A Phase 1 Study of WU-NK-101 in Patients With Relapsed or Refractory (R/R) Acute Myeloid Leukemia (AML)

Inclusion Criteria:

1. Confirmed diagnosis of primary or secondary AML (any subtype except acutepromyelocytic leukemia) according to World Health Organization (WHO) 2016classification

2. Unlikely to benefit from standard of care therapy defined by any one of thefollowing criteria:

3. Primary induction failure (PIF) defined as leukemia refractory to ≥ 1 inductionattempts. Induction attempts include 1 high-dose and/or 2 standard-dosecytarabine

• an anthracyclines/anthracenedione ± an anti-metabolite, with or withoutgrowth factor or targeted therapy containing regimens.

2. For adults who are age 75 years or older, or who have comorbidities thatpreclude use of intensive induction chemotherapy; PIF is defined as AMLrefractory to one of the following less intensive regimens:

• ≥ 2 but ≤ 4 cycles of Bcl-2 inhibitors in combination with azacitidine,decitabine, or low dose cytarabine
• ≥ 2 but ≤ 4 cycles of gemtuzumab ozogamicin monotherapy
• ≥ 6 but ≤ 8 cycles ivosidenib or enasidenib

3. Leukemia in relapse after achieving CR

• Early Relapse: disease recurrent within ≤ 6 month of documented remission
• Late Relapse: disease recurrent within > 6 month of documented remission
• Refractory-Relapse: refractory to ≥ 1 unsuccessful salvage attempts

3. Patients with AML post hematopoietic stem cell transplant (HSCT) [permitted inCohort Expansion Phase only] must meet the following criteria:

• There must be histological confirmation of AML relapse after HSCT

• Undergone allogeneic HSCT (alloSCT) > 90 days prior to enrollment from a matchrelated donor, matched unrelated donor, cord blood donor, or haplo- identicaldonor

• Off all immunosuppressive medications for a minimum of 2 weeks with theexception of physiologic doses (<10 mg) of corticosteroids

• No history of Grade ≥ 3 veno-occlusive disease, or active graft versus hostdisease

4. Patients with known central nervous system (CNS) involvement with AML are eligibleif they have been treated and cerebrospinal fluid is clear for at least 2 weeksprior to enrollment into the study. CNS therapy (radiotherapy or chemotherapy)should continue as medically indicated during the study treatment.

5. Patients with extramedullary disease are permitted if bone marrow blast count is >5%

6. Adequate organ function as defined in the protocol

7. Life expectancy >12 weeks

8. Eastern Cooperative Oncology Group (ECOG) Performance Status ≤ 2 at screening

Exclusion Criteria:

1. Circulating blast count >30,000/µL by morphology or flow cytometry (cytoreductivetherapies such as leukapheresis or hydroxyurea are allowed)

2. Uncontrolled or untreated bacterial, fungal, or viral infections, including HIV,Hepatitis B or C infection, or uncontrolled infection of any etiology

3. Uncontrolled angina, severe uncontrolled ventricular arrhythmias, orelectrocardiogram (ECG) suggestive of acute ischemia or active conduction systemabnormalities

4. Severe renal impairment, defined as creatinine clearance <40 mL/min

5. New progressive pulmonary infiltrates on screening chest x-ray or chest CT scan thathave not been evaluated with bronchoscopy. Infiltrates attributed to infection mustbe stable/improving after 1 week of appropriate therapy (4 weeks for presumed orproven fungal infections).

6. Known hypersensitivity to one or more of the study agents

7. Received any investigational drugs within the 14 days prior to the first dose offludarabine (wash-out period of at least 5 half-lives from the last dose of anyinvestigational therapy prior to screening period or 14 days, whichever is longer)

8. Pregnant or nursing (lactating) women

9. Any condition that, in the opinion of the Investigator, would prevent theparticipant from consenting to or participating in the study