NCT01499888

Brief Summary

The investigators propose to determine the engraftment and transplant related morbidity and mortality after a non-myeloablative allogeneic hematopoietic stem cell transplant protocol using immune- suppressive agents and low-dose total body irradiation (TBI) without standard chemotherapy in patients with aggressive sickle cell disease who are not candidates for or experienced complications from hydroxyurea therapy. Fully HLA matched siblings will be used as donors for hematopoietic stem cells to reduce the risk of morbidity and mortality in this cohort of patients.

Trial Health

75
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
45

participants targeted

Target at P50-P75 for phase_1

Timeline
41mo left

Started Nov 2011

Longer than P75 for phase_1

Geographic Reach
1 country

1 active site

Status
active not recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Progress81%
Nov 2011Oct 2029

Study Start

First participant enrolled

November 11, 2011

Completed
12 days until next milestone

First Submitted

Initial submission to the registry

November 23, 2011

Completed
1 month until next milestone

First Posted

Study publicly available on registry

December 26, 2011

Completed
16.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 23, 2028

Expected
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

October 1, 2029

Last Updated

April 11, 2025

Status Verified

April 1, 2025

Enrollment Period

16.9 years

First QC Date

November 23, 2011

Last Update Submit

April 8, 2025

Conditions

Keywords

Sickle Cell DiseaseSubtype Hgb SSSubtype Hgb SCSubtype Hgb SBChronic Transfusion TherapyPrior StrokeAllogeneicStem Cell TransplantationAlemtuzumabSirolimusTotal Body IrradiationHydroxyurea Intolerant

Outcome Measures

Primary Outcomes (1)

  • To determine the engraftment after non-myeloablative HSC transplant

    Up to 30 days post-transplant.

Secondary Outcomes (4)

  • To assess the frequency of acute and chronic complications of sickle cell disease

    Up to 100 days post-transplant.

  • To evaluate the immune reconstitution after transplant.

    Up to 12 months after transplant.

  • To determine the transplant related morbidity and mortality.

    Up to 365 days post-transplant.

  • To determine the long-term engraftment after non-myeloablative HSC transplant

    Up to 10 years post-transplant.

Other Outcomes (1)

  • To determine whether ocular findings from sickle cell disease are reversible in patients undergoing stem cell transplantation to treat their sickle cell disease.

    Up to 5 years post-transplant

Study Arms (1)

Allogeneic Non-Myeloablative Stem Cell Transplantation

EXPERIMENTAL

The transplant regimen will consist of alemtuzumab 1mg/kg divided over five days, 300 cGy TBI, followed by sirolimus dosed for a target serum trough level of 10- 15 ng/mL.

Procedure: Allogeneic Non-Myeloablative Stem Cell TransplantationDrug: AlemtuzumabDrug: Sirolimus

Interventions

Alemtuzumab-based non-myeloablative allogeneic hematopoietic stem cell transplantation using immune-suppressive agents and low-dose total body irradiation (TBI) without standard chemotherapy. Transplant regimen Day -7 to -3: Alemtuzumab (1mg/kg, total dose) divided over the 5 days, IVPB over 2 hours daily Day -3 until 100% chimerism obtained: Sirolimus dosed for target trough level of 10-15 ng/mL Day -2: Total body irradiation with 300cGy Day 0: Stem cell infusion

Allogeneic Non-Myeloablative Stem Cell Transplantation

In this protocol, patients will be given alemtuzumab 1mg/kg divided equally over five days with the maximum dose of 20mg per day.

Also known as: Campath, MabCampath, Campath-1H
Allogeneic Non-Myeloablative Stem Cell Transplantation

On day -1, patients will receive a loading dose of 12 mg followed by 4 mg per day. Subsequent dosing will be based on clinical toxicity, GVHD concurrent medications, medical conditions, prior drug levels, drug-drug interactions, and blood levels with target of 3 to 12 ng/mL.

Also known as: Rapamune, Rapamycin
Allogeneic Non-Myeloablative Stem Cell Transplantation

Eligibility Criteria

Age16 Years - 60 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • Patients with sickle cell disease, subtype Hgb SS, SC, or SB disease who are on chronic transfusion therapy for a prior stroke or those patients who were intolerant of hydroxyurea therapy or were being treated with hydroxyurea therapy and were complicated by at least one of the following:
  • Stroke or central nervous system event lasting longer than 24 hours
  • Frequent vaso-occlusive pain episodes, defined as ≥ 3 per year severe enough to interfere with the patient's normal daily function or require medical attention in the clinic, emergency room, acute care center, or hospital
  • Recurrent episodes of priapism, defined as ≥ 2 per year requiring emergency room visits
  • Acute chest syndrome with recurrent hospitalizations, defined as ≥ 2 lifetime events
  • Red-cell alloimmunization (≥ 2 antibodies) during longterm transfusion therapy
  • Bilateral proliferative retinopathy with major visual impairment in at least one eye
  • Osteonecrosis of 2 or more joints
  • Sickle cell nephropathy
  • Stage I or II sickle lung disease
  • Symptoms of pulmonary hypertension and mean pulmonary artery pressure \> 25mmHg
  • Age 16-60 years
  • Karnofsky performance status of 70 or higher
  • Adequate cardiac function, defined as left ventricular ejection fraction ≥ 40%
  • Adequate pulmonary function, defined as diffusion lung capacity of carbon monoxide ≥ 50%
  • +8 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Illinois at Chicago

Chicago, Illinois, 60612, United States

Location

MeSH Terms

Conditions

Anemia, Sickle Cell

Interventions

AlemtuzumabSirolimus

Condition Hierarchy (Ancestors)

Anemia, Hemolytic, CongenitalAnemia, HemolyticAnemiaHematologic DiseasesHemic and Lymphatic DiseasesHemoglobinopathiesGenetic Diseases, InbornCongenital, Hereditary, and Neonatal Diseases and Abnormalities

Intervention Hierarchy (Ancestors)

Antibodies, Monoclonal, HumanizedAntibodies, MonoclonalAntibodiesImmunoglobulinsImmunoproteinsBlood ProteinsProteinsAmino Acids, Peptides, and ProteinsSerum GlobulinsGlobulinsMacrolidesLactonesOrganic Chemicals

Study Officials

  • Damiano Rondelli, MD

    University of Illinois at Chicago

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 1
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

November 23, 2011

First Posted

December 26, 2011

Study Start

November 11, 2011

Primary Completion (Estimated)

September 23, 2028

Study Completion (Estimated)

October 1, 2029

Last Updated

April 11, 2025

Record last verified: 2025-04

Locations