A Phase I/II Study Evaluating the Safety and the Efficacy of SMART101 Injection to Accelerate Immune Reconstitution After T Cell Depleted Allogeneic Hematopoietic Stem Cell Transplantation in Pediatric and Adult Patients With Hematological Malignancies
The purpose of this study is to evaluate the safety and the efficacy of SMART101 (Human T Lymphoid Progenitor (HTLP)) injection to accelerate immune reconstitution after T cell depleted allogeneic hematopoietic stem cell transplantation (HSCT) in adult and pediatric patients with hematological malignancies.
∙ Group A (adults):
• Adult patients affected by:
‣ Acute leukemia (AML, ALL) defined as:
• Acute Myeloid Leukemia (AML):
‣ High risk AML in CR1; any adverse genetic abnormality, secondary or therapy related AML excluding good risk genetic abnormalities
⁃ Chemo-refractory relapse (MRD+)
⁃ ≥ CR2
∙ Acute Lymphoblastic Leukemia (ALL):
‣ Chemo-refractory relapse (MRD+)
⁃ High risk ALL in CR1; Philadelphia (like) or any poor risk feature
⁃ ≥ CR2
∙ Acute leukemia of ambiguous lineage:
‣ ≥ CR1 with a minimal residual disease (MRD) \<5% (flow cytometry, molecular and/or cytogenetics accepted)
⁃ Myelodysplastic Syndrome (MDS) with least one of the following:
• Revised International Prognostic Scoring System risk score of intermediate or higher at the time of transplant evaluation.
∙ Life-threatening cytopenia.
∙ Karyotype or genomic changes that indicate high risk for progression to acute myelogenous leukemia, including abnormalities of chromosome 7 or 3, mutations of TP53, or complex or monosomal karyotype.
∙ Therapy related disease or disease evolving from other malignant processes.
• Patient eligible for a T-depleted allogeneic HSCT
• Age ≥ 18y and clinical condition compatible with allogeneic stem cell transplantation
• Karnofsky index ≥ 70% prior to conditioning regimen
• Patients with normal organ function prior to conditioning regimen
∙ Group B (pediatrics):
• Pediatric patients affected by acute leukemia defined as:
‣ Acute Myeloid Leukemia (AML):
• High risk AML in CR1; any adverse genetic abnormality, secondary or therapy related AML excluding good risk genetic abnormalities,
∙ Chemo-refractory relapse (MRD+)
∙ ≥ CR2
⁃ Acute Lymphoblastic Leukemia (ALL):
• Chemo-refractory relapse (MRD+)
∙ High risk ALL in CR1; Philadelphia (like) or any poor risk feature
∙ ≥ CR2
⁃ Acute leukemia of ambiguous lineage:
• ≥ CR1 with a minimal residual disease (MRD) \<5% (flow cytometry, molecular and/or cytogenetics accepted)
• Patient eligible for a T-depleted allogeneic HSCT
• Age \< 18y at the time of inclusion
• Absence of a matched sibling donor (MSD)
• Lansky ≥ 70% / Karnofsky performance status ≥ 70% prior to conditioning regimen
• Patients with normal organ function prior to conditioning regimen