Autologous Stem Cell Transplant for Neurologic Autoimmune Diseases

Running, not enrolling · Phase 2

Conditions studied: Autoimmune Disease, Neurologic Autoimmune Disease, Autologous Transplant Autoimmune, Multiple Sclerosis Transplant, MS Stem Cell Transplant, Multiple Sclerosis Stem Cell Transplant, Stiff Person Syndrome, HCT for Neurologic Autoimmune Disorders, CIDP Transplant, Myasthenia Gravis Transplant, Autoimmune Nervous System Disorder, Central Nervous System Vasculitis, Cerebellar Degeneration, Chronic Inflammatory Demyelinating Polyneuropathy, Lambert Eaton Myasthenic Syndrome, Myasthenia Gravis, Neuromyelitis Optica, Opsoclonus Myoclonus Syndrome, Rasmussen Subacute Encephalitis

In brief

This phase II trial studies the side effects and how well carmustine, etoposide, cytarabine and melphalan together with antithymocyte globulin before a stem cell transplant works in treating patients with autoimmune neurologic disease that did not respond to previous therapy. In autoimmune neurological diseases, the patient's own immune system 'attacks' the nervous system which might include the brain/spinal cord and/or the peripheral nerves. Giving high-dose chemotherapy, including carmustine, etoposide, cytarabine, melphalan, and antithymocyte globulin, before a stem cell transplant weakens the immune system and may help stop the immune system from 'attacking' a patient's nervous system. When the patient's own (autologous) stem cells are infused into the patient they help the bone marrow make red blood cells, white blood cells, and platelets so the blood counts can improve.

Key facts

Study ID

NCT00716066

Run by

Fred Hutchinson Cancer Center

People needed

53

Starts

2008-06-01

Expected to finish

2030-01-31

Last updated by the study team

2026-02-27

Who can join

Age: any, up to 71. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Patients with an autoimmune disorder of the central or peripheral nervous system will be eligible; this will include:
• Primary Central Nervous System (CNS) vasculitis
• Rasmussen's encephalitis
• Autoimmune peripheral neuropathy (anti-Hu [Anna-1], anti-GM1 [GD1b], anti-MAG, anti-ganglioside, anti-sulfatide)
• Autoimmune cerebellar degeneration
• Gait Ataxia with Late age Onset Polyneuropathy (GALOP)
• Stiff Person Syndrome
• Chronic Inflammatory Demyelinating Polyneuropathy
• Myasthenia Gravis
• Lambert-Eaton myasthenic syndrome
• Human T-cell lymphotropic virus (HTLV)-1-associated myelopathy (HAM) / tropical spastic paraparesis (TSP)
• Opsoclonus/myoclonus (anti-Ri)
• Neuromyelitis optica
• Multiple sclerosis
• Other central or peripheral nervous system autoimmune diseases as approved by study neurologists and the Fred Hutchinson Cancer Research Center (FHCRC) faculty at Patient Care Conference (PCC)
• Patients must satisfy the criteria for a diagnosis of one of the severe neurological autoimmune disorders outlined
• Patients age =< 70 years
• Evidence of disease activity as outlined (e.g. gadolinium enhancement on magnetic resonance imaging of the brain or clinical progression)
• Patients must have failed at least 2 lines of standard therapy as outlined for the specific diseases
• DONOR: Sibling of any patient enrolled on this protocol proven by ABO typing, human leukocyte antigen (HLA) typing and variable number tandem repeat (VNTR) analysis to be syngeneic with the patient (e.g. identical twin)
• DONOR: Willing to undergo multiple apheresis procedures (except donors < 12 years who will undergo bone marrow harvests)

You may not qualify if…

• Age >= 71 years
• Pregnancy or expressed plans to become pregnant within 1 year of the procedure
• Patients who are serologically positive for human immunodeficiency virus (HIV)
• Patients with pulmonary, cardiac, hepatic or renal impairment that would limit their ability to receive cytoreductive therapy and compromise their survival; this should include patients with any of the following:
• Severe pulmonary dysfunction associated with a carbon monoxide diffusing capacity (DLCO) (corrected for hemoglobin) < 60%, or requires supplemental oxygen; patients who are unable to perform pulmonary function test (because of underlying disease) will be excluded if the oxygen saturation is < 92% on room air
• Uncontrolled malignant arrhythmias, or clinical evidence of congestive heart failure (New York class III-IV) or ejection fraction < 50%
• Renal disease with estimated glomerular filtration rate (GFR) by creatinine clearance or iothalamate clearance < 50 ml/min/1.73 m\^2 body surface area
• Serum glutamate pyruvate transaminase (SGPT)/aspartate aminotransferase (AST) > 3 times normal or direct bilirubin greater than 2.5 mg/dL on two repeated tests
• Active uncontrolled infection
• Demonstrated lack of compliance with prior medical care
• Patients whose life expectancy is limited by illness other than their neurological condition
• Patients with evidence of myelodysplasia
• Active malignancy (excluding localized squamous cell or basal cell carcinoma of the skin)
• DONOR: Inadequate documentation that donor and recipient are syngeneic
• DONOR: Donors who do not fulfill criteria as apheresis donors as established by institutional guidelines
• DONOR: Concordant for autoimmune neurological disease(s) as determined by neurological evaluation

Where it is running

• Colorado Blood Cancer Institute — Denver, Colorado, United States
• Fred Hutch/University of Washington Cancer Consortium — Seattle, Washington, United States
• Swedish Medical Center-First Hill — Seattle, Washington, United States

Full record on ClinicalTrials.gov

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