Treatment of CMV Infections With Viral-Specific T Cells Against CMV in Pediatric and Adult Immunocompromised Patients or Recipients of Allogeneic Stem Cell Transplantation

  • STATUS
    Recruiting
  • End date
    Sep 23, 2026
  • participants needed
    20
  • sponsor
    University of Wisconsin, Madison
Updated on 23 October 2022
pneumonia
stem cell transplantation
ganciclovir
antiviral therapy
valganciclovir
cmv infection
foscarnet
antiviral drugs
colitis
dhpg
viremia

Summary

The present trial will consist of the treatment of 20 pediatric and adult Hematopoietic Stem Cell Transplantation (HSCT) recipients or immunocompromised participants diagnosed with opportunistic Cytomegalovirus (CMV) infections with virus-specific, antigen-selected T-cells. CMV-specific T-cells will be isolated from donor leukapheresis products using the CliniMACS® Prodigy. Prior studies on transfer of CMV specific T-cells have been shown to be safe and efficacious in the treatment of CMV infections.

The main trial objective is to evaluate the feasibility and safety of CMV-specific T-cell transfer in adult and pediatric participants suffering from CMV infections or reactivation following HSCT or due to other immunocompromised states (e.g.; primary immunodeficiency, cytotoxic therapy).

Participants will be followed for one year.

Details
Condition CMV Infection, Cytomegalovirus Infections, CMV Viremia, Opportunistic Infections
Treatment CMV-specific T-cells
Clinical Study IdentifierNCT03798301
SponsorUniversity of Wisconsin, Madison
Last Modified on23 October 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Adult or pediatric patient suffering from CMV reactivation/infections following HSCT or due to other immunocompromised states (e.g.; primary immunodeficiency, cytotoxic therapy)
CMV reactivation/viremia defined as positive (>500 copies/ml) CMV qPCR and/or
Presence of symptoms secondary to CMV infection or evidence of invasive CMV infection (e.g. pneumonitis, colitis) AND
Patients must have ONE OF THE FOLLOWING CRITERIA
Absence of an improvement of viral load after ≥ 14 days of antiviral therapy with ganciclovir, valganciclovir or foscarnet (decrease by at least 1 log, i.e. 10-fold), or
New, persistent and/or worsening CMV-related symptoms, signs and/or markers of end organ compromise while on antiviral therapy with ganciclovir, valganciclovir or foscarnet, or
Have contraindications or experience adverse effects of antiviral therapy with ganciclovir, valganciclovir or foscarnet, or
Known resistance to ganciclovir and/or foscarnet based on molecular testing
Recipients of an allogeneic HSCT must be 28 days after stem cell infusion at the time
Written informed consent given by patient or legal representative
of T-cell transfer
Minimum patient age 1 month
Minimum weight 7 lbs
Female patients of childbearing age with negative pregnancy tests
Patient Karnofsky/Lansky Performance Status >30%
Donor eligible based on FACT infectious screening requirements

Exclusion Criteria

Patient with acute GVHD > grade 2 or active moderate or severe chronic GVHD at time of T-cell transfer
Patient receiving steroids (>1.0 mg/kg body weight (BW) prednisone equivalent) at the time of T-cell transfer
Patient received allogeneic HSCT less than 28 days prior to T-cell transfer
Patient treated with donor lymphocyte infusion (DLI) within 28 days prior to T-cell transfer
Patient treated with Thymoglobulin (ATG), Alemtuzumab or T-cell immunosuppressive monoclonal antibodies within 28 days
Patients with CMV retinitis
Patient with organ dysfunction or failure as determined by Karnofsky (patients >16 years) or Lansky (patients ≤16 years) score ≤30% (Appendix 5)
Concomitant enrollment in another clinical trial with endpoints interfering with this study
Any medical condition which could compromise participation in the study according to the investigator's assessment
Known HIV infection
Female patient who is pregnant or breast-feeding, or adult of reproductive potential not willing to use an effective method of birth control during study treatment. Note: Women of childbearing potential must have a negative serum pregnancy test at study entry
Patients unwilling or unable to comply with the protocol or unable to give informed consent
Donor Eligibility
The original donor will be the first choice as source of T cells. If the original donor is
not available for donation (such as NMDP donor, cord blood unit, or related donor not
available) of peripheral mononuclear cells or does not meet all donor eligibility criteria
(including donor selection criteria based on University of Wisconsin - Madison Standard
Operating Procedures for the selection of allogeneic donors), alternative related donors
will be selected, with preference for those who have full HLA matching in 6/6 loci over
those with partial HLA matching (≥ 3/6 HLA loci)
All donors must be ≥ 18 years old, available, CMV IgG positive, eligible and capable
of undergoing a single standard 2 blood volume leukapheresis. If original HSCT donor
is not available, CMV IgG negative or ineligible, a CMV IgG positive fully matched or
Donors must be CMV IgG seropositive
haploidentical family donor will be used
Related donors must be at least partially HLA compatible, matching with recipient in
at least 3/6 HLA loci (HLA-A, HLA-B and HLA-DRB1 will be considered for this)
Donors must show CMV T-cell activation after incubation with MACS GMP PepTivator
Peptide Pools of CMV pp65 before undergoing leukapheresis
Donor must meet the criteria for donor selection defined in the Standard Operating
Procedures of the University of Wisconsin Hospitals and Clinics Stem Cell Transplant
Program and in FACT standards
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