This proposal is submitted in response to RFA: HL-11-013 to propose the Stanford University Blood and Marrow Transplant (BMT) Program as a Core Clinical Center for the Blood and Marrow Clinical Trials Network. The BMT Program at Stanford University performs ~250 adult transplant and ~ 20 pediatric transplants/ year including autologous and allogeneic procedures with matched related, mismatched related and matched unrelated donors. Both myeloablative and non-myeloablative transplants are performed for hematologic malignancies. The BMT Program at Stanford participates in clinical research as a single institution, consortia, regional oncology group and national trials and has been a leader in defining the role and optimizing transplantation for patients with hematologic malignancies. The Program has a highly experienced data management group and a GMP-certified stem cell processing laboratory. The Stanford BMT program is an active participant in current network activities and has performed at a high level as one of the charter Core Centers. Stanford has accrued 141 patients to date to 10 CTN trials and Stanford investigators have served as national Chairs on three network protocols and chaired two CTN committees. The protocol that is proposed aims to improve upon the strategy of T cell depletion in the allogeneic myeloablative HCT setting in patients with hematologic malignancies using matched related donors. We propose T cell add back after HCT simultaneously with infusion of naturally occurring regulatory T cells in pre-defined doses and ratios. The hypothesis is that such maneuvers will improve immune reconstitution and decrease relapse risk but with control of acute GVHD due to the suppressive mechanisms of the regulatory T cells. No post-HCT immunesuppression will be administered. The Stanford BMT Program is committed to continued participation in network trials as well as contributing concepts for consideration by the group.

Public Health Relevance

The mission of this grant is to form a network of established stem cell transplant centers such as the Stanford Blood and Marrow Transplant Program to collaborate and conduct multicenter clinical trials. The common goal of these clinical trials is to cure cancers such as leukemia, lymphoma, myeloma and some non-malignant diseases such as sickle cell disease and aplastic anemia. Some of the clinical trials also aim to reduce the side effects and toxic effects of stem cell transplantation

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Cooperative Clinical Research--Cooperative Agreements (U10)
Project #
5U10HL069291-15
Application #
8860223
Study Section
Special Emphasis Panel (ZHL1)
Program Officer
Di Fronzo, Nancy L
Project Start
2001-09-30
Project End
2016-06-30
Budget Start
2015-07-01
Budget End
2016-06-30
Support Year
15
Fiscal Year
2015
Total Cost
Indirect Cost
Name
Stanford University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94304
Steering Committee Of The Blood And Marrow Transplant Clinical Trials Network (2016) The Blood and Marrow Transplant Clinical Trials Network: An Effective Infrastructure for Addressing Important Issues in Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant 22:1747-1757
Majhail, Navneet S; Chitphakdithai, Pintip; Logan, Brent et al. (2015) Significant improvement in survival after unrelated donor hematopoietic cell transplantation in the recent era. Biol Blood Marrow Transplant 21:142-50
Klyuchnikov, Evgeny; Bacher, Ulrike; Kröger, Nicolaus M et al. (2015) Reduced-Intensity Allografting as First Transplantation Approach in Relapsed/Refractory Grades One and Two Follicular Lymphoma Provides Improved Outcomes in Long-Term Survivors. Biol Blood Marrow Transplant 21:2091-2099
Bachanova, V; Burns, L J; Wang, T et al. (2015) Alternative donors extend transplantation for patients with lymphoma who lack an HLA matched donor. Bone Marrow Transplant 50:197-203
Howard, C Alan; Fernandez-Vina, Marcelo A; Appelbaum, Frederick R et al. (2015) Recommendations for donor human leukocyte antigen assessment and matching for allogeneic stem cell transplantation: consensus opinion of the Blood and Marrow Transplant Clinical Trials Network (BMT CTN). Biol Blood Marrow Transplant 21:4-7
Appelbaum, Frederick R; Anasetti, Claudio; Antin, Joseph H et al. (2015) Blood and marrow transplant clinical trials network state of the Science Symposium 2014. Biol Blood Marrow Transplant 21:202-24
Cutler, Corey; Logan, Brent; Nakamura, Ryotaro et al. (2014) Tacrolimus/sirolimus vs tacrolimus/methotrexate as GVHD prophylaxis after matched, related donor allogeneic HCT. Blood 124:1372-7
Giralt, Sergio; McCarthy, Philip L; Anderson, Kenneth C et al. (2013) Anatomy of a successful practice-changing study: a Blood and Marrow Transplantation Clinical Trials Network-National Cancer Institute Cooperative Group collaboration. Biol Blood Marrow Transplant 19:858-9
Tomblyn, Marcie R; Ewell, Marian; Bredeson, Christopher et al. (2011) Autologous versus reduced-intensity allogeneic hematopoietic cell transplantation for patients with chemosensitive follicular non-Hodgkin lymphoma beyond first complete response or first partial response. Biol Blood Marrow Transplant 17:1051-7
Krishnan, Amrita; Pasquini, Marcelo C; Logan, Brent et al. (2011) Autologous haemopoietic stem-cell transplantation followed by allogeneic or autologous haemopoietic stem-cell transplantation in patients with multiple myeloma (BMT CTN 0102): a phase 3 biological assignment trial. Lancet Oncol 12:1195-203