see if the new stem cells will grow without bad graft vs. host disease (GVHD). This treatment approach is experimental in the United States.

Official title: TCRαβ+ and CD19+ Depleted Hematopoietic Stem Cell Transplant From Closely Matched Unrelated Donors or Haploidentical Related Donors for Hematologic Diseases in Children and Young Adults

Key Details

Gender

All

Age Range

3 Months - 25 Years

Study Type

INTERVENTIONAL

Enrollment

Start Date

2026-06

Completion Date

2030-05

Last Updated

2026-05-26

Healthy Volunteers

Conditions

Blood Disease

Interventions

BIOLOGICAL

TCRαβ+/CD19+ depleted Hematopoietic stem cell (HSC) graft

After undergoing a disease specific conditioning regimen (standard of care), participants will receive peripheral blood stem cell transplant from a haploidentical donor or closely matched unrelated donor, depleted of TCR αβ+ and CD19+ cells using the CliniMACS TCR α/β-biotin and CD19 Systems.

DEVICE

CliniMACS® System

The CliniMACS Cell Selection System is based on magnetic-activated cell sorting mechanism. The CliniMACS device is a powerful tool for the isolation of many cell types from heterogeneous cell mixtures.

Inclusion Criteria: * No Human leukocyte antigen (HLA) identical sibling available AND * NO HLA matched unrelated donor available OR urgent need of HSCT precludes time necessary to search for suitable HLA matched unrelated donor AND * Haploidentical donor OR closely matched unrelated donor available and willing to undergo mobilization and apheresis * If subject has genetically confirmed inherited bone marrow failure, related donor must be evaluated for this disorder and testing must be negative. * If subject has sickle cell disease, donor must be unaffected or have only sickle cell trait * Patient must be diagnosed with one of the following diseases or disorders: * Hemoglobinopathies * Sickle Cell Disease for patients ≤ 21 years of age for whom hydroxyurea has been trialed for at least six months, and failed * Thalassemia Major for patients ≤ 21 years of age * Acquired Bone Marrow Failure Syndromes * Paroxysmal Nocturnal Hemoglobinuria with bone marrow failure * Myelodysplastic Syndromes (lower risk) * Severe acquired aplastic anemia * Inherited Bone Marrow Failure Syndromes * Fanconi Anemia * Diamond Blackfan Anemia * Dyskeratosis Congenita and related telomere disorders * Congenital Thrombocytopenia Syndromes * Severe Congenital Neutropenia * Shwachman-Diamond Syndrome * Inborn Errors of Immunity (IEI) or Primary Immune Regulatory Disorders (PIRD) * Wiskott-Aldrich syndrome (WAS) * Chronic granulomatous disease (CGD) * Severe combined immunodeficiency (SCID) * Primary hemophagocytic lymphohistiocytosis (HLH) * Age ≤ 25 years (except patients with hemoglobinopathies) * Life Expectancy ≥ 3 months * Karnofsky (patients \> 16 years)/Lansky (patients ≤ 16 years) index ≥ 60 * Organ Function Requirements * Renal Function * Creatinine clearance or radioisotope Glomerular Filtration Rate (GFR) greater than or equal to 60 ml/min/1.73m\^2 * Liver Function * Total bilirubin \< 3 mg/dL * Alanine aminotransferase (ALT)/ Serum glutamic-pyruvic transaminase; synonymous with ALT (SCPT) ≤ 3 x Upper Limit of Normal (ULN) for age * Cardiac Function * Ejection fraction of \> 40% by Multiple gated acquisition scan (MUGA) or echocardiogram * Pulmonary Function * No evidence of dyspnea at rest * No supplemental oxygen requirement * If measured, carbon monoxide diffusion capacity (DLCO) \> 50% * Willing to use effective birth control method if patient is of reproductive potential * Informed consent obtained (patient or legal representative) Exclusion Criteria: * Pregnant * HIV infection * Uncontrolled, serious active infection at screening * Significant serious intercurrent illnesses * Enrollment in any other treatment study that would interfere with the endpoints of this study according to judgement of Principal Investigator (or PI designee).