Stem Cell Transplant + JSP191 for Fanconi Anemia
Trial Summary
What is the purpose of this trial?
The objective of this clinical trial is to develop a cell therapy for Fanconi Anemia which enables enhanced donor hematopoietic and immune reconstitution with decreased toxicity by transplanting depleted stem cells from a donor after using an experimental antibody treatment called JSP-191 as a part of conditioning. This experimental treatment will hopefully cause fewer side effects than chemotherapy (the current standard of care method). Participants will be administered the conditioning regimen, are assessed until they receive the depleted stem cell infusion, and will be followed for up to 2 years after the cell infusion.
Will I have to stop taking my current medications?
The trial does not specify if you need to stop taking your current medications, but you cannot participate if you have taken investigational agents, chemotherapy, or radiation therapy within 14 days before enrolling. Also, you cannot have used androgens in the last 3 months.
What data supports the effectiveness of this treatment for Fanconi Anemia?
Research shows that using TCRαβ+/CD19+-depleted stem cell transplants in patients with Fanconi Anemia resulted in a high success rate, with 91.6% achieving sustained engraftment and a 100% overall survival rate over a median follow-up of 5.2 years. This suggests that the treatment is effective in achieving long-term survival and engraftment in these patients.12345
Is the Stem Cell Transplant + JSP191 treatment generally safe for humans?
The treatment involving TCRαβ+/CD19+-depleted stem cell transplantation has shown to be generally safe in humans, with low rates of severe complications like graft-versus-host disease (GVHD) and no fatal transplant-related toxicity observed in a study with Fanconi anemia patients. Another study in children with acute myeloid leukemia also reported manageable safety outcomes, with a 10% transplant-related mortality rate and a 39% incidence of moderate acute GVHD.12367
How is the treatment Stem Cell Transplant + JSP191 for Fanconi Anemia different from other treatments?
This treatment is unique because it uses a specific type of stem cell transplant that is depleted of certain immune cells (TCRαβ+ T-cells and CD19+ B-cells) to reduce the risk of complications like graft-versus-host disease (GVHD), making it a safer option for patients without a fully matched donor.12378
Eligibility Criteria
This trial is for children and adults with Fanconi Anemia, confirmed by specific tests and genetic mutations. Participants must be over 2 years old, have certain organ function levels (kidney, lung, heart), not be pregnant or breastfeeding, willing to use contraception if of childbearing potential, and have a life expectancy of at least 2 years. They should not have active cancers or uncontrolled infections.Inclusion Criteria
Exclusion Criteria
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
Conditioning
Participants receive a reduced-intensity preparative regimen containing JSP191 in combination with rATG, cyclophosphamide, fludarabine, and rituximab before the stem cell transplant
Stem Cell Infusion
Participants receive an infusion of donor stem cells depleted of αβ+T cells
Follow-up
Participants are monitored for safety and effectiveness after treatment, including hematopoietic and immunologic recovery
Treatment Details
Interventions
- Depleted Stem Cell Transplant (Stem Cell Transplant)
- JSP191 (Monoclonal Antibodies)