Multivirus-specific T Cells in the Treatment of Refractory CMV and/or EBV Infection After Allo-HSCT

Sponsor

Peking University People's Hospital (Other)

Overall Status

Not yet recruiting

CT.gov ID

NCT06075927

Collaborator

(none)

Enrollment

Arm

Anticipated Duration (Months)

Study Details

Study Description

Brief Summary

To evaluate the safety and tolerability of partial HLA-matched VSTs against both CMV and EBV viruses in recipients of allogeneic hematopoietic stem cells with refractory viral infections (CMV and/or EBV).

Preliminary evaluation of the efficacy of partial HLA-matched VSTs against both CMV and EBV viruses in recipients of allogeneic hematopoietic stem cells with refractory viral infections (CMV and/or EBV); To monitor the duration and expansion of multi-virus VSTs cells after infusion.

Condition or Disease	Intervention/Treatment	Phase
CMV Infection EBV Infection Stem Cell Transplant	Biological: Virus specific T cells	Phase 1/Phase 2

Detailed Description

This study consists of two parts: (1) The first stage is the safety evaluation of multi-virus VSTs and the exploration of DLT and MTD; (2) The second phase is to evaluate the safety and efficacy of multi-viral VSTs in selecting appropriate doses in the first phase.

Study Design

Study Type:

Interventional

Anticipated Enrollment :

29 participants

Allocation:

N/A

Intervention Model:

Single Group Assignment

Masking:

None (Open Label)

Primary Purpose:

Treatment

Official Title:

An Exploratory Clinical Study of Multivirus-specific T Cells in the Treatment of Refractory Cytomegalovirus and/or Epstein-Barr Virus Infection After Allogeneic Hematopoietic Stem Cell Transplantation

Anticipated Study Start Date :

Nov 1, 2023

Anticipated Primary Completion Date :

Jul 30, 2025

Anticipated Study Completion Date :

Oct 30, 2025

Arms and Interventions

Arm	Intervention/Treatment
Experimental: VSTs infusion Phase I (dose escalation) : An open, single-arm, dose-escalation clinical study to explore the safety, tolerability, and cytodynamic characteristics of CMV and EBV-specific T cells (VSTs), with initial efficacy observations. Subjects enrolled with refractory CMV and/or EBV infection after allogeneic hematopoietic stem cell transplantation were subjected to a 3+3 dose-climb test. Exploring the safety, dose-limiting toxicities (DLT) and maximum tolerated dose (MTD) of intravenous infusion of multi-virus VSTs. (2) Phase II (dose expansion) : According to the clinically recommended or safe and effective dose determined by the phase I climb test, the extended study of 1-2 dose groups with 20 cases per dose was performed after joint review by the investigators and project collaborators.	Biological: Virus specific T cells Subjects will receive partial HLA-matched viral-specific T cells (VSTs) against both CMV and EBV on one of the following dose levels: Level One: 1 x 10^7 cells/m2 Level Two: 2 x 10^7cells/m2 Level Three: 5x 10^7 cellss/m2

Arm

Intervention/Treatment

Experimental: VSTs infusion

Phase I (dose escalation) : An open, single-arm, dose-escalation clinical study to explore the safety, tolerability, and cytodynamic characteristics of CMV and EBV-specific T cells (VSTs), with initial efficacy observations. Subjects enrolled with refractory CMV and/or EBV infection after allogeneic hematopoietic stem cell transplantation were subjected to a 3+3 dose-climb test. Exploring the safety, dose-limiting toxicities (DLT) and maximum tolerated dose (MTD) of intravenous infusion of multi-virus VSTs. (2) Phase II (dose expansion) : According to the clinically recommended or safe and effective dose determined by the phase I climb test, the extended study of 1-2 dose groups with 20 cases per dose was performed after joint review by the investigators and project collaborators.

Biological: Virus specific T cells

Subjects will receive partial HLA-matched viral-specific T cells (VSTs) against both CMV and EBV on one of the following dose levels: Level One: 1 x 10^7 cells/m2 Level Two: 2 x 10^7cells/m2 Level Three: 5x 10^7 cellss/m2

Outcome Measures

Primary Outcome Measures

Assessment of safety and toxicity outcomes in subjects receiving VSTs infusion [within 56 days after the first VSTs infusion]
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0, and graft-versus-host-disease will be summarized using descriptive statistics for each dose level
Assessment of antiviral efficacy of VSTs infusion [within 56 days after the first VSTs infusion]
Antiviral efficacy including clinical signs of viral infections, virus reinfection, and laboratory measurement of viral load after VSTs infusion will be determined

Secondary Outcome Measures

Virus-specific immune reconstitution [within 56 days after the first VSTs infusion]
Laboratory measurement of virus-specific immune reconstitution before and after VSTs infusion will be tested

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years to 70 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Yes

Inclusion Criteria:

Age ≥18 years old, and less than or equal to 70 years old, gender is not limited.
Prior myeloablative or non-myeloablative allogeneic hematopoietic stem cell transplantation.
Persistent infection with CMV and/or EBV persists despite standard treatment .
Prednisone or its equivalent hormone is less than or equal to 0.5 mg/kg/ day when enrolled.
ECOG score ≤3, expected survival greater than 3 months.
End blood oxygen saturation ≥90% on room air.
Available multi-virus-specific cytotoxic T lymphocytes.
Negative pregnancy test in female patients if applicable.
Written informed consent and/or signed assent line from patient, parent or guardian.

Exclusion Criteria:

Within 28 days after allogeneic hematopoietic stem cell transplantation.
Active III-IV acute GVHD, and/or moderate and above chronic GVHD.
Severe organ dysfunction: Heart: New York Heart Association (NYHA) levels III and IV;

Liver: Total bilirubin>34umol/l; ALT, AST>2 times the normal upper limit; Kidney:

Blood creatinine >130umol/L; Lung: Type I or II respiratory failure; Brain:

unconsciousness, intracranial hypertension.

Received DLI, other CTL, CAR-T, NK and other cell therapies, T cell monoclonal antibody immunosuppressants, or participated in any other clinical research related to drugs and medical devices within 28 days before enrollment.
Poor compliance, and subjects deemed unsuitable for study participation by the investigator.